bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Tracheal Transplantation Using a Cryopreserved Aortic Allograft
Authors: Carbognani P. , Spaggiari L. , Solli P. , Corradi A. , Cantoni Anna M. , Barocelli Elisabetta , Tincani G. , Polvani G. , Guarino Anna , Rusca M.
Published: April 2003

Background: The tracheal reconstruction after wide resections remains a critical surgical problem. Our aim was to replace trachea with a tissue easy to vascularize, which allows a simple reconstruction and does not require an immunosuppressive regimen. Materials and Methods: A segment of cryopreserved aorta was used in order to verify its adequacy as tracheal substitute. In phase 1, the thoracic aorta of 10 rabbits was excised, obtaining 20 segments that were cryopreserved. Ten segments were implanted in the omentum of 10 rabbits that were sacrificed on postoperative days 7, 14 and 21, and the grafts were examined histologically. In phase 2, a segment of cryopreserved aorta arranged with a silicone prosthesis was transplanted in 10 rabbits and wrapped with omentum. The animals were sacrificed on postoperative days 7, 14 and 21. Results: In phase 1, the neovascularization of the grafts was present after 7 days, and after 14 days the fibroblasts invaded the lumen of the aorta. In phase 2, 8 rabbits survived and the histologic examination after 7, 14 and 21 days showed neovascularization, the absence of rejection and the proliferation of fibroblasts inside the lumen of the aorta; this growth has been restrained by an endoluminal prosthesis. Conclusions: Our study demonstrated that replacing the trachea with cryopreserved aorta is technically feasible and does not evoke immunologic reactions. It requires, however, a silicone tube inside the allograft to limit the colonization of fibroblasts.
In vivo Studies on Insulin Permeability of an Immunoisolation Device Intended for Islet Transplantation Using the Microdialysis Technique
Authors: Rafael E. , Wernerson A. , Arner P. , Tibell A.
Published: April 2003

In this study, insulin was injected into TheracyteTM immunoisolation devices to analyze changes in the permeability of the device over time after implantation. The recovery of insulin was studied after subcutaneous implantation of the devices in rats, using the microdialysis technique. The area under the insulin cocnetration vs. time curves (AUC) after insulin injection in devices implanted 1 day previously did not differ significantly from the AUC after subcutaneous injection. At 1, 2 and 4 weeks after implantation, the recovery of insulin was significantly reduced, but at 3 months, the AUC was not significantly different from that in the control group. Histological examination showed that the number of vascular profiles within 15 μm of the device were significantly higher at 2, 4 weeks and 3 months after transplantation when compared to numbers at 1 week. The design of the device allows transplantation of cells at a chosen time point after its implantation. Delayed filling of the device would allow neovascularization of the device surface before graft implanatation and we suggest that such a schedule might improve function of the encapsulated graft.
Immunomodulating Effects of Second-Generation Calcium Channel Blockers on Experimental Heart Transplantation
Authors: Lapointe Nathalie , Chen H. , Qi S. , Xu D. , Daloze P. , Dumont L.
Published: April 2003

The administration of second-generation calcium channel blockers (CCBs) to counteract the adverse effects of conventional immunosuppression gains more and more acceptance. Since these newly developed molecules differ in their chemical structure and possess specific pharmacokinetic profiles, we hypothesized that exposure to clinically relevant concentrations may have a significant immunomodulatory potential. The effects of various second-generation CCBs, felodipine, amlodipine, mibefradil and clentiazem, on cardiac allograft survival were therefore evaluated. Inbred male Lewis rats were used as recipients and Brown-Norway rats as donors. After abdominal implantation of the donor heart, allograft recipients were exposed to felodipine (31 μg/kg/day), amlodipine (25 μg/kg/day), mibefradil (3 mg/kg/day) or clentiazem (2.5 mg/kg/day). Other allograft recipients were treated with low-dose cyclosporine (CsA) alone (2 mg/kg/day) or with low-dose CsA combined with amlodipine (25 μg/kg/day), mibefradil (3 mg/kg/day) or clentiazem (2.5 mg/kg/day). All drugs were given daily by gavage. Median survival time of untreated cardiac allografts was 6.5 days. When given alone, not all the second-generation CCBs elicited a positive effect: the dihydropyridines felodipine and amlodipine were ineffective (median survival time was 6.5 and 7.0 days, respectively), the T- and L-type CCB mibefradil had a significant but minor impact (median survival time = 9.0 days, p <0.0015) while the benzothiazepine clentiazem produced the most significant result (median survival time = 16.0 days, p <0.0033). Neither amlodipine nor mibefradil modified the extent of survival provided by low-dose CsA (median survival time = 9.0 days), while clentiazem had a significant positive effect. These data indicate that second-generation CCBs differ in their immunomodulatory potential. These observations of pharmacodynamic specificity appear to be related to differences in their chemical structure as well as their interaction with other sites than the calcium channel.
Selective Ablation of Porcine and Rabbit Liver Tissue Using Radiofrequency: Preclinical Study
Authors: Nakagawa A. , Kamiyama Y. , Matsui Y. , Nakagawa M. , Araki H. , Kasamatsu S. , Wei T. , Okuda Y. , Kitade H. , Kamiya T. , Noro T. , Kubo N. , Nakase Y.
Published: April 2003

Temperature changes and their distribution induced by 13.56-MHz radiofrequency (RF) heating of agar phantom and porcine and rabbit liver were investigated. It was possible to produce selective local heating of approximately 50°C in the RF field of 2 × 2 × 2 cm3 of the pig or rabbit liver. Coagulation necrosis after heating became pronounced and the margin between the coagulated lesion and normal tissue became clearer with time. Within 1 week after RF heating at 50°C for 20 min, the coagulated area was replaced selectively and totally by necrotic tissue.
Effect of Nitric Oxide on Postoperative Adhesion Formation
Authors: Özden A. , Bostanci B. , Sarioglu A. , Taşkiran D. , Tetik C.
Published: April 2003

Peritoneal adhesions continue to be a significant cause of postoperative complications. The purpose of the present study was to investigate the effect of nitric oxide in preventing postoperative adhesion formation in rats. Three randomized groups of Sprague-Dawley rats were subjected to a standardized lesion by cecal abrasion and parietal peritoneal defect. 0.9% NaCl (control, group 1), L-arginine (300 mg/kg, group 2) and Nω-nitro arginine methyl ester (L-NAME; 25 mg/kg, group 3) were administered intraperitoneally before abdominal closure and during 3 consecutive days after surgery. Two weeks after surgery, a relaparotomy was performed and the extent of adhesion formation was determined. In groups 1 and 3 heavy adhesions were detected. In the L-arginine group, adhesion formation was significantly less than in the other groups (p < 0.05). This study showed that L-arginine reduced adhesion formation.
Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up
Authors: Petrakis I. , Vassilakis S.J. , Vrachassotakis N. , Koutsoumpas V. , Chalkiadakis G.
Published: April 2003

Background: Recently, gastric stapling with posterior truncal vagotomy has been performed by laparoscopic surgery, as an alternative to highly selective vagotomy (HSV) and the Taylor procedure for the treatment of chronic duodenal ulcer. Aim: To investigate, after a mean 5-year follow-up, the effect of the stapling-modified laparoscopic Taylor procedure, on gastric secretion, emptying and reflux as well as clinical parameters and recurrence rates in patients treated for duodenal ulcer. Methods: 16 patients, aged 38–66 years, were treated from January 1993 to January 1996 (median 60.5 months), by the laparoscopic stapling-modified Taylor procedure, using the Endo-GIA stapler device. Assessment of the results of gastric acid secretion, solid and liquid gastric emptying, enterogastric reflux, endoscopic findings and clinical parameters, using the Visick grading, was performed. Results: Endoscopy found healing ulcer in 15 patients. One patient showed signs of chronic ulcerative disease without gastritis or pyloric stenosis indicative of progressive ulcerative diathesis and was classified as Visick III. 14 patients were classified as Visick I and 1 as II. The enterogastric reflux index ranged from 0 to 26%, basal and peak acid output were 1.4 ± 0.6 and 11.7 ± 6.1 mmol H+/h, respectively. The half-emptying times of the solid and liquid meal were 82 ± 7 and 16 ± 6 min, respectively. These results are likely to be similar to those obtained from series of patients who underwent HSV or Taylor procedure and are closed to those from healthy controls. Conclusions: The laparoscopic modified Taylor procedure, using the Endo-GIA stapler device allows a more rapid, technically easier and radical performance of the operation with excellent long- term results and should be included in the armamentarium of the treatment of chronic duodenal ulcer.
Effect of Preoperative Portal Vein Embolization on Liver Volume and Hepatic Energy Status of the Nonembolized Liver Lobe in Humans
Authors: Chijiiwa K. , Saiki S. , Noshiro H. , Kameoka N. , Nakano K. , Tanaka M.
Published: April 2003

Clinically portal vein embolization (PVE) is presently preferred to extended hepatectomy. Nevertheless, its effect on hepatic adenosine triphosphate (ATP) and energy charge levels, which are essential for organ viability, has been little studied in humans. Fourteen patients with (n = 7) and without (n = 7) preoperative right PVE participated in this study. Changes in hepatic lobar volume and serum liver function tests were examined before and after percutaneous transhepatic right PVE. Liver volume (cm3) was calculated on computed tomograms before and 20 ± 3 days after PVE. At the time of surgery (mean of 25 days after PVE), small liver specimens were obtained from portal vein (PV) nonembolized left lobes immediately after laparotomy without any ischemic procedures. Concentrations of adenine nucleotides were measured by high performance liquid chromatography, and hepatic energy charge levels were calculated. These values were compared with those in control patients who had not undergone preoperative PVE. Serum liver function tests including the indocyanine green retention rate did not differ significantly before and after PVE. The volume of the PV-nonembolized left lobe significantly increased after right PVE (from 473 ± 32 to 624 ± 66 cm3), with a significant increase in the percentage of the left lobe to total liver volume. The concentrations of AMP, ADP, and ATP, and hepatic energy charge levels in the PV-nonembolized left lobe were similar to those of the control liver. These results suggest that preoperative right PVE increases the volume of the nonembolized left lobe, keeping the hepatic engery charge and ATP levels similar to the control liver, thereby increasing the total amount of ATP and hepatic energy reserve of the PV-nonembolized lobe in proportion to its volume increase at the time of surgery.
Total Pancreatico-Duodenal Transplantation with Portal Venous Drainage: Metabolic Assessments in Diabetic Rats
Authors: Elian N. , Carnot F. , Bailbé D. , Cugnenc P.-H. , Altman J.-J.
Published: April 2003

A perfect metabolic correction of diabetes is essential to completely eradicate long-term chronic complications. Only a total pancreatic graft with portal venous drainage enables such an achievement. Isogenic Lewis rats were used for donors, recipients and controls. Pancreatico-duodenal transplantation was either heterotopic with systemic venous drainage (n = 12) or paratopic with portal drainage (n = 11). All animals were regularly monitored for non-fasting plasma glucose and insulin. Both techniques promptly restored the non-fasting plasma glucose to normal values (p < 0.003). Normo-insulinemia (47.4 ± 6.4 μU/ml) was obtained in the paratopic group, while the heterotopic group showed hyperinsulinism (132.0 ± 15.2 μU/ml). Perfect metabolic control justifies the additional technical difficulties of total paratopic pancreatic transplantation with portal venous drainage.
Susceptibility to Lipopolysaccharide of Cholestatic Rat Liver Produced with Bile Duct Ligation: Assessments of the Mitochondrial Glutathione Pool and the Effects of N-Acetylcysteine
Authors: Nakano H. , Fujiwara Y. , Kitamura N. , Kumada K. , Matsumiya A. , Sakai H. , Hatakeyama T. , Yamaguchi M. , Jaeck D.
Published: April 2003

We investigated whether rats with obstructive jaundice produced with bile duct ligation for 2 weeks are more susceptible to the additional stress of lipopolysaccharide (LPS) administration than sham-operated rats and also examined the effects of N-acetylcysteine (NAC) on LPS stimulation in rats with bile duct ligation. The effects of LPS on the mitochondrial glutathione pool and on oxidative stress of polymorphonuclear leukocytes were investigated in cholestatic rats. Serum concentrations of α-glutathione S-transferase showed that lipopolysaccharide stimulation caused more severe hepatocellular injury in cholestatic rats than in sham-operated rats. In addition, concentrations of mitochondrial reduced and oxidized glutathione and hepatic adenosine triphosphate showed that LPS stimulation decreased mitochondrial function more in cholestatic rats than in sham-operated rats. Intraperitoneal administration of NAC for 2 weeks significantly improved mitochondrial function and decreased hepatocellular injury. However, the oxidative stress of polymorphonuclear leukocytes that had infiltrated hepatic tissue was increased by NAC. The present results indicate that the cholestatic liver is susceptible to the additional stress of LPS, that NAC suppresses the adverse effects of LPS in cholestatic livers, and that the oxidative stress of polymorphonuclear leukocytes is not significantly involved in mitochondrial dysfunction or hepatocellular injury in this model.
Matrix Metalloproteinases 2 and 9 in Indomethacin-Induced Rat Gastric Ulcer
Authors: Lempinen M. , Inkinen K. , Wolff H. , Ahonen J.
Published: April 2003

The restoration of functional connective tissue is a major goal of the wound healing process. The 72- and 92-kD gelatinases (MMP-2 and MMP-9) are extracellular matrix metalloproteinases (MMPs), which are known to degrade type IV and V collagens and gelatin, and have a potential role in wound healing. The spatial and temporal gelatinolytic activities of MMP-2 and MMP-9 were analyzed as a function of ulcer age, in homogenates of rat, indomethacin-induced, chronic gastric ulcers. The rats were sacrificed on 1, 3, 7, 12, 18, 24 and 28 days after subcutaneous indomethacin injections. Zymographic analyses revealed elevated activation of MMP-9 and latent and active MMP-2 in gastric ulcers, when compared to gastric tissue from non-indomethacin-treated rats. The intact tissue and tissue from ulcerous lesions contained MMP-2. The highest activity of MMP-2 was found in 3 day gastric ulcers and returned to the control level by day 24. MMP-9 was not present in the intact tissue and the highest gelatinolytic activity of MMP-9 was also observed on the 3rd day after administration of indomethacin. The activity thereafter decreased and returned to the control level by day 24. In situ hybridization was used to evaluate which cells synthesize MMP-2 and MMP-9. MMP-2 was seen mostly in fibroblast-like cells in the submucosa and MMP-9 in macrophage-like cells in the mucosa on the margins of the ulcers. Thus, we conclude that these two MMPs seem to have different functions during the gastric ulcer injury/healing process. MMP-2 may participate in the physiological turnover of the gastric extracellular matrix, whereas MMP-9 may be important in the early phase of gastric ulcer formation and also in the healing process.
Hepatic Lymphocyte Transplantation in Hyperbilirubinemic Gunn Rats
Authors: Yoshida Y. , Kobayashi E. , Nozawa M. , Uchida H. , Fujimura A. , Yamanaka T. , Miyata M.
Published: April 2003

Hepatic lymphomyeloid cells (HLCs) are thought to contain liver stem cells. We investigated whether HLCs generated enzyme-producing cells in vivo. HLCs from normal Wistar/Shi rats and rats in which liver ischemia was induced using a portal clamp 4 days previously were studed histopathologically and characterized using flow cytometry. Splenic lymphocytes obtained from these animals were compared as a control. The proliferative activity of HLCs and splenic cells from both groups was also tested by stimulation with concanavalin A. HLCs contained a significantly higher number of NK–T cells and OV6+ cells compared with the splenic cells. The HLCs from rats in which liver ischemia was induced tended to have greater proliferative activity than those from normal rats, while the proliferative activity of splenic lymphocytes was impaired by liver ischemia. The HLCs obtained from Wistar/Shi rats with liver ischemia were then injected into hereditary hyperbilirubinemic Gunn rats to determine whether the HLCs generated enzyme-producing cells. After injection of these stimulated HLCs, the titer of serum bilirubin in the recipient rats was markedly reduced over a long time course (6.80 ± 0.93 to 4.87 ± 0.22 mg/dl after 1 month and 3.52 ± 1.33 mg/dl after 6 months). The results of the present study indicate that HLCs have different populations than splenic cells, and ischemia-reperfusion of the liver increased their proliferative activity. HLC transplantation successfully reduced high bilirubin levels over a long time course.
Diverting Colostomy Increases Anastomotic Leakage in the Rat Colon
Authors: Månsson P. , Fork T. , Blomqvist P. , Jeppsson B. , Thorlacius H.
Published: April 2003

In the present study, we examined the effect of a diverting colostomy on the intestinal healing of colonic anastomosis in the rat. For this purpose, we created a colonic stenosis 2 days prior to the formation of a distal one-layer end-to-end anastomosis with or without a proximal double-barreled deviation colostomy in the rats. Radiological examination of anastomotic leakage was performed daily for 4 days and on day 7 after the operation. We found that anastomotic leakage was markedly increased in rats with a diverting colostomy compared to control animals; i.e. the leakage index (percentage of days with leakage during the experimental period) in colostomy rats was 29%, whereas in animals with no colostomy, the leakage index was only 7%. Interestingly, it was observed that anastomosis formation was associated with a higher mortality rate in rats with colostomy diversion (36%) compared to control animals (7%). However, there was no difference in suture holding capacity on day 7. Moreover, body weight decreased significantly in the colostomy group compared to rats without surgical defunctioning when followed for up to 7 days after surgery. Taken together, our novel findings suggest that a diverting colostomy may increase intestinal leakage after anastomosis formation in the rat colon. Thus, the role of proximal colostomy in the protection of colorectal anastomosis needs to be reevaluated and further investigations are required to resolve the influence of surgical defunctioning on intestinal healing.
Effects of Dibutyryl Cyclic Adenosine Monophosphate on the Ultrastructure of Endothelial Cells in Rat Lungs Cold Preserved for 15 Hours
Authors: Ueda M. , Hasegawa S. , Nakamura T. , Hirata T. , Fukuse T. , Suzuki Y. , Wada H.
Published: April 2003

Background: Dibutyryl cyclic adenosine monophosphate (db-cAMP) has been shown to protect vascular endothelial cells by increasing the level of intracellular cAMP, and we have previously reported its effectiveness in lung preservation. Here, the effects of db-cAMP in lung preservation were ultrastructurally investigated, and the ultrastructural changes before reperfusion were correlated with pulmonary function after reperfusion. Methods: The lungs of 17 Lewis rats were flushed with perfusate and prostaglandin E1, and were then divided into three groups. In the fresh group (n = 6), the lungs were flushed with extracellular-type trehalose-containing (ET-K) solution and were reperfused immediately. In the control group (n = 6) and db-cAMP group (n = 5), the lungs were flushed with ET-K solution and ET-K solution plus db-cAMP (2 mM), respectively, and were reperfused after cold preservation at 4°C for 15 h. Before reperfusion, tissue was sampled and ultrastructurally analyzed by transmission electron microscopy. Results: In the endothelial cells of pulmonary arterioles, the incidence of protrusion was significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.05). The incidence of detachment and microvillus formation were significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.01). The ultrastructure of the alveoli did not allow separation of the control and db-cAMP groups. The shunt fraction and wet to dry weight ratio of the lung tissue after reperfusion were significantly lower in the fresh and db-cAMP groups than in the control group (p < 0.01). Positive correlations were found between the incidence of these ultrastructural changes in the endothelial cells of the pulmonary arterioles and pulmonary function after reperfusion. Conclusion: These findings suggest that db-cAMP might attenuate the lung injury caused by cold preservation and ischemia-reperfusion, partly by suppressing the acceleration of the structural changes in the endothelial cells in the pulmonary arterioles.
Combined Congenital Absence of the Vagina and Cervix
Authors: Letterie Gerard S.
Published: April 2003

The combination of congenital absence of the cervix and vagina is an extremely infrequent anatomic abnormality. We report a patient in whom this combination was diagnosed preoperatively by magnetic resonance imaging and managed surgically in a two-stage procedure using a modified McIndoe vaginoplasty followed by the creation of a uterovaginal fistula.
Immunolocalisation of Interleukin-4 and Interleukin-4 Receptor in Placenta and Fetal Membranes in Association with Pre-Term Labour and Pre-Eclampsia
Authors: Henriques Carsten U. , Rice Gregory E. , Wong May H. , Bendtzen Klaus
Published: April 2003

The aim of this study was to characterise the localisation and staining intensity of immunoreactive (ir) interleukin-4 (IL-4) and IL-4 receptor (IL-4R) in human placenta and fetal membranes in association with pre-term and term labour, and pre-eclampsia. The data obtained in this study establish the presence of irIL-4 and IL-4R in human placenta and fetal membranes obtained from women at 25–41 completed weeks of gestation. IL-4 and IL-4R immunohistochemical staining was principally localised in villous and chorionic trophoblast, and to amnion epithelial cells. The intensity of IL-4 and IL-4R immunohistochemical staining was not significantly affected by labour status at term or pre-term (p > 0.05), with the exception of IL-4R in the amnion (p < 0.05). In term amnion, IL-4R was only detectable following labour onset. When data were stratified with respect to the presence or absence of pre-eclampsia, no statistical difference in immunohistochemical localisation or staining intensity for either IL-4 or IL-4R could be identified for any of the tissues studied. Co-localisation of IL-4 and IL-4R within gestational tissues may indicate auto- and/or paracrine mechanisms of action for this cytokine. Tissue-specific, labour-associated induction of IL-4R may contribute to the regulation of biological effects of IL-4 within the uteroplacental unit.
Correlation of Change in Uterine Activity to Blood Loss in theThird Stage of Labour
Authors: Choo W.L. , Chua S. , Chong Y.S. , Vanaja K. , Oei P.L. , Ho L.M. , Roy A.C. , Arulkumaran S.
Published: April 2003

In 47 women, the change in the uterine activity after the administration of a uterotonic agent was correlated with the amount of blood loss during the same period of time. Uterine activity was measured by a Gaeltec® catheter-tipped pressure transducer inserted transcervically within 5 min of delivery of the placenta. A uterotonic agent (either intravenous syntocinon, intramuscular syntometrine or oral misoprostol) was given after the insertion of the intrauterine pressure catheter and pressure recorded for another 90 min. Blood loss over the same 2-hour period was collected with absorbent paper which was then assessed by colorimetric measurement of the haemoglobin content in the sample. Our results show that the change in uterine activity is associated with the total blood loss. However, there is a poor linear correlation between the two variables probably because of the biological variation in myometrial activity and differences in coagulation mechanisms in normal women.
Single Fetal Demise in a Twin Gestation: Umbilical Vein Thrombosis
Authors: Baxi Laxmi V. , Daftary Aditya , Loucopoulos Andrew
Published: April 2003

Background: Single fetal demise in a twin pregnancy is a rare event, the common causes being twin-twin transfusion syndrome, chromosomal or congenital anomalies and abnormalities of the umbilical cord and placenta. Umbilical vein thrombosis is a very rare cause of single fetal demise in twins. Case: Three days after a reassuring biophysical profile, a 40-year-old primigravida with twin pregnancy presented at 38 weeks’ gestation in early labor when demise of 1 of the twins was recognized. She underwent a cesarean section for arrest of labor, delivering twin A, a stillborn female weighing 2,360 g and twin B, a liveborn male weighing 2,200 g. Umbilical vein thrombus was noted in twin A. Conclusion: Umbilical vein thrombosis is a rare and sudden cause of fetal demise.
Influence of Cigarette-Smoking on the Result of the Triple Test
Authors: Hafner E. , Stangl G. , Rosen A. , Schuchter K. , Plattner M. , Philipp K.
Published: April 2003

The aim was to establish whether the risk of trisomy 21 in women smokers undergoing triple test differs to women nonsmokers, whether increased smoking changes the hormonal values, and if the cessation of smoking at the beginning of pregnancy has any influence on the triple test. 1,854 pregnant women were interviewed regarding their smoking habits at the time of the triple test. They were divided into 5 groups: (a) nonsmokers; (b) smokers before pregnancy; (c) 1–5 cigarettes; (d) 6–10; (e) 11 or more. MOM values of AFP, E3 and β-HCG and Down risk calculated by the triple test were compared within the 5 groups. Increasing smoking was associated with a reduction in MOM values of β-HCG. Smokers were significantly less likely to be counseled for karyotyping (cut-off level 1:250) than nonsmokers. The values of women who stopped smoking at the beginning of pregnancy were not different to nonsmokers. The results suggest the benefits of inclusion of smoking habits for the calculation of the triple test.
Fibrogenesis in Peritoneal Endometriosis
Authors: Matsuzaki Sachiko , Canis Michel , Darcha Claude , Dechelotte Pierre , Pouly Jean-Luc , Bruhat MauriceA.
Published: April 2003

Objective: To evaluate the degree of fibrosis in the stroma of peritoneal endometriosis, according to the macroscopic appearance. Methods: Red and black lesions of peritoneal endometriosis were collected and type-I collagen was immunohistochemically identified. The percentage of the stained area in the stroma was measured using a computerized image analysis system. Results: There was a significant difference in the mean percentage of the total stained area between red and black lesions. Conclusion: The amount of type-I collagen is significantly higher in the stroma of black peritoneal lesions than in red peritoneal lesions.
Experience with Isotonic 2.2% Glycine as Distension Medium for Hysteroscopic Endomyometrial Resection
Authors: Tapper Anna-Maija , Heinonen Pentti K.
Published: April 2003

The feasibility of performing hysteroscopic endomyometrial resection using isotonic 2.2% glycine as distension medium was studied in 181 consecutive operations. A standard continuous flow loop-resectoscope was used. Distension was achieved by means of a gravity-fed system and glycine flowed out under its own pressure. The mean (±SEM) glycine deficit was 160 ± 20 ml and in only 7 patients was it >1 liter (maximum 1,800 ml). Only in patients with >1 liter glycine absorption was there a significant decrease in serum sodium level (mean 9 mmol/l), while serum osmolality remained normal. Apart from 1 case of transient nausea, these patients had no sequelae. We experienced isotonic 2.2% glycine as a useful and safe distending medium for operative hysteroscopy.
Maternal Circulating Nitrite Levels Are Decreased in both Normal Normotensive Pregnancies and Pregnancies with Preeclampsia
Authors: Hata Toshiyuki , Hashimoto Michio , Kanenishi Kenji , Akiyama Masashi , Yanagihara Toshihiro , Masumura Sumio
Published: April 2003

Objective: To evaluate whether maternal nitric oxide synthesis in pregnancies with preeclampsia is different from that in normal normotensive pregnancies. Materials: Maternal circulating combined nitrate and nitrite levels or nitrite level were compared between 10 normotensive nonpregnant women, 30 normotensive pregnant women (10 first-trimester, 10 second-trimester, and 10 third-trimester pregnancies), 20 normotensive postpartum women (10 at 1 week after delivery, and 10 at 4 weeks after delivery), and 13 preeclamptic women (32 to 40 weeks’ gestation). End-products of nitric oxide synthesis were measured from maternal venous blood samples using a fluorometric assay. Results: Maternal circulating nitrite levels in nonpregnant women (1.13 ± 0.22 μM) were significantly higher than those in the first-trimester pregnant women (0.68 ± 0.13 μM), second-trimester pregnant women (0.65 ± 0.13 μM), third-trimester pregnant women (0.48 ± 0.17 μM), first puerperal week women (0.36 ± 0.16 μM), and fourth puerperal week women (0.67 ± 0.17 μM), respectively (p < 0.05). Maternal circulating nitrite level was decreased with advancing gestation, still remained low just after delivery, and was increased 4 weeks later. There was no significant difference in maternal circulating nitrite level between preeclamptic women (0.40 ± 0.17 μM) and third-trimester pregnant women (0.48 ± 0.17 μM). However, there were no significant differences in maternal circulating combined nitrate and nitrite levels among the gorups. Conclusion: These results suggest that the maternal nitric oxide synthesis is not changed in normal normotensive pregnancies and pregnancies with preeclampsia. However, plasma nitrite level, which has stronger spasmolytic activity than the activity of the nitrate, was decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.
Ploidy Analysis and S-Phase Fraction Determination by Flow Cytometry in Anembryonic Pregnancy and Spontaneous Abortions
Authors: Özeren Mehmet , Aydemir Vedat , Tekelioglu Yavuz , Topcuoglu Kenan , Bozkaya Hasan
Published: April 2003

The nuclear DNA content of 20 anembryonic pregnancies was studied by flow cytometry from paraffin embedded tissue blocks. An abnormal amount of DNA content was found in 8 of the cases. This was a significantly higher percentage than encountered in spontaneous abortions studied by the same population (40 and 9%, respectively, p < 0.05). The S-phase fraction in anembryonic pregnancies was lower than in spontaneous abortions (22.4 ± 12.7 and 35.4 ± 6.8, respectively, p < 0.01). The results indicated that abnormal embryogenesis with grave chromosomal aberrations may play a major role in the etiology of anembryonic pregnancy.
Comparative Study of Cervical Laminar Tents prior to Extra-Amniotic Injection of Ethacridine Lactate (Rivanol) and a Condom-Nelathon Catheter Method for Second-Trimester Pregnancy Interruption in Vietnam
Authors: Järnbert Arne , Klang Bengt , Vinh Nguyen Thi , Ham Nguyen Ngoc
Published: April 2003

Objective: To determine whether the regimen for termination of second-trimester pregnancies using laminaria tents 12–24 h prior to extra-amniotic ethacridine lactate (Rivanol) instillation, is more effective in shortening the insertion-expulsion interval than the presently used method of abortion induction by a condom/Nelathon catheter. Design: A prospective randomised comparative study was performed at Uong Bi General Hospital in Quang Ninh Province, Vietnam, on 91 women undergoing pregnancy termination in the second trimester. Interventions: The subjects were randomly allocated to 2 treatment groups, receiving either the Nelathon catheter-condom method (n = 50) or by insertion of a laminaria tent into the cervical canal for preinduction, 13–29 h before extra-amniotic instillation of ethacridine lactate (n = 34). Seven subjects were not pretreated with the laminaria tent. Main Outcome Measures: The insertion-expulsion intervals and the incidence of side effects were assessed. Results: The mean insertion-expulsion interval in the 2 groups was not significantly different (mean 27.5 ± 16.1 and 26.4 ± 16.4 h, respectively), calculating the insertion-expulsion interval from the start of active treatment, i.e. from the instillation of Rivanol or insertion of the Nelathon catheter and condom, until expulsion of the fetus. Conclusions: The laminaria-Rivanol method for pregnancy interruption is not more advantageous than the existing Nelathon catheter-condom method. Simple, successful and cost-effective methods in achieving second-trimester abortion in the Vietnamese context have therefore to be identified and tested.
Serum Leptin Profiles in the Normal Menstrual Cycles and Gonadotropin Treatment Cycles
Authors: Yamada Masayo , Irahara Minoru , Tezuka Michiko , Murakami Takashi , Shima Kenji , Aono Toshihiro
Published: April 2003

Circulating levels of leptin, estradiol (E2) and progesterone (P4) throughout normal menstrual cycles (n = 13), and controlled, stimulated cycles (n = 33) were examined using sensitive specific radioimmunoassays in order to investigate the relationships between sex hormones (E2, P4). Serum leptin levels during the normal menstrual cycle remained constant. However, in the ovulation induction cycle, E2 levels and circulating leptin levels increased in parallel with the process of stimulation. In addition, leptin/body mass index ratios for all samples were significantly correlated with log10E2. We conclude that particularly high levels of E2 may have an effect on the secretion of leptin from adipose tissue.
Clinical Significance of c-met Oncogene Alterations in Human Colorectal Cancer
Authors: Umeki Kensuke , Shiota Goshi , Kawasaki Hironaka
Published: April 2003

Abnormalities of the c-met oncogene have been studied in cancers of many organs including thyroid, lung, pancreas, and stomach. However, little is known about the clinical significance of c-met oncogene abnormalities in colorectal cancer. We investigated the amplification and overexpression of the c-met gene in surgically resected samples from 43 patients with colorectal cancer using Southern blot analysis and reverse transcription-polymerase chain reaction (RT-