bluuebunny/crossref_metadata_2025 huggingface dataset:
The Microanatomy of the Rectal Salt Gland of the Port Jackson Shark, Heterodontus portusjacksoni (Meyer) (Heterodontidae): Suggestions for a Counter-Current Exchange System
Authors: Newbound Dennyse R. , O’Shea James E.
Published: April 2003

A comprehensive anatomical study was undertaken to examine the rectal salt gland in the Port Jackson shark, Heterodontus portusjacksoni, a shark known to invade estuarine environments. The microstructure and vascular organisation of the rectal salt gland was investigated using histological observation and scanning electron microscopy of vascular corrosion casts. Cellular specialisation was observed in the lining of the central lumen of this gland. This may indicate that there is some modification of the principal product of the gland prior to its secretion. The rectal salt gland has a complex structure related to its function. Contrary to previous reports, the flow in secretory tubules is in the opposite direction to that of the capillaries and thus constitutes a counter-current arrangement. The similarity in the organisation of the counter-current and lobulate arrangement of salt-secreting glands through phylogenetically diverse organisms, such as sharks and birds, suggests that this arrangement is important in achieving efficient salt secretion.
Temporomandibular Disorders and Hormones in Women
Authors: Warren Michelle P. , Fried Joanna L.
Published: April 2003

Temporomandibular disorders (TMD) are loosely defined as an assorted set of clinical conditions, characterized by pain and dysfunction of the masticatory system. Pain in the masticatory muscles, in the temporomandibular joint (TMJ), and in associated hard and soft tissues, limitation in jaw function, and sounds in the TMJ are common symptoms. That women make up the majority of patients treated for TMD is extensively hypothesized and documented in numerous epidemiological studies. Certain contradictory studies exist which propose that there are no statistically significant gender differences in the actual incidence of changes in joint morphology. Nonetheless, extensive literature suggests the disorder is 1.5–2 times more prevalent in women than in men, and that 80% of patients treated for TMD are women. The severity of symptoms is also related to the age of the patients. Pain onset tends to occur after puberty, and peaks in the reproductive years, with the highest prevalence occurring in women aged 20–40, and the lowest among children, adolescents, and the elderly. The gender and age distribution of TMD suggests a possible link between its pathogenesis and the female hormonal axis. In this review, we will use the hypothesis that the overwhelming majority of patients treated for temporomandibular disorders are women and use the available literature to examine the role of hormones in TMD.
Morphological Characteristics of Dying Cells in Axial Structures of Developing Human Embryos
Authors: Vilović K. , Sapunar D. , Ilijić E. , Mimica M.D. , England M.A. , Saraga-Babić M.
Published: April 2003

Programmed cell death (PCD) is a widespread phenomenon in the development of vertebrates. In most cases, dying cells during development exhibit generalized morphological features typical of apoptosis. We analyzed the morphological features of dying cells in the developing axial structures of 5 human embryos between 5 and 8 weeks of postovulatory age. Cell death in the axial structures, i.e. spinal cord, notochord and surrounding mesenchyme and somites, was analyzed using light and electron microscopy. Tissue samples were taken from the cervicothoracic region of normal human conceptuses. Two morphological types of cell death were found: apoptosis which was characterized by round or semilunar nuclear chromatin condensations, condensation and shrinkage of the cytoplasm and formation of apoptotic bodies, and cell death without the morphological features of apoptosis which was characterized by pyknotic nuclear chromatin condensations, vacuolated cytoplasm and the formation of numerous intercellular spaces. Apoptotic death occurred during the 5th week of normal development in all the axial structures. Later, apoptotic death appeared in all the axial structures, with the exception of the notochord, where some dying cells displayed features of secondary necrosis. According to our findings, apoptosis seems to be the most frequently observed type of PCD, but it is not the exclusive type of morphological cell death during the development of axial structures in human embryos.
Expression of Nucleotide P2X Receptor Subtypes during Spermatogenesis in the Adult Rat Testis
Authors: Glass R. , Bardini M. , Robson T. , Burnstock G.
Published: April 2003

The expression of ATP-gated ion channels (P2X receptors) was investigated in testes of adult rats by immunohistochemistry and Western blotting with antibodies against all seven P2X receptor subtypes. Immunoreactive cells were identified and monitored during germ cell maturation. Results of immunohistochemical and Western blotting experiments showed the expression of P2X1, P2X2, P2X3, P2X5 and P2X7 receptors, while P2X4 and P2X6 receptors were absent from the testis. Blood vessels displayed immunostaining for P2X1 and P2X2 receptors; the P2X1 receptors were present exclusively in blood vessels. P2X2, P2X3 and P2X5 receptors were found to be expressed differentially in the various germ cell types throughout the different stages of the cycle of the seminiferous epithelium; P2X2 and P2X3 receptors were always observed together in the same cell types and at the same stages. Sertoli cells also showed differential staining for P2X2 and P2X3 receptors during the cycle of the seminiferous epithelium, whereas P2X7 receptor expression was present throughout all stages. No immunostaining for P2X receptors was detected on Leydig cells. The possible roles of purinergic signalling in the control of germ cell maturation are discussed. In particular, it is suggested that purinergic signalling may play a role in controlling the maturation of germ cell subsets of different developmental ages that exist alongside each other in the adult testis.
Argyrophilic and Glucagon-Immunoreactive Cells in the Ileum and Colon of the Developing Opossum Didelphis albiventris (Marsupialia)
Authors: Fonseca C.C. , Nogueira J.C. , Barbosa A.J.A.
Published: April 2003

