bluuebunny/crossref_metadata_2025 huggingface dataset:
APPLICATION OF POLYGONAL FINITE ELEMENTS IN LINEAR ELASTICITY
Authors: TABARRAEI A. , SUKUMAR N.
Published: July 2007

In this paper, a conforming polygonal finite element method is applied to problems in linear elasticity. Meshfree natural neighbor (Laplace) shape functions are used to construct conforming interpolating functions on any convex polygon. This provides greater flexibility to solve partial differential equations on complicated geometries. Closed-form expressions for Laplace shape functions on pentagonal, hexagonal, heptagonal, and octagonal reference elements are derived. Numerical examples are presented to demonstrate the accuracy of the method in two-dimensional elastostatics.
Advanced glycation end products elicit externalization of phosphatidylserine in a subpopulation of platelets via 5-HT2A/2C receptors
Authors: Wang Yingjie , Beck Werner , Deppisch Reinhold , Marshall Sally M. , Hoenich Nicholas A. , Thompson Michael G.
Published: July 2007

Advanced glycation end products (AGE) are substantially elevated in individuals with diabetes and/or chronic kidney disease (CKD). These patients are at greatly increased risk of cardiovascular events. The purpose of this study was to investigate the novel hypothesis that AGE elicit externalization of the platelet membrane phospholipid phosphatidylserine (PS). This contributes to hemostasis through propagation of the coagulation cascade leading to thrombus formation. Platelet-rich plasma (PRP) was prepared by differential centrifugation, and PS externalization was quantified by a fluorescence-activated cell sorter using annexin V-FITC. Human serum albumin (HSA)-AGE was generated by incubating HSA with glucose for 2, 4, or 6 wk, and total HSA-AGE was assessed by fluorescence intensity. The 2-wk HSA-AGE preparation (0–2 mg/ml) stimulated a concentration-dependent increase in PS externalization in a subpopulation of platelets that was threefold at 2 mg/ml. In contrast, the 4- and 6-wk preparations were maximal at 0.5 mg/ml and fivefold in magnitude. These effects mirrored the change in total HSA-AGE content of the preparations. The PS response was maximal at 10 min and inhibited by the PKC-δ inhibitor rottlerin and the serotonin [5-hydroxytryptamine (5-HT)]2A/2C receptor antagonist ritanserin in a dose-dependent manner. Moreover, the 5-HT2A/2C receptor agonist 1,2,5-dimethoxy-4-iodophenyl-2-aminopropane mimicked the effect of HSA-AGE on PS externalization. These data demonstrate, for the first time, that HSA-AGE stimulates PS externalization in a subpopulation of platelets via the 5-HT2A/2C receptor. This may have important consequences for platelet involvement in inflammatory responses and the increased cardiovascular risk observed in individuals with diabetes and/or CKD.
Detection of adiponectin in cerebrospinal fluid in humans
Authors: Neumeier Markus , Weigert Johanna , Buettner Roland , Wanninger Josef , Schäffler Andreas , Müller André Michael , Killian Stephan , Sauerbruch Sophie , Schlachetzki Felix , Steinbrecher Andreas , Aslanidis Charalampos , Schölmerich Jürgen , Buechler Christa
Published: July 2007

Adiponectin circulates in the body in high concentrations, and 100-fold lower amounts were described in the cerebrospinal fluid (CSF) of mice, whereas in humans, contradictory results have been published. To clarify whether adiponectin is present in human CSF and is derived from the circulation, it was determined in human CSF and plasma of 52 nonselected patients. Adiponectin was detected by immunoblot in CSF and was quantified in CSF and serum by ELISA. CSF adiponectin was positively correlated to systemic levels, and the CSF/serum adiponectin ratio was correlated to the CSF/serum albumin ratio. Furthermore, disturbed function of the blood-brain barrier (BBB) was associated with an elevated CSF/serum adiponectin ratio. Adiponectin mRNA was not found in the brain, indicating that adiponectin crosses the BBB and/or the blood-cerebrospinal fluid barrier (BCB). Rat adiponectin with a COOH-terminal tag was injected into the tail vein of rats and was detected 3 h later in CSF. However, CSF adiponectin in humans and rats was ∼0.1% of the serum concentration and therefore was below the 0.5% expected in the CSF because of the residual leakage of an undisturbed BBB/BCB. Taken together, data from the present study show that adiponectin in human CSF is far below the level expected by the baseline BBB/BCB permeability, indicating that adiponectin enters the brain much less efficiently than albumin, thus supporting recent data that exclude adiponectin transport to the CSF. Additional studies are needed to reveal whether these low levels of adiponectin in CSF have a physiological function.
β-Adrenoceptor signaling in regenerating skeletal muscle after β-agonist administration
Authors: Beitzel Felice , Sillence Martin N. , Lynch Gordon S.
Published: July 2007

Stimulating the β-adrenoceptor (β-AR) signaling pathway can enhance the functional repair of skeletal muscle after injury, but long-term use of β-AR agonists causes β-AR downregulation, which may limit their therapeutic effectiveness. The aim was to examine β-AR signaling during early regeneration in rat fast-twitch [extensor digitorum longus (EDL)] and slow-twitch (soleus) muscles after bupivacaine injury and test the hypothesis that, during regeneration, β-agonist administration does not cause β-AR desensitization. Rats received either the β-AR agonist fenoterol (1.4 mg·kg−1·day−1 ip) or saline for 7 days postinjury. Fenoterol reduced β-AR density in regenerating soleus muscles by 42%. Regenerating EDL muscles showed a threefold increase in β-AR density, and, again, these values were 43% lower with fenoterol treatment. An amplified adenylate cyclase (AC) response to isoproterenol was observed in cell membrane fragments from EDL and soleus muscles 7 days postinjury. Fenoterol attenuated this increase in regenerating EDL muscles but not soleus muscles. β-AR signaling mechanisms were assessed using AC stimulants (NaF, forskolin, and Mn2+). Although β-agonist treatment reduces β-AR density in regenerating muscles, these muscles can produce large cAMP responses relative to healthy (uninjured) muscles. Desensitization of β-AR signaling in regenerating muscles is prevented by altered rates of β-AR synthesis and/or degradation, changes in G protein populations and coupling efficiency, and altered AC activity. These mechanisms have important therapeutic implications for modulating β-AR signaling to enhance muscle repair after injury.
Exercise reverses high-fat diet-induced impairments on compartmentalization and activation of components of the insulin-signaling cascade in skeletal muscle
Authors: Yaspelkis Ben B. , Lessard Sarah J. , Reeder Donald W. , Limon Jose J. , Saito Misato , Rivas Donato A. , Kvasha Ilya , Hawley John A.
Published: July 2007

The aims of this investigation were 1) to determine whether endurance exercise training could reverse impairments in insulin-stimulated compartmentalization and/or activation of aPKCζ/λ and Akt2 in skeletal muscle from high-fat-fed rodents and 2) to assess whether the PPARγ agonist rosiglitazone could reverse impairments in skeletal muscle insulin signaling typically observed after high-fat feeding. Sprague-Dawley rats were placed on chow (NORCON, n = 16) or high-fat ( n = 64) diets for 4 wk. During a subsequent 4-wk experimental period, high-fat-fed rats were allocated ( n = 16/group) to either sedentary control (HFC), exercise training (HFX), rosiglitazone treatment (HFRSG), or a combination of both exercise training and rosiglitazone (HFRX). Following the 4-wk experimental period, animals underwent hindlimb perfusions. Insulin-stimulated plasma membrane-associated aPKCζ and -λ protein concentration, aPKCζ/λ activity, GLUT4 protein concentration, cytosolic Akt2, and aPKCζ/λ activities were reduced ( P < 0.05) in HFC compared with NORCON. Cytosolic Akt2, aPKCζ, and aPKCλ protein concentrations were not affected in HFC compared with NORCON. Exercise training reversed the deleterious effects of the high-fat diet such that insulin-stimulated compartmentalization and activation of components of the insulin-signaling cascade in HFX were normalized to NORCON. High-fat diet-induced impairments to skeletal muscle glucose metabolism were not reversed by rosiglitazone administration, nor did rosiglitazone augment the effect of exercise. Our findings indicate that chronic exercise training, but not rosiglitazone, reverses high-fat diet induced impairments in compartmentalization and activation of components of the insulin-signaling cascade in skeletal muscle.
A comparative study of renal function in the desert-adapted spiny mouse and the laboratory-adapted C57BL/6 mouse: response to dietary salt load
Authors: Dickinson Hayley , Moritz Karen , Wintour E. Marelyn , Walker David W. , Kett Michelle M.
Published: July 2007

The desert-adapted spiny mouse has a significantly lower glomerular number, increased glomerular size, and a more densely packed renal papillae compared with the similar-sized laboratory-adapted C57BL/6 mouse. In the present study we examined the functional consequences of these structural differences in young adult male spiny and C57BL/6 mice and detailed the impact of 1 wk of a high-salt (10% wt/wt NaCl) diet. Basal food and water intake, urine and feces production, and urinary electrolyte concentrations were not different between species, although urinary urea concentrations were higher in spiny mice ( P < 0.05). On normal salt, MAP of the anesthetized spiny mouse was ∼18 mmHg lower, effective renal plasma flow (ERPF) was 40% lower ( P < 0.001), and glomerular filtration rate (GFR) tended to be lower than in the C57BL/6 mouse. On the high-salt diet, both species had similar 24-h NaCl excretions; but C57BL/6 mice required a significantly increased amount of water (lower urine NaCl concentration) than the spiny mice. Filtration fraction was greater in both species on the high-salt diet. Spiny mice had greater GFR and ERPF after the high-salt diet, whereas the C57BL/6 mouse showed little change in GFR. The ability of the spiny mouse to tolerate a significantly higher plasma osmolality after salt, measured by a decreased drinking response, and the ability to increase ERPF at a lower MAP are features that allow this species to conserve water more efficiently than can be done in the C57BL/6 mouse. These features are important, particularly since the desert mouse has a smaller kidney, with fewer nephrons.
A High Association of Upper Urinary Tract Transitional Cell Carcinoma with Nonfunctioning Kidney Caused by Stone Disease in Taiwan
Authors: Yeh Chin-Chung , Lin Tien-Huang , Wu Hsi-Chin , Chang Chao-Hsiang , Chen Chia-Chen , Chen Wen-Chi
Published: July 2007

Introduction: Although many studies have reported that upper urinary tract stones in patients with nonfunctioning kidneys are associated with malignancy, the incidence and frequency of the tumor cell type remain unclear. Therefore, we aimed to investigate the percentage of malignancies present in patients with nonfunctional kidneys who underwent nephrectomy. Materials and Methods: From July 1995 to December 2005, we reviewed a total of 47 patients who underwent nephrectomy to treat a nonfunctional kidney due to urolithiasis with clinical symptoms such as complicated chronic infection. Pathology revealed malignancies in 24 patients. Relationships between clinical presentations and malignancy were analyzed. Results: Malignancy was diagnosed in 24 patients after nephrectomy. Image studies revealed possible malignancy in only 7 patients before surgery. A high incidence (17/24) of transitional cell carcinoma was noted. The remaining malignancies included 5 renal cell carcinomas, 1 squamous cell carcinoma and 1 epidermoid carcinoma. There were 5 deaths during the follow-up interval. Conclusions: There is a high incidence of malignancy associated with nonfunctional kidney caused by stone disease. We suggest careful examination of the pathological specimens from nephrectomy for nonfunctional kidney regardless of clinical manifestations.
A Prospective Randomized and Placebo-Controlled Study for the Evaluation of Antibiotic Prophylaxis in Transurethral Resection of the Prostate
Authors: Ozturk Metin , Koca Orhan , Kaya Cevdet , Karaman M. Ihsan
Published: July 2007

Aim: To evaluate the risk of bacteriuria after transurethral resection of the prostate and the preventive effects of different kinds of antibiotics. Patients and Methods: Urine was collected for culturing 1 week before the operation and on postoperative days 2 and 10. The patients were divided into four groups: group 1 patients were given a first-generation cephalosporin (cefazolin 1 g), group 2 patients received a second-generation cephalosporin (cefuroxime 750 mg), group 3 patients were given a third-generation cephalosporin (ceftazidime 1 g), and group 4 patients received a placebo. Results: The 2nd-day postoperative bacteriuria rates were similar in all groups. On the 10th day, the incidence rates of bacteriuria in group 4 and group 1 patients were 40 and 31%, respectively (p = 0.661). In group 2, the bacteriuria incidence rate was 6.6%, and when compared with the placebo group, the difference was considered significant (p = 0.002). The difference between group 3 and group 4 was also significant (p = 0.003). There were statistically significant differences between group 1 and group 2 (p = 0.008) and between group 1 and group 3 (p = 0.01). Conclusions: Our study demonstrated that postoperative bacteriuria incidence rates are high, even in patients who underwent transurethral resection of the prostate with sterile urine, but it can be reduced by using antibiotic prophylaxis with cefuroxime or ceftazidime.
Cathepsin D Serum Levels Are Not a Valid Serum Marker in Renal Cell Carcinoma
Authors: Merseburger Axel S. , Hennenlotter Joerg , Stenzl Arnulf , Beger Gundhild , Rinnab Ludwig , Kuczyk Markus A. , Kuefer Rainer
Published: July 2007

Background: It was the aim of this study to evaluate the serum levels of cathepsin D (Cath D) as a diagnostic tool in patients with renal cell carcinoma (RCC) in comparison with healthy volunteers. Methods: Cath D serum levels were measured in serum samples obtained preoperatively from 32 patients with histologically confirmed RCC versus 30 healthy individuals using an enzyme immunoassay. Additionally, for the tumor group, Cath D serum levels were correlated with tumor stage and grade as determined according to the 2002 TNM classification. Results: The serum Cath D concentration was not significantly different in patients with RCC compared with healthy individuals (mean 16.58 vs. 16.64 ng/ml; p = 0.43). Furthermore, there was no significant association between Cath D serum levels and several patient or tumor characteristics such as tumor stage, tumor grade, lymph node status, presence of metastasis, gender or age. Conclusions: In contrast to overexpression of Cath D in primary RCC tissue, serum Cath D is not altered in RCC patients when compared with healthy volunteers. In this small cohort, Cath D serum levels did not reveal additional clinical information in patients diagnosed with a small renal mass. Further prospective multicenter studies might shed more light on the value of Cath D in the diagnostics of RCC.
DNA Variation in MSR1, RNASEL and E-Cadherin Genes and Prostate Cancer in Poland
Authors: Cybulski Cezary , Wokołorczyk Dominika , Jakubowska Anna , Gliniewicz Bartłomiej , Sikorski Andrzej , Huzarski Tomasz , Dębniak Tadeusz , Narod Steven A. , Lubiński Jan
Published: July 2007

Introduction: We investigated whether or not inherited variation in MSR1, RNASEL and E-cadherin contribute to prostate cancer risk in Poland. Material and Methods: We sequenced the coding region of these three genes in individuals from Poland and identified five common DNA variants (R462Q and D541E in RNASEL, R293X and P275A in MSR1, and 2076C>T (A692A) in E-cadherin). These five variants and the –160C>A promoter change in E-cadherin were genotyped in 737 prostate cancer cases and 511 controls. Results: The frequencies of genotyped variants in MSR1, RNASEL and E-cadherin genes in cases and controls were similar. We did not see any association for the studied variants when cases were stratified by age of diagnosis, by family history, by prostate-specific antigen level at the time of diagnosis, by Gleason sore or by tumor stage. Conclusions: Inherited variation in RNASEL, MSR1 and E-cadherin genes do not seem to contribute to prostate cancer development in Poland.
A Comparison of the Platinum Analogues in Bladder Cancer Cell Lines
Authors: Powles Thomas , Perry Jacky , Shamash Jonathan , Liu Wai , Oliver Tim , Joel Simon
Published: July 2007

Background: Oxaliplatin is a 3rd generation platinum analogue, which is active in a broad spectrum of tumours. Clinical trials using this drug in bladder cancer are underway, but not yet reported. There are currently no in vitro data regarding oxaliplatin in bladder cancer. Therefore, this study compares the efficacy of oxaliplatin with cisplatin and carboplatin, which are both used widely in this tumour type, in bladder cancer cell lines. Method: The efficacy of oxaliplatin, carboplatin and cisplatin were compared in 4 bladder cancer cell lines (5637, J82, HT1197 and 253J). Cell parameters including cell number, viability and apoptosis were assessed after 3 days of drug exposure. The effects of the drugs on the cell cycle were also observed. Results: Overall cisplatin was the most potent at inducing cell death (IC50 11.5–70.6 µM). Oxaliplatin was the 2nd most potent drug (IC50 15.2–126.3 µM) and carboplatin the least effective (IC50 75.4–137.8 µM). Carboplatin was significantly less potent at inducing cell death than the other two drugs in all 4 cell lines. Carboplatin was also inferior at inducing apoptosis in 3 of the 4 cell lines. All three drugs had a similar effect on the cell cycle, causing an initial G2 block. Conclusions: These data suggest that oxaliplatin is a potent agent in bladder cancer cell lines and is superior to carboplatin in this in vitro setting. It justifies the clinical studies using oxaliplatin that are underway.
Squamous Cell Carcinoma of the Bladder following PTFE Implantation
Authors: Sezhian N. , Rimal D. , Lawrence K. , Suresh G.
Published: July 2007

Squamous cell carcinoma of the bladder in non-bilharzial bladder usually presents in the 7th decade and is more common in males than females. An association between recurrent urinary tract infection (UTI) and long-term catheterisation with carcinoma of the bladder has been established with the pathogenesis thought to be due to chronic irritation and inflammation. In our case the patient had been free from recurrent UTI for 15 years prior to developing carcinoma of the bladder.
Multiple Metastases of Prostatic Adenocarcinoma to the Urethra after Radical Prostatectomy
Authors: Constantinides Constantinos , Haritopoulos Konstantinos , Anastasiou Ioannis , Dritsas Charalambos , Papamichael Virginia , Zervas Anastasios
Published: July 2007

We present a rare case of multiple metastases of a prostatic adenocarcinoma to the urethra. Radical prostatectomy had been performed 13 years before, and during this time he had been frequently treated with transurethral resections of the bladder neck for obstructive urinary symptoms.
Cerebellum and Reading
Authors: Vlachos Filippos , Papathanasiou Ilias , Andreou Georgia
Published: July 2007

Background: Traditionally, the cerebellum has been considered to control coordinated movement. However, in recent years it has been argued that it contributes to higher cognitive functions. Objectives: This review aims to present recent evidence concerning the role of the cerebellum and discusses how it can contribute to reading. Method: The procedure used involves findings coming from three quite different areas, lesion, anatomic and functional imaging studies. Results: These studies indicate a link between cerebellum and reading and its relationship with specific reading difficulties. Conclusions: Our review provides evidence which is in accordance with the recently established role of the cerebellum as a regulator of mental functions and supports theoretical models suggesting that cerebellar deficits might be a cause of developmental dyslexia.
Language Disorders Subsequent to Left Cerebellar Lesions: A Case for Bilateral Cerebellar Involvement in Language?
Authors: Murdoch Bruce E. , Whelan Brooke-Mai
Published: July 2007

Background: Crossed cerebello-cerebral diaschisis, reflecting a functional depression of supratentorial language areas due to reduced input via cerebello-cortical pathways, may represent the neuropathological mechanism responsible for language deficits associated with cerebellar pathology. Although it has been proposed that language is lateralized to the right cerebellar hemisphere, recent clinical and neuroimaging studies suggest that the cerebellum may bilaterally influence the regulation of language, with the left cerebellar hemisphere also contributing to the mediation of language via ipsilateral cerebello-cortical pathways. Aims: The aim of the study was to determine the effect of left primary cerebellar lesions on general as well as higher-level language function. Methods and Procedures: Linguistic profiles of a group of ten individuals with left primary cerebellar lesions were compared with those of a group of non-neurologically impaired controls matched for age, gender and level of education. Outcomes and Results: The findings confirmed that higher-level language deficits may result from left primary cerebellar lesions possibly as a consequence of ipsilateral cerebral diaschisis. Conclusions: The results challenge the notion of a right lateralized cerebellum and support a role for the left as well as the right cerebellar hemisphere in the regulation of language function.
The Impact of a Cerebellar Tumour on Language Function in Childhood
Authors: Docking Kimberley M. , Murdoch Bruce E. , Suppiah Ram
Published: July 2007

Background/Aims:Childhood-acquired cerebellar studies to date have appeared to present a concordant pattern of specific neuropsychological profiles depending on lesion site. The aim was to determine the impact of a cerebellar tumour specifically on language function in children by reporting both the general and high-level language abilities of 4 cases with differing sites of hemispheric and vermal involvement. Methods: The language abilities of 4 children (aged from 7 years 9 months to 13 years), treated with surgery and/or radiotherapy for cerebellar tumour 6 months to 3 years previously, were examined. A standardized battery of general and high-level language assessments was administered. Results: Analysis revealed intact abilities across all 4 cases on measures of general language, including receptive language, expressive language, receptive vocabulary and naming. While 2 of the 4 cases also demonstrated intact high-level language skills across all measures, the remaining 2 demonstrated specific deficits in linguistic problem solving at 6 months after treatment. Follow-up assessment of 1 case also demonstrated further decline in this area 12 months later. Conclusion: Findings of high-level language deficits in problem solving in 2 of the 4 cases examined supported previous reports of specific impairments in high-level language and in thinking flexibility and problem solving following cerebellar hemispheric damage in childhood.
S100B Is Not a Reliable Prognostic Index in Paediatric TBI
Authors: Piazza O. , Storti M.P. , Cotena S. , Stoppa F. , Perrotta D. , Esposito G. , Pirozzi N. , Tufano R.
Published: July 2007

Background: As far as paediatric traumatic brain injury is concerned, it is difficult to quantify the extent of the primary insult, to monitor secondary changes and to predict neurological outcomes by means of the currently used diagnostic tools: physical examination, Glasgow Coma Scale (GCS) score and computed tomography. For this reason, several papers focused on the use of biochemical markers (S100B, neuron-specific enolase) to detect and define the severity of brain damage and predict outcome after traumatic head injury or cardiac arrest. Objective: The aim of this paper is measuring the range of S100B serum concentrations in children affected by traumatic brain injury and describing the possible roles of this protein in the reaction to trauma. Methods: Fifteen children aged 1–15 years were included in the study. Traumatic brain injury severity was defined by paediatric GCS score as mild (9 patients), moderate (2 patients) or severe (4 patients). Blood samples for S100B serum measurement were taken at emergency department admission and after 48 h. Results: The serum S100B concentration was higher in the group of severe trauma patients, who scored the lowest on the GCS at admission, and among them, the highest values were reported by the children with concomitant peripheral lesions. Conclusions: The role of S100B in paediatric traumatic brain injury has not been clarified yet, and the interpretation of its increase when the head trauma is associated with other injuries needs the understanding of the physiopathological mechanisms that rule its release in the systemic circulation. The levels of S100B in serum after a brain injury could be related to the mechanical discharge from a destroyed blood-brain barrier, or they could be due to the active expression by the brain, as a part of its involvement in the systemic inflammatory reaction. Early increase of this protein is not a reliable prognostic index of neurological outcome after pediatric traumatic brain injury, since even very elevated values are compatible with a complete neurological recovery.
Novalis Radiosurgery of Optic Gliomas in Children: Preliminary Report
Authors: Han Seong Rok , Yoon Sang Won , Yee Gi Taek , Choi Chan Young , Sohn Moon Jun , Lee Dong Joon , Whang Choong Jin
Published: July 2007

Aim: To evaluate the effectiveness of Novalis radiosurgery (RS) in children with optic gliomas. Methods: Four pediatric patients (1 male and 3 female) were treated for optic gliomas with Novalis RS in our institution between February 2002 and July 2002. Their mean age was 12 (range 5–16) years at presentation for Novalis RS. The mean target dose was 44 (range 41–45) Gy, with a mean fractionation dose of 1.58 (range 1.5–1.65) Gy. Follow-up included magnetic resonance imaging and ophthalmologic and endocrine examinations. Results: The mean follow-up period was 54 (range 50–58) months. During the follow-up period, all patients were alive. Local control of the tumor was obtained in all patients. None of the patients showed clinically relevant morbidity, especially endocrine dysfunction. Conclusions: Novalis RS may be an excellent treatment method for optic gliomas in children. However, long-term follow-up is required for further evaluation of efficacy and potential side effects.
Expression of the Neural RNA-Binding Protein Musashi1 in Pediatric Brain Tumors
Authors: Nakano Aya , Kanemura Yonehiro , Mori Kanji , Kodama Eri , Yamamoto Atsuyo , Sakamoto Hiroaki , Nakamura Yasuhiro , Okano Hideyuki , Yamasaki Mami , Arita Norio
Published: July 2007

Musashi1 (MSI1) is an evolutionarily conserved RNA-binding protein, selectively expressed in neural stem cells (NSCs) and considered a versatile marker for normal NSCs and tumor cell diagnosis. Here, we examined MSI1 expression in primary pediatric brain tumors, medulloblastomas and ependymomas, by double immunostaining with lineage phenotypic markers (Lin). These tumors highly express MSI1 and are heterogeneous, containing both MSI1+/Lin– tumor cells in regions of relatively high cellularity and proliferative activity and MSI1+/Lin+ tumor cells in regions of lower cellularity. These findings suggest that MSI1 may be a useful marker for characterizing tumor heterogeneity and for examining in situ the analogy between normal NSCs and MSI1+ cells in pediatric brain tumors. This test could be easily applied to routine clinical diagnosis.
Cervical Rib Fracture: An Unusual Etiology of Thoracic Outlet Syndrome in a Child
Authors: Martins Roberto S. , Siqueira Mario G.
Published: July 2007

Thoracic outlet syndrome in children is an extremely rare disorder. Only 5 previous reports were presented in the literature with a description of thoracic outlet syndrome in 8 children. In these cases, the diagnosis of a cervical rib was common. We describe a case of neurogenic thoracic outlet syndrome in a 9-year-old patient where the initial symptoms occurred 2 months after a fall. Clinically, the patient developed progressive pain, numbness and tingling along the inner surface of the left forearm and in the palmar surface of the fourth finger and lateral aspect of the fifth finger. A plain radiography showed a cervical rib fracture and an electrophysiologic study suggested the presence of left lower brachial plexus neuropathy. Her fractured cervical rib was resected through a supraclavicular approach. Her symptoms resolved completely in the postoperative period. Although very rare one should keep in mind the possibility of thoracic outlet syndrome in children, especially with a history of trauma over the shoulder girdle presenting with a cervical rib and a lower brachial plexopathy.
Neurohypophyseal Granulomatous Germinoma Invading the Right Cavernous Sinus: Case Report and Review of the Literature
Authors: Fukushima Takeo , Takemura Yusuke , Tsugu Hitoshi , Iwaasa Mitsutoshi , Nabeshima Kazuki , Takano Koichi , Utsunomiya Hidetsuna
Published: July 2007

We encountered a rare case of neurohypophyseal germinoma with a prominent granulomatous reaction, which invaded the right cavernous sinus. The neuroimaging and histopathology features in this case were unique, distinguishing it from other types of suprasellar lesions. A 13-year-old boy presented with loss of appetite and polyuria; both symptoms were present for 1 year, and headache, general fatigue and blurred vision present for the prior 2 months. On admission, neurological examination indicated bitemporal hemianopsia and optic atrophy. Endocrinological exam showed panhypopituitarism. Tumor markers such as α-fetoprotein, human growth hormone, carcinoembryonic antigen, and placental alkaline phosphatase were negative. Brain CT revealed a suprasellar tumor with calcification. MR T1-weighted and T2-weighted images showed the tumor to be isointense to normal brain parenchyma and to be enhanced densely. The tumor also involved the right cavernous sinus, so that a biopsy was performed by the transsphenoidal approach. On pathologic examination of the specimen, typical large tumor cells with lymphocytic cell infiltration and prominent granulomatous reaction were observed. Neurohypophyseal granulomatous germinoma was diagnosed. Radiotherapy was performed with a total dose of 51 Gy and the tumor shrank remarkably. The patient returned to school under hormone replacement therapy.
Non-Hodgkin Lymphoma Presenting with Tetraparesis in a 3-Year-Old Child
Authors: Kombogiorgas Dimitris , Hobin David , Sgouros Spyros
Published: July 2007

Introduction: Spinal cord compression (SCC) is a rare presentation of non-Hodgkin lymphoma (NHL) which requires early diagnosis and prompt treatment to avoid devastating events and permanent neurological deficits. Material: We report a 3-year-old boy with a history of rapidly progressive tetraparesis. MRI revealed a large mass in the left side of the neck extending from the skull base into the supraclavicular fossa with extra- and intra-dural extension of this mass, causing cervical SCC from C1/2 to C7/T1 level. Liver and right kidney lesions were present as well. A ‘tru-cut’ needle biopsy was performed under general anaesthetic and histological examination showed a high-grade B cell lymphoma. In light of the extensive CNS involvement, chemotherapy was commenced with prednisolone, cyclophosphamide, vincristine, doxorubicin, methotrexate, cytarabine and etoposide. Patient neurological status started to improve clinically 1 week after commencement of chemotherapy. He made good neurological recovery and after 6 months was fully mobile without any neurological deficits. Six-month MRI showed complete resolution of the intraspinal-extradural disease, which unfortunately recurred 1 year after the initial diagnosis, involving the cervical and upper thoracic spinal cord. Discussion: In view of the satisfactory neurological outcome that treatment with chemotherapy can achieve, and bearing in mind the potential complications and late adverse consequences of decompressive laminectomy or radiotherapy in a very young child, biopsy of the extraspinal part of the tumour causing SCC should be considered first, before more aggressive therapeutic measures are decided.
Acetaminophen, Phenacetin and Dipyrone Do Not Modulate Pressor Responses to Arachidonic Acid or to Pressor Agents
Authors: Nossaman Bobby D. , Baber Syed R. , Nazim Mohammed M. , Waldron Paul R. , Hyman Albert L. , Kadowitz Philip J.
Published: July 2007

In contrast to nonsteroidal anti-inflammatory drugs (NSAIDs), the nonopioid analgesics phenacetin, acetaminophen and dipyrone exhibit weak anti-inflammatory properties. An explanation for this difference in pharmacologic activity was provided by the recent discovery of a new cyclooxygenase isoform, cyclooxygenase (COX)-3, that is reported to be inhibited by phenacetin, acetaminophen and dipyrone. However, COX-3 was found to be a spliced variant of COX-1 and renamed COX-1b. Although recent studies provide evidence for the existence of this new COX isoform, it is uncertain whether this COX-3 (COX-1b) isoform, or putative acetaminophen-sensitive pathway, plays a role in the generation of vasoactive prostaglandins. NSAIDs increase systemic blood pressure by inhibiting the formation of vasodilator prostanoids. Angiotensin II, norepinephrine and other vasoconstrictor agents have been reported to release prostaglandins. It is possible that this acetaminophen-sensitive pathway also modulates pressor responses to these vasoconstrictor agents. Therefore, the purpose of the present study was to determine whether this acetaminophen-sensitive pathway plays a role in the generation of vasoactive products of arachidonic acid or in the modulation of vasoconstrictor responses in the pulmonary and systemic vascular bed of the intact-chest rat. In the present study, the nonopioid analgesics did not attenuate changes in pulmonary or systemic arterial pressure in response to injections of the prostanoid precursor, arachidonic acid, to the thromboxane A2 mimic, U46619, or to angiotensin II or norepinephrine. The results of the present study do not provide evidence in support of a role of a functional COX-3 (COX-1b) isoform, or an acetaminophen-sensitive pathway, in the generation of vasoactive prostanoids or in the modulation of responses to vasoconstrictor hormones in the intact-chest rat.
Characteristic Changes in Platelet-Large Cell Ratio, Lactate Dehydrogenase and C-Reactive Protein in Thrombocytosis-Related Diseases
Authors: Kabutomori Osamu , Kanakura Yuzuru , Iwatani Yoshinori
Published: July 2007

We examined the clinical usefulness of 3 parameters of routine laboratory tests [platelet-large cell ratio (P-LCR), lactate dehydrogenase (LDH) and C-reactive protein (CRP)] in 84 patients with thrombocytosis-related diseases (reactive thrombocytosis, chronic myeloid leukemia, essential thrombocythemia and polycythemia vera). These thrombocytosis-related diseases were characterized using the 3 parameters P-LCR, LDH and CRP as follows: high P-LCR and high LDH in chronic myeloid leukemia; high CRP in reactive thrombocytosis; slightly high P-LCR and high LDH in essential thrombocythemia and polycythemia vera. For essential thrombocythemia and polycythemia vera, levels of P-LCR and CRP were nearly identical, but the LDH level in essential thrombocythemia was significantly higher than in polycythemia vera. These characteristics of P-LCR, LDH and CRP may be useful for simple and very rough differentiation of the thrombocytosis-related disease mentioned above.
Decreased Left Ventricular Coronary Artery Density in Pulmonary Atresia and Intact Ventricular Septum
Authors: Hwang Mao-Sheng , Taylor Glenn P. , Freedom Robert M.
Published: July 2007

Background: The prognosis for pulmonary atresia and intact ventricular septum (PAIVS) has been poor. Our hypothesis is that intrinsic abnormal left ventricular (LV) intramyocardial circulation might be related to the poor outcomes of these patients. Methods:Neonatal heart specimens were examined microscopically in four groups of 6 cases each. Group I had PAIVS with ventriculocoronary artery connections (VCAC), group II had PAIVS without VCAC, group III had normal hearts, and group IV had LV hypertrophy. A projection microscope with grid overlay was used to count the LV intramyocardial coronary artery density (IMCAD), which was expressed as the number of profiles/mm2. Results: The LV IMCAD of groups I (0.40 ± 0.14/mm2) and II (0.45 ± 0.15/mm2) were significantly lower than those of groups III (0.77 ± 0.11/mm2) and IV (0.76 ± 0.09/mm2; all with p = 0.002). There was no significant difference between either groups I and II (p = 0.394) or groups III and IV (p = 0.818). Conclusions: This study demonstrates lower LV IMCAD in a widely heterogeneous spectrum of neonatal hearts with PAIVS, which might potentially predispose these patients to myocardial ischemia and in turn contribute to the poor prognosis of this disease.
Plasma C-Reactive Protein and 5-Lipoxygenase-Activating Protein Gene Promoter Poly-A Polymorphism in Patients with Coronary Artery Disease
Authors: Jeng Jing-Ren
Published: July 2007

Objectives: The purpose of this study was to explore the possible associations of the 5-lipoxygenase-activating protein (FLAP) poly-A genotype, plasma high-sensitivity C-reactive protein (hsCRP) and the extent score of coronary artery disease (CAD). Methods: The 17A/21A genotypes and plasma hsCRP levels were determined in 555 Chinese patients, 424 with and 131 without CAD. The luciferase reporter assay was performed to explore the functional significance of promoter poly-A polymorphism. Results: CAD patients showed significantly higher plasma hsCRP (p = 0.007) than non-CAD subjects, but no differences in the 17A allele carriers and frequency. The extent score of CAD was significantly correlated with plasma hsCRP (p = 0.03). Furthermore, the 17A allele carriers showed significantly higher hsCRP than the 21A homozygotes (p = 0.02). Multiple linear regression analysis documented an impact of the poly-A genotype on plasma hsCRP (p = 0.03). In vitro, the 17A construct was found to have greater promoter activity than the 21A construct (p = 0.02). Conclusions: The present study demonstrated a significant correlation of FLAP gene promoter 17A allele carriers with higher plasma hsCRP levels in patients with CAD. This association might be related to the increased transcriptional activity of the FLAP gene and the resulting pro-inflammatory effect on the 5-lipoxygenase pathway.
Augmentation of Pulmonary Vein Backflow Velocity during Left Atrial Contraction: A Novel Phenomenon Responsible for Progression of Atrial Fibrillation in Hypertensive Patients
Authors: Maruyama Toru , Kishikawa Toshisuke , Ito Hiroyuki , Kaji Yoshikazu , Sasaki Yasushi , Ishihara Yasushi
Published: July 2007

Background: Atrial fibrillation (AF) is a common arrhythmia showing disease progression. However, echocardiographic prediction of such progression remains incomplete. This study aimed to identify echocardiographic predictors of AF progression in hypertensive patients. Methods: Hypertensive patients with paroxysmal AF were divided into two groups: patients with AF which became permanent (group A; n = 13) and those with AF which remained paroxysmal (group B; n = 46) during the same follow-up period (8.0 ± 2.4 years). Clinical baselines showed no significant differences except for age. Transthoracic echocardiography was recorded 1–2 weeks after termination of the first-detected paroxysms of AF. Results: Echocardiography showed greater left atrial (LA) dimension (p = 0.023) and late diastolic pulmonary vein (PV) backflow velocity (p < 0.001), and a lower LA fractional shortening (p = 0.008) in group A than in group B. Multilogistic regression analysis demonstrated that augmented PV backflow (p = 0.007) and reduced LA fractional shortening (p = 0.032) were independent predictors of the progression of AF. The receiver-operating characteristic curve demonstrated that PV backflow augmentation is the best predictor of future AF perpetuation. Conclusion: PV backflow leading to cyclic stretching of PV musculature contributes to AF progression.
Out-of-Hospital Cardiac Arrests in Patients with Acute ST Elevation Myocardial Infarctions in the East Bohemian Region over the Period 2002–2004
Authors: Pleskot Miloslav , Babu Anush , Hazukova Radka , Stritecky Jakub , Bis Josef , Matejka Jan , Cermakova Eva
Published: July 2007

Background: Early reperfusion by direct percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarctions (STEMI) with an out-of-hospital cardiac arrest (OHCA) reduces hospital and longterm mortality. Aims: Evaluating the significance of direct PCI for the short-term (discharge from acute hospitalization) and 1-year survival in patients with acute STEMI after OHCA. Methods: In this prospective study, from April 1, 2002 up to August 31, 2004, a total of 26 hospitalized individuals (22 men, 4 women, aged 35–79 years, median 58.5) from the East Bohemian region with OHCA (primary group of 718 individuals) with acute STEMI were included. Urgent coronary angiography was performed in 20 individuals, and direct PCI was done in 19 of them. The remaining 6 patients did not undergo angiography. Results: Fifteen patients (57.7%) survived acute hospitalization, of whom 11 were without neurological deficits. In the subgroup with urgent coronary angiography 14 patients (70%) survived hospitalization, and in the subgroup without coronarography only 1 patient survived hospitalization (16.7%). In the subgroup with PCIs, 13 out of the 19 patients survived (68.4%). None of the patients died during the 1-year follow-up after being discharged from acute hospitalization. According to the urgent coronarography the artery most commonly responsible for the infarction was the left anterior descending artery (50%). Initial TIMI flow grade 0–I was found in 17 patients and grade II–III in 3 individuals. After PCI, irrespective of stent implantation, an optimal angiographic success (TIMI flow grade II–III) was obtained in 17 cases. Conclusion: Short-term survival of patients after OHCA with STEMI treated with direct PCI was found to be 68.4%. Out of 6 patients not receiving reperfusion therapy 1 survived (16.7%). Over the course of the 1-year follow-up none of the patients died.
Stable and Unstable Ventricular Tachycardias in Patients with Previous Myocardial Infarction: A Clinically Oriented Strategy for Catheter Ablation
Authors: Ventura Rodolfo , Klemm Hanno U. , Rostock Thomas , Lutomsky Boris , Risius Tim , Steven Daniel , Weiss Christian , Meinertz Thomas , Willems Stephan
Published: July 2007

Objective: Catheter ablation of ventricular tachycardia (VT) after myocardial infarction (MI) can be complex and time-consuming. We only targeted the previously documented VTs and those with similar or longer cycle lengths. Methods: 30 patients with VTs after MI were included in the study. Voltage mapping was performed using an electro-anatomic mapping system (CARTOT). Stable VTs were mapped during tachycardia and unstable VTs during sinus rhythm. Results: Clinical VTs were stable in 16 (53%) and unstable in 14 (47%) patients, and ablation was successful in 11 (69%) and 9 patients (64%), respectively (p = 0.42). During follow-up (14 ± 6 months), 4 patients (25%) treated for stable and 6 (43%) for unstable VTs had recurrences (p = 0.82); ablation was successful in none and 2 (33%) of them, respectively. Non-target VTs were inducible in 11 (55%) of 20 patients after successful ablation and non-inducible in 9 (45%). During follow-up, inducibility of non-target VTs did not predict recurrences (9 vs. 11%, p = 0.88). Conclusions: Catheter ablation of VTs after MI can be successfully performed. Acute success rates seem to be similar for stable and unstable VTs. VTs faster than those documented clinically exert a minor effect on VT recurrences during follow-up.
Flash Pulmonary Edema Heralding Renal Artery Spasm
Authors: Sharifkazemi Mohammad Bagher , Zamirian Mahmood , Aslani Amir
Published: July 2007

Flash pulmonary edema is a condition characterized by sudden and recurrent episodes of dyspnea resulting from acute pulmonary venous congestion in the presence of normal or well-preserved left ventricular systolic function. This is usually associated with bilateral renal artery stenosis or stenosis of a single surviving kidney. We describe a patient with clinical presentation of flash pulmonary edema due to renal artery spasm. To the best of our knowledge, this is the first reported case of flash pulmonary edema due to renal artery spasm.
Wide QRS Tachycardia with Ventriculoatrial Dissociation in Early Postoperative Aortic Valve Replacement Period: An Atypical Nodal Reentry Presentation
Authors: Palanca Victor , Quesada Aurelio , Jimenez Javier , Jacas Victoria
Published: July 2007

We report an atypical presentation of atrioventricular (AV) nodal reentry tachycardia with periods of ventriculoatrial Wenckebach and complete ventriculoatrial dissociation which appeared in a male patient in the postoperative period following aortic valve replacement and plication of Valsalva’s posterior sinus. The context for the onset of this AV nodal reentry tachycardia and the concurrent electrophysiological findings support the hypothesis of a strictly nodal location of the circuit and suggest that the electrical modifications sustained by the perinodal region are the triggering agent for the reentry mechanism. Therefore, the AV nodal reentry is a mechanism that must be considered when tachycardia appears in the early postoperative period following aortic valve replacement.
Eating Behavior and Gastric Emptying in Adults with Prader-Willi Syndrome
Authors: Hoybye Charlotte , Barkeling Britta , Naslund Erik , Thorén Marja , Hellstrom Per M.
Published: July 2007

Background/Aims: Prader-Willi syndrome (PWS) is a complex genetic disorder characterized by distinctive physical, behavioral and psychiatric features. One cardinal symptom is excessive eating, often leading to extreme obesity. The etiology of the hyperphagia is unknown, but eating behaviors and gastrointestinal motility could play a pivotal role. In this pilot study, we therefore sought to give a closer description of the two. Methods: 12 PWS adults, 6 men and 6 women, 17–37 years of age with a median BMI of 34.9 were evaluated. Computerized monitoring of eating behavior and assessment of gastric emptying using paracetamol absorption were analyzed. Gastric emptying rate was compared to the rate in normal and obese controls. Results: Eating behavior pattern was nonhomogeneous in the PWS patients, but they experienced both hunger and satiation. In PWS gastric emptying was similar to lean subjects (p > 0.05), but longer than in obese subjects (p < 0.05). Conclusions: Despite obesity, this group of adults with PWS did not display overeating in the test situation and gastric emptying rate was normal. Numbers are small, but the results are important for the treatment of obesity in this special group of patients.