The ontogenesis of glucagon-producing cells of the ileum and colon of pouch young and of weaned and adult opossums Didelphis albiventris was studied in comparison with the endocrine argyrophilic cell population development. In the ileum, the mean population of argyrophilic cells/mm2 increased with ontogenesis from 122.9 ± 18.7 in the pouch young to 211.4 ± 48.9 in adult animals, while the number of glucagon-immunoreactive cells/mm2 remained practically constant, i.e. 29.2 ± 7.3 in the pouch young and 28.1 ± 5.0 in the adult animal. In the colon, the population of argyrophilic cells/mm2 remained constant throughout ontogenesis, i.e. 45.8 ± 6.2 in the pouch young and 48.9 ± 10.4 in the adult animals. In turn, the enteroglucagon-producing cells increase in number from 4.5 ± 2.9 to 14.6 ± 5.2 cells/mm2 from the pouch young to the adult. We conclude that the intestinal glucagon-producing cells of D. albiventris present a differentiated development in the ileum and colon. This fact suggests that glucagon-immunoreactive cells may play a distinct role in these segments of the intestine during ontogenesis.
Employment of Confocal Microscopy for the Dynamic Visualization of Domes in Intact Epithelial Cell Cultures
Authors: Rotoli B.M. , Orlandini G. , Gatti R. , Dall’Asta V. , Gazzola G.C. , Bussolati O.
Published: April 2003

Many epithelial cells cultured on plastic ware form domes, fluid-filled localized raisings of the cell monolayer. Domes are due to active vectorial ion transport and their presence demonstrates the maintenance of a differentiated polarized phenotype and of tight junctional complexes. Through a confocal laser microscope equipped with a special flow chamber, intact domes were evaluated in real time for prolonged experimental periods. Both in CAPAN-1 pancreatic duct adenocarcinoma cells and in renal tubular LLC-PK1 cells, vertical sections of calcein-loaded cultures provided a clear visualization of dome outlines during the slow deflation induced by specific agonists (respectively, 1 µM secretin or 10 µM vasopressin). Section series of calcein-loaded domes were used for three-dimensional reconstructions. In CAPAN-1 cultures, cell depolarization induced by secretin was detected with the potentiometric dye bis-oxonol. In the same cells pyranine, a fluid phase marker that is cell impermeant, visualized dome compartment and paracellular pathways, also providing an evaluation of dome fluid pH. Confocal laser scanning microscopy of domes represents a convenient device for the functional assessment of living epithelial cells.
Neuropsychological Sequelae of Patients Treated with Microsurgical Clipping or Endovascular Embolization for Anterior Communicating Artery Aneurysm
Authors: Chan Agnes , Ho Salina , Poon Wai S.
Published: April 2003

Background and Purpose: While microsurgical clipping has been the choice of treatment for anterior communicating artery (ACoA) aneurysm, endovascular embolization is increasingly popular for treating intracranial aneurysms. Previous studies showed that in terms of mortality (i.e., death) and morbidity (i.e., functional outcome, independent living, rebleeding) rates, the clinical outcomes of coil embolization for intracranial aneurysms are as good as or even better than those of surgical clipping. However, little is known about the impact of these treatments on the cognitive functions of those survived after the treatment. Thus, the present study is designed to examine the cognitive deficits of patients treated with either surgical clipping or coil embolization. Method: Eighteen patients with a ruptured ACoA aneurysm were recruited. Half of them had undergone surgical clipping and the other half had endovascular embolization. Standardized neuropsychological tests were employed to assess their memory, executive function, motor ability, language and visual perceptual abilities. Results: The performance of the patients was in general poorer than that of the normal control subjects on tests of verbal memory, flexible thinking, ability to resist interference and motor control. However, in terms of severity, the patients who received surgical clipping demonstrated more severe impairment than those had endovascular embolization on these cognitive domains. In addition, while 33% of patients in the clipping group showed impairments on memory and executive function, no patient in the embolization group demonstrated these impairments. Conclusions: Patients with ACoA aneurysm demonstrated impaired verbal memory, executive function and motor abilities while their language and visual perception abilities remained relatively intact. However, when comparing the effect of treatment choice on the cognitive functions of these patients, the present results favored the coil embolization as the patients treated with coil embolization demonstrated significantly fewer severe cognitive deficits than patients who had undergone surgical clipping.
Zolmitriptan versus a Combination of Acetylsalicylic Acid and Metoclopramide in the Acute Oral Treatment of Migraine: A Double-Blind, Randomised, Three-Attack Study
Authors: Geraud G. , Compagnon A. , Rossi A.
Published: April 2003

This multicentre, randomised, double-blind study compared oral zolmitriptan 2.5 mg with a combination of oral acetylsalicylic acid 900 mg and metoclopramide 10 mg as acute anti-migraine therapy for 3 migraine attacks. In total, 666 patients took at least one dose of study medication (326 took zolmitriptan and 340 took acetylsalicylic acid plus metoclopramide). The percentage of patients with a 2-hour headache response after the first dose for all 3 attacks (the primary end point) was 33.4% with zolmitriptan and 32.9% with acetylsalicylic acid plus metoclopramide [odds ratio 1.06, 95% confidence interval (CI) 0.77–1.47; p = 0.7228]. For the majority of secondary end points, the two treatments demonstrated comparable efficacy. However, post hoc analysis showed that significantly more patients receiving zolmitriptan were free of pain 2 h after the first dose in all 3 attacks compared with patients receiving acetylsalicylic acid plus metoclopramide (10.7 vs. 5.3%; odds ratio 2.19, 95% CI 1.23–4.03; p = 0.0095). In addition, post hoc analysis showed that the overall 2-hour pain-free response rate was consistently higher with zolmitriptan (34.6%) than with acetylsalicylic acid plus metoclopramide (27.9%) (odds ratio 1.40, 95% CI 1.09–1.78; p = 0.007). Both treatments reduced migraine-associated nausea, vomiting, phonophobia and photophobia. There were no important inter-group differences with respect to the onset of meaningful migraine relief, the frequency of headache recurrence, the usage or efficacy of a second dose of medication or the use of escape medication. However, at the last attack, the proportion of patients who expressed overall satisfaction with the treatment was significantly higher in the zolmitriptan group, i.e. 83.7%, versus 75.0% with acetylsalicylic acid plus metoclopramide (p = 0.0346). Both agents were well tolerated. Adverse events were reported by 40.8% (133/326) of zolmitriptan-treated patients and 29.1% (99/340) of those treated with acetylsalicylic acid plus metoclopramide. The incidence of withdrawals due to adverse events was very low with both zolmitriptan (0.9%) and the combination regimen (1.5%); the latter percentage included 1 patient who withdrew from the study due to phlebitis, which was classified as a serious adverse event. This study showed that zolmitriptan is effective and well tolerated for the acute treatment of moderate to severe migraine. Zolmitriptan was at least as effective as acetylsalicylic acid plus metoclopramide in achieving a 2-hour headache response, but significantly more effective than the combination therapy for other end points, including the 2-hour pain-free response.
Dystypia: Isolated Typing Impairment without Aphasia, Apraxia or Visuospatial Impairment
Authors: Otsuki Mika , Soma Yoshiaki , Arihiro Shoji , Watanabe Yoshimasa , Moriwaki Hiroshi , Naritomi Hiroaki
Published: April 2003

We report a 60-year-old right-handed Japanese man who showed an isolated persistent typing impairment without aphasia, agraphia, apraxia or any other neuropsychological deficit. We coined the term ‘dystypia’ for this peculiar neuropsychological manifestation. The symptom was caused by an infarction in the left frontal lobe involving the foot of the second frontal convolution and the frontal operculum. The patient’s typing impairment was not attributable to a disturbance of the linguistic process, since he had no aphasia or agraphia. The impairment was not attributable to the impairment of the motor execution process either, since he had no apraxia. Thus, his typing impairment was deduced to be based on a disturbance of the intermediate process where the linguistic phonological information is converted into the corresponding performance. We hypothesized that there is a specific process for typing which branches from the motor programming process presented in neurolinguistic models. The foot of the left second frontal convolution and the operculum may play an important role in the manifestation of ‘dystypia’.
High Occurrence Rate of Glaucoma among Patients with Alzheimer’s Disease
Authors: Bayer A.U. , Ferrari F. , Erb C.
Published: April 2003

The purpose of the current study was to reveal the occurrence rate of glaucoma among patients with Alzheimer’s disease (AD). All 112 patients of four nursing homes in Upper Bavaria, Germany, who met the diagnostic criteria of probable AD, were incorporated into the study. Visual field defects and/or optic disc cupping compatible with the diagnosis of glaucoma were found in 29 out of 112 patients with AD (25.9%). When compared to a control group (5.2%) and to the prevalence of glaucoma in western countries revealed in a number of glaucoma surveys (2.6–4.7%), patients with AD may have a significantly increased occurrence rate of glaucoma. In addition, ocular hypertension with normal visual fields and normal optic nerve heads was not found in patients with AD. The prevalence of ocular hypertension in the control group was 7.8% and parallels previous surveys. Therefore, we assume that the optic nerve seems to be less resistant to elevated intraocular pressure levels in AD patients.
Fibrinogen Kaiserslautern III: A New Case of Congenital Dysfibrinogenemia with Aα 16 Arg → Cys Substitution
Authors: Loreth R.M. , Meyer M. , Albert F.W.
Published: April 2003

An abnormal fibrinogen was identified in a man with suspicious prolonged prothrombin time and a mild bleeding tendency. Coagulation studies showed marked prolonged thrombin and reptilase clotting times and a discrepancy between functional fibrinogen test and fibrinogen antigen. The rate of fibrinopeptide B release by thrombin was slightly delayed while the release of fibrinopeptide A was only half the normal amount. DNA sequencing revealed a heterozygous C to T point mutation in position 1202 of exon 2 of the Aα chain, resulting in the substitution of Arg → Cys at position 16, the thrombin cleavage site. This mutation was found also in his 2 children. Both had a mild bleeding tendency too.
Changes in Haemostasis after Laparoscopic Surgery in Gynaecology: Contribution of the Thrombin Generation Test
Authors: Freyburger G. , Dubreuil M. , Audebert A. , Labrouche S. , Pistre J.C. , Molinari I. , Dubecq F. , Laville C. , Villanove X.
Published: April 2003

Surgery induces immediate hypercoagulability by direct alteration of the vascular bed, release of procoagulant substances from the extravascular spaces and blood flow decrease, and delayed hypercoagulation in response to tissue damage which triggers inflammatory responses. Thus, the postoperative period represents a high-risk time for thrombosis. Recognition of high-risk individuals would make it possible to improve thromboembolism prevention. We studied in women undergoing laparoscopic surgery a series of markers known to be related to the thrombotic risk and confronted their results with those of a global test, the thrombin generation test (TGT) described by Hemker’s group. Our results show that two groups of patients can be distinguished according to usual risk markers (PAI-1, TAT, body mass index): the higher risk group demonstrates higher initial TGT values, but also a postoperative decrease of the TGT values whose mechanisms remain to be defined.
Increased Indexes of Thrombin Activation in Advanced Stages of Hypertension
Authors: Trifiletti Aldo , Scamardi Rina , Pizzoleo Maria Antonia , Sottilotta Gianluca , Barbera Natale , Frisina Nicola
Published: April 2003

Background: The hemostatic system plays an important role in thrombotic lesions, which can complicate the clinical course of hypertensive patients. The aim of this study was to verify a possible activation of the blood clotting processes, the evaluation of two markers of thrombin activation in 62 hypertensive patients, with and without vascular complications, compared with a control group. Methods and Results: In 22 patients with newly diagnosed uncomplicated essential hypertension, in 40 hypertensive patients with clinically evident vascular complications (20 patients with controlled blood pressure and 20 with uncontrolled and high blood pressure) and in 20 normotensive sex- and age-matched subjects, two indexes of thrombin generation and action, namely prothrombin fragment 1 + 2 (F1 + 2) and fibrinopeptide A (FPA) were evaluated. The observed values show an increase of the F1 + 2 levels in patients with overt vascular complications; those with higher blood pressure, moreover, showed FPA levels higher than those with controlled blood pressure. Conclusions: These results seem to indicate that plasma F1 + 2 levels are significantly elevated, as a marker of a thrombosis-prone status, in patients with organic damage. Successively, with progress of hypertension and increasing blood pressure, the evidence of elevated FPA levels seems to indicate a clear prethrombotic situation which could turn into a thrombotic state.
Alfimeprase: Pharmacology of a Novel Fibrinolytic Metalloproteinase for Thrombolysis
Authors: Toombs Christopher F.
Published: April 2003

Alfimeprase is a recombinantly produced, truncated form of fibrolase, a known directly fibrinolytic zinc metalloproteinase that was first isolated from the venom of the southern copperhead snake (Agkistrodon contortrix contortrix). Both fibrolase and alfimeprase have been shown to have direct proteolytic activity against the fibrinogen Aα chain. In vivo pharmacology studies have shown that thrombolysis with alfimeprase is up to 6 times more rapid than with plasminogen activators. Alfimeprase can be bound and neutralized by serum α2-macroglobulin, a prevalent mammalian protease inhibitor which is capable of forming a macromolecular complex with alfimeprase. As a result, systemic bleeding complications have been greatly reduced due to the inhibitory effects of α2-macroglobulin. This article reviews the biochemical in vitro and in vivo characteristics of this novel acting thrombolytic.
Multifunctional Snake C-Type Lectins Affecting Platelets
Authors: Clemetson Kenneth J. , Navdaev Alexei , Dörmann Dagmar , Du Xiao-Yan , Clemetson Jeannine M.
Published: April 2003

Snake venoms contain a wide range of components, many of which affect haemostasis by activation or inhibition of platelets or coagulation factors. They can be classified into groups based on structure and mode of action. One group is the snake C-type lectins, so called because of the typical folding which closely resembles that found in classical C-type lectins, such as selectins and mannose-binding proteins. Unlike the classic C-type lectins, those from snakes are generally heterodimeric with two subunits, α and β. Some are multimeric heterodimers. The subunits have homologous sequences and are generally linked by a disulphide bond as well as by swapping loops. One of the first C-type lectins with a defined function was echicetin which was demonstrated to bind to platelet GPIb and block several functions of this receptor. Since then, many proteins with similar structure have been reported to act on platelet receptors or coagulation factors and several have been crystallized. These proteins were thought to be specific for a single platelet receptor or coagulation factor, i.e. they had only one receptor per heterodimer. Recent studies show that most of these C-type lectins have binding sites for more than one ligand and have complex mechanisms of action.
Molecular Basis for the Partition of the Essential Functions of Thrombin among Snake Venom Serine Proteinases
Authors: Maroun R.C.
Published: April 2003

Thrombin is a mammalian serine proteinase that plays a prominent role in the maintenance and regulation of hemostasis through its interaction with various substrates and/or ligands. The venoms of several snakes contain glycosylated serine proteinases that have been recognized to possess one or more of the essential activities of thrombin on fibrinogen (Fg) and/or platelets. These proteinases share about 60% sequence identity. One class of snake venom serine proteinases are those known as thrombin-like (TLE), named after their ability to directly clot Fg in order to preferentially produce fibrinopeptide A, fibrinopeptide B or both. To understand the molecular basis of this phenomenon, the corresponding amino acid sequences and molecular structures need to be analyzed. Given the absence of experimentally determined tertiary structures of snake venom, TLEs, three-dimensional molecular models should prove useful in this context. Towards this goal, we obtained models of snake venom TLEs that used TSV-PA as template, TSV-PA being the only snake venom serine proteinase whose crystal structure is known to date. Along with a comparative sequence analysis the models contribute to the identification and description of thrombin-homologous or alternative binding sites, helping thus to understand differences in specificity.
Why Be Moral? A Conceptual Model from Developmental Psychology
Authors: Bergman Roger
Published: April 2003

This paper is concerned with the relationships among moral reasoning, moral motivation, moral action, and moral identity. It explores how major figures in developmental psychology have understood these relationships, with attention to schematic models or conceptual maps. After treating Piaget, Kohlberg, Rest, Colby and Damon, and Blasi, I present a critical synthesis, a conceptual model of how developmental psychology might best answer the question, Why be moral?
Mastocytosis: Mediator-Related Signs and Symptoms
Authors: Castells Mariana , Austen K. Frank
Published: April 2003

Patients with systemic mastocytosis present symptoms related to the tissue response to the release of mediators from mast cells and to the local mast cell burden. Such patients often have a history of chronic and acute mediator-related symptoms. Most patients have indolent disease with a good prognosis and a normal life span. Symptoms can include pruritus, flushing, syncope, gastric distress, nausea and vomiting, diarrhea, bone pain and neuropsychiatric symptoms, most of which are controlled by medication. Because there is no current cure for mastocytosis, successful therapeutic interventions rely on the recognition of mediator-related symptoms and their treatment, and established intervention approaches for the relatively uncommon leukemic concomitants. Efforts to link a particular mast cell-derived mediator to some aspect of the symptom complex depend on the known actions of the mediator and the efficacy of target-based interventions.
Functional Insulin-Like Growth Factor-1/Insulin-Like Growth Factor-1 Receptor-Mediated Circuit in Human and Murine Thymic Epithelial Cells
Authors: de Mello Coelho Valéria , Villa-Verde Déa Maria Serra , Farias-de-Oliveira Désio Aurélio , de Brito José Marques , Dardenne Mireille , Savino Wilson
Published: April 2003

Interactions between thymocytes and thymic epithelial cell (TEC) can be modulated by growth hormone via insulin-like growth factor-1 (IGF-1). In this study, we showed IGF-1 and IGF-1 receptor mRNA expression by human and murine TEC and thymocytes. Functionally, IGF-1 stimulates extracellular matrix production by human TEC. Moreover, pretreatment of murine TEC with IGF-1 increases their adhesion to thymocytes. Interestingly, we observed an increase in the frequency of CD4–CD8–CD90+ T cells which adhered to pretreated TEC, supporting the concept that IGF-1 may also act indirectly on intrathymic T cell differentiation and migration through the thymic epithelium.
Overexpression of β1,4N-Acetylgalactosaminyl- transferase mRNA as a Molecular Marker for Various Types of Cancers
Authors: Sugita Yurika , Fujiwara Yoshiyuki , Hoon Dave S.B. , Miyamoto Atsushi , Sakon Masato , Kuo Christine T. , Monden Morito
Published: April 2003

Objective: To determine GalNAcT mRNA expression in human carcinoma cell lines and primary tumor tissues. Assessment of the potential use of GalNAcT mRNA as a molecular marker for detection of metastatic cancer cells in the peripheral blood of patients with hepatocellular carcinoma. Methods/Results: We investigated GalNAcT mRNA expression in various human cancer cell lines and primary cancer tissues using RT-PCR assay for GalNAcT mRNA. The expression of GalNAcT mRNA was detected in 25 of 26 cancer cell lines tested and in the majority of primary tumors from different organs: 8 of 10 colon cancers, 9 of 9 breast cancers, 11 of 12 esophageal cancers, 14 of 14 gastric cancers, 4 of 18 pancreatic cancers, 6 of 12 biliary tract cancers, 17 of 18 hepatocellular carcinomas and 13 of 14 lung cancers. Semi-quantitative analysis with duplex RT-PCR showed that the amount of the GalNAcT mRNA was enhanced in cancer tissues as compared to the surrounding cancer-free tissues. Blood specimens of 5 of 14 patients with hepatocellular carcinoma were positive for GalNAcT mRNA, all of whom developed recurrent disease in less than 24 months. Peripheral blood samples of 30 normal subjects were negative for GalNAcT mRNA. Conclusion: Our results suggest that the RT-PCR assay for GalNAcT mRNA could be a potentially useful molecular marker for detecting cancer dissemination in blood circulation of patients with malignancy.
p53 Protein Accumulation in Multiple Oesophageal Squamous Cell Carcinoma: Relationship to Risk Factors
Authors: Saeki Hiroshi , Ohno Shinji , Miyazaki Mitsuhiro , Araki Koshi , Egashira Akinori , Kawaguchi Hidetoshi , Watanabe Masayuki , Morita Masaru , Sugimachi Keizo
Published: April 2003

To clarify mechanisms involved in the carcinogenesis of multiple oesophageal squamous cell carcinoma, the expression of p53 protein in 46 lesions surgically excised from 13 Japanese patients was investigated immunohistochemically and the relation of p53 protein accumulation to the patient’s history of alcohol consumption and cigarette smoking was analyzed. p53 protein accumulation was observed in 13 main lesions, that is in 6 (85.7%) of 7 subjects with a history of heavy drinking and smoking, but only in 1 (16.7%) of 6 with no such history (Fisher’s exact test, p = 0.025). As regards the 46 lesions, p53 protein accumulation was evident in 22 (88.0%) of 25 lesions of the high-risk patients, but in 7 (33.3%) of 21 lesions of the other subjects (Fisher’s exact test, p < 0.001). p53 protein accumulation was similarly recognized in all oesophageal lesions in 5 of 7 high-risk patients. Thus, use of both alcohol and cigarettes is clearly associated with a high frequency of p53 protein accumulation in multiple oesophageal squamous cell carcinoma present at the same time. These findings are considered to support the concept of field carcinogenesis of the oesophagus.
Corneal Allograft Rejection: Current Understanding
Authors: Bertelmann Eckart , Jaroszewski Jan , Pleyer Uwe
Published: April 2003

Though keratoplasty is the most successful transplantation [1], corneal graft rejection is still the most frequent complication after corneal grafting and often leads to irreversible transplant failure. A recently published study on the outcome of corneal graft rejection showed that 49% of transplant rejections were irreversible [2]. The rate of reversibility was influenced by preoperative diagnosis and by corneal thickness at the time of first diagnosis of rejection. Patients who received a corneal graft because of bullous keratopathy or because of prior graft failure had a higher risk of graft rejection than patients with keratoconus or Fuchs’ endothelial dystrophy. Moreover, grafts that underwent irreversible rejection were significantly thicker at the time of rejection diagnosis than transplants that cleared up after the rejection episode. Another recent study focusing on regrafting confirmed the influence of repeated transplantation on graft survival [3]. While 37 and 43% of first and second regrafts survived the follow-up period, the percentage of clear grafts decreased to 25 and 0% for the third and fourth regrafts. Immune reactions occurred in 31% of all observed transplants (regrafts). These findings indicate that prevention and therapy of allograft rejection is still the most challenging field of today’s keratoplasty.
Normal Magnetic Resonance Contrast Enhancement of Extraocular Muscles: A Quantitative Analysis
Authors: Karakaş Hakkı Muammer , Tasalı Nuri , Çakır Bilge
Published: April 2003

The purpose was to evaluate quantitatively the magnetic resonance contrast enhancement of normal extraocular muscles and the use of temporal muscles as a reference of enhancement. Eighty extraocular and 20 temporal muscles were taken into analysis. Before contrast administration, mean intensity of extraocular muscles was found to be higher than that of temporal muscles (p < 0.000). With contrast agent, all extraocular muscles were enhanced more (111% enhancement) than the temporal muscles (45% enhancement, p < 0.000). Lateral recti had the lowest signal intensity, both in pre- and postcontrast images (p < 0.005). Normal extraocular muscles showed prominent enhancement on contrast-enhanced T1-weighted images. Temporal muscles were also enhanced in all subjects, urging the observers to compare the enhancement of extraocular muscles not with the latter.
Age-Corrected Normal Values for Perimetry
Authors: Wohlrab Thomas-Michael , Erb Carl , Rohrbach Jens Martin
Published: April 2003

Purpose: Age-corrected values are indispensable in assessing discrete changes in light difference sensitivity (LDS) when evaluating perimetric results. In order to detect incipient visual field defects, the present study aimed particularly to determine function of normal values depending on age and eccentricity. Methods: A test group (n = 83) of ophthalmologically and clinically unremarkable subjects 18–74 years of age was examined with the ‘Centerfield’ perimeter. A brief introductory program was first used to familiarize each test person with the situation. Then values in the central visual field (30Results: Age-related normal values were calculated both as group averages and as lines of regression by statistical analysis of the resulting data. In contrast to other perimetric studies, decreases in LDS at different test points for persons aged 20 years to persons over 60 were not linear. Conclusions: Age-related normal values should be reviewed for other perimeters.
Effects of Timolol and Dorzolamide on Retrobulbar Hemodynamics in Patients with Newly Diagnosed Primary Open-Angle Glaucoma
Authors: Galassi Fernando , Sodi Andrea , Renieri Giulia , Ucci Francesca , Pieri Benedetta , Harris Alon , Siesky Brent
Published: April 2003

The authors considered a group of patients with newly diagnosed primary open-angle glaucoma studying the effects of a 4-week treatment with timolol or dorzolamide on retrobulbar vessels. Ocular hemodynamics were assessed by means of color Doppler imaging of the ophthalmic artery, the temporal short posterior ciliary arteries (SPCAs) and the central retinal artery. For each vessel, systolic and diastolic blood flow velocities were measured, and the resistivity index (RI) was calculated. The only significant result was a reduction of temporal SPCA RI after dorzolamide treatment in comparison with baseline (p = 0.011). In the same group, dorzolamide treatment had a slight and nonsignificant increase in temporal SPCA diastolic velocity. The resistance decrease observed after dorzolamide treatment in the ciliary circulation may be due to the decrease in intraocular pressure or a possible direct vasodilating effect of the drug.
In vitro Activity of Sagamicin against Ocular Bacterial Isolates
Authors: Marone Piero , Monzillo Vincenzina , Carretto Edoardo , Haeusler Edward , Antoniazzi Elena
Published: April 2003

The in vitro antibacterial activity of sagamicin, gentamicin, tobramycin and norfloxacin was evaluated against 180 recent clinical isolates obtained from patients with ocular infections. Good activity was demonstrated for the 3 aminoglycosides against methicillin-sensitive Staphylococcus aureus and Staphylococcus epidermidis. All 4 compounds showed a lower activity against methicillin-resistant staphylococci. Sagamicin was highly effective against enterobacteriaceae with a MIC90 of 2 mg/l and presented good antipseudomonal activity similar to that of gentamicin. Intraocular lenses impregnated with a sagamicin solution showed a good antistaphylococcal activity immediately after preparation. In our strain collection, the ability to produce slime was more frequent among methicillin-resistant S. epidermidis strains than methicillin-sensitive S. epidermidis (85 versus 70%). The attachment of 2 S. epidermidis strains to plastic surfaces was partially prevented by sagamicin subinhibitory concentrations. On the contrary, sub-MIC levels of norfloxacin increased the adhesion of S. epidermidis.
Gene Expression of Neurotrophins and Their High-Affinity Trk Receptors in Cultured Human Müller Cells
Authors: Oku Hidehiro , Ikeda Tsunehiko , Honma Youichi , Sotozono Chie , Nishida Kohji , Nakamura Yo , Kida Teruyo , Kinoshita Shigeru
Published: April 2003

Purpose: To investigate the gene expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3) and their high-affinity receptors (TrkA, TrkB and TrkC) in cultured human Müller cells. Methods: The polymerase chain reaction was performed using specific primers for NGF, BDNF, NT-3, TrkA, TrkB and TrkC with complementary DNAs as the template, which were generated from poly-A+ RNA of cultured human Müller cells. Results: We detected the precursor mRNA transcripts for NGF, BDNF, NT-3, TrkB and TrkC, but not TrkA. Conclusion: Human Müller cells can direct mRNA expressions of a number of neurotrophins which may have a neurotrophic function in the retina. An autocrine mode of action is suggested, since Müller cells not only synthesize neurotrophic factors, but also express their specific receptors.
Spontaneous Intracranial Hemorrhage Caused by Pheochromocytoma in a Child
Authors: Chuang Huo-Li , Hsu Wen-Hsing , Hsueh Chuen , Lin Jer-Nan , Scott R. Michael
Published: April 2003

We report a 6-year-old boy who presented with left occipital spontaneous lobar hematoma and hypertension. Cerebral angiography failed to demonstrate a vascular malformation. Subsequently, a left adrenal tumor was found that proved to be a pheochromocytoma. This is the first report in the literature of a lobar hematoma in a child caused by a concomitant pheochromocytoma. In children with hypertension and resulting intracerebral hematoma, a pheochromocytoma should be considered in the differential diagnosis.
Intramedullary Cavernous Angiomas of the Spinal Cord in the Pediatric Age Group: A Pediatric Series
Authors: Nagib Mahmoud G. , O’Fallon M. Therese
Published: April 2003

The authors have reviewed available data from 7 pediatric patients with intramedullary spinal cord cavernous angioma (ISCCA) reported in the literature, and added from their own series 2 pediatric patients, for a total of 9 patients. This group of pediatric patients’ clinical presentation, course, management and outcome were compared to their adult counterparts as reported in the literature. In contrast to adults, children with symptomatic ISCCA do not show a gender imbalance and the thoracic spinal cord is not predominantly involved. Pediatric patients commonly present with an acute episode and rapid deterioration. A more favorable outcome has been reported in children as compared to adults in the face of relatively similar presenting deficits. As in adults, magnetic resonance imaging (MRI) remains the diagnostic and postoperative test of choice. Complete resection affords the best chance for cure. Symptomatic children with ISCCA characteristically present with an acute deficit and rapid deterioration. MRI of the entire neuraxis is recommended for lesion multiplicity. An attempt at total resection and long-term MRI follow-up are recommended.
Percutaneous Testicular Sperm Aspiration and Intracytoplasmic Sperm Injection in Obstructive and Non-Obstructive Azoospermia: An Easy Alternative to TESE and MESA
Authors: Makhseed Ma’asoumah , Al Salem Muntaha Hamad , Ahmed Mohammad Abrar
Published: April 2003

Objective: To evaluate the recovery rate of sperm from the testis using percutaneous testicular aspiration with a 22-gauge hypodermic needle followed by evaluation of the fertilization rate and pregnancy rate after intracytoplasmic sperm injection. Materials and Methods: This is a prospective observational study performed in a private in vitro fertilization setting in Kuwait. Fifteen patients with obstructive and non-obstructive azoospermia were included in the study. Thirteen of them had previous microepididymal sperm aspiration, percutaneous epididymal sperm aspiration or testicular sperm extraction. The sperm were retrieved using percutaneous testicular aspiration under local analgesia. This was followed by intracytoplasmic sperm injection. A total of 146 eggs were collected and 112 were injected. Results: Normal fertilization occurred in 91 oocytes (87.5%) and the total number of embryos cleaved was 83 (91%). Embryo transfer was performed in 13 with pregnancy rate of 33.3 per treatment cycle and 38.5 per embryo transfer. Failure to retrieve sperm was encountered in 2 cases both in the hypospermatogenesis group. Conclusions: Percutaneous testicular sperm aspiration using hypodermic needles under local analgesic is an easy and cheap method with high patient acceptability, minimal complications and no need of special training. In this small group, it seems to have an acceptable success rate in terms of sperm retrieval and pregnancy in the obstructive type as well as hypospermatogenesis, but to lesser extent.
Analysis of the Pathophysiology of Lower Urinary Tract Symptoms in Patients after Prostatectomy
Authors: Kuo Hann-Chorng
Published: April 2003

Objectives: To analyze the pathophysiology of persistent lower urinary tract symptoms (LUTS) in patients after transurethral prostatectomy (TURP). Methods: A total of 185 patients who had persistent LUTS after TURP were enrolled into this study. All of these patients underwent multichannel videourodynamic studies and were classified into 6 groups according to the urodynamic results. Preoperative prostate volume, resected adenoma weight, and preoperative Qmax were determined in each of the groups and the symptomatology and urodynamic findings were compared. Results: A normal videourodynamic tracing was found in 17 patients (9.1%), pure detrusor instability in 18 (9.6%), low detrusor contractility in 35 (18.7%), detrusor instability and inadequate detrusor contractility (DHIC) in 27 (14.4%), poor relaxation of the urethral sphincter in 36 (19.3%), and bladder outlet obstruction (BOO) in 52 (27.8%). Incontinence was noted in 74 patients (40%), and 18 of them had BOO (24.3%). In urodynamic findings, Qmax and residual urine showed no significant difference among patients with low contractility, poor relaxation of sphincter, DHIC and BOO. Concerning the preoperative prostatic volume, patients with low contractility, poor relaxation of urethral sphincter, and DHIC had a nonsignificantly smaller prostate volume and resected prostate weight than other groups. Preoperative Qmax showed no significant difference among all groups. Conclusions: Symptoms alone are unreliable in predicting urodynamic findings with respect to obstruction and detrusor instability after TURP. Over half of the patients with persistent LUTS had a small prostate volume and small resected adenoma weight, indicating that some of these patients may not have had BOO. Videourodynamic study is helpful in making an accurate diagnosis for refractory LUTS after TURP.
Diagnostic Value of 18F-FDG Positron Emission Tomography for Detection and Treatment Control of Malignant Germ Cell Tumors
Authors: Tsatalpas Panagiotis , Beuthien-Baumann Bettina , Kropp Joachim , Manseck Andreas , Tiepolt Claudia , Hakenberg Oliver W. , Burchert W. , Franke Wolf G. , Wirth Manfred P.
Published: April 2003

Introduction: The role of positron emission tomography (PET) with 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) is currently under evaluation in urologic oncology. The aim of the present study was to investigate the use of [18F]FDG positron emission tomography ([18F]FDG-PET) in the detection and treatment control of malignant germ cell tumors compared to computed tomography (CT). Materials and Methods: Thirty-two PET studies and CT scans were carried out in 23 patients with histologically proven germ cell tumors (10 seminomas, 12 non-seminomatous germ cell tumors (NSGCT), 1 unclassified serologic recurrent disease) Lugano stage I–III. The scans were done either after initial diagnosis (n = 21) and/or within 3–45 days after chemotherapy was completed (n = 11). PET and CT were validated either by histology (n = 7) or clinical follow-up of 6–11 months after the last PET study has been performed (n = 16). Sensitivity, specificity, accuracy, positive and negative predictive values were determined for PET and CT. Differences between PET and CT for parameters of diagnostic value were evaluated by χ2 test. Results: Although not statistically significant, the sensitivity, accuracy and negative predictive value were higher for PET than for CT with respect to the detection of metastatic infradiaphragmatic and supradiaphragmatic lesions after initial diagnosis. The specificity and positive predictive value of PET and CT were comparable. After chemotherapy, PET was found to be significantly superior in specificity and accuracy compared to CT with respect to infradiaphragmatic lesions (p < 0.05). False-positive PET findings in supradiaphragmatic lesions after chemotherapy occurred in the case of inflammatory processes and resulted in a loss of specificity and accuracy compared to CT (p < 0.05). Conclusions: These preliminary results demonstrate [18F]FDG-PET to be a useful diagnostic tool for the initial staging and treatment control in patients with germ cell tumors. Possible advantages compared to CT, however, are as yet not clearly defined. The possibility of false-positive PET findings due to reactive supradiaphragmatic inflammatory processes early after chemotherapy have to be considered.
Recurrence of Renal Cell Carcinoma with Extensive Vena Caval Thrombus Three Years after Radical Nephrectomy
Authors: Finkelstein Michael P. , Drinis Sophia , Tortorelis Dean G. , Lafaro Rocco J. , Konno Sensuke , Choudhury Muhammad S.
Published: April 2003

A 70-year-old man, who had undergone a radical nephrectomy for localized renal cell carcinoma (RCC) three years ago, was recently evaluated for shortness of breath. During his work-up, a transesophageal echocardiogram and magnetic resonance imaging indicated an extensive vena caval thrombus originating from the renal vein stump. Successful vena caval thrombectomy with cardiopulmonary bypass confirmed that the thrombus was comprised of RCC. This is a rare type of RCC recurrence with an unusual timing (3 years after a nephrectomy), alerting the importance of strict follow-up on all patients even after complete surgical excision of all suspected tumors.
Cefixime for Switch Therapy
Authors: Hamilton-Miller Jeremy
Published: April 2003

Switch therapy, or step-down therapy, is the concept of switching from an intravenous antibiotic to an oral preparation after a few days, once the condition of the patient has improved and the pathogen and its susceptibility have been determined. The orally active third-generation cephalosporin cefixime is a primary candidate for switch therapy owing to its very good efficacy and safety profile. Preliminary studies have shown excellent clinical outcomes with switch therapy to cefixime after 2–3 days for a variety of serious infections. Importantly, dramatic cost benefits have also been found, particularly with respect to reduced length of hospital stays. However, guidelines are required to indicate under what conditions switch therapy is appropriate, and awareness must be developed within hospitals among physicians, pharmacists and administrators alike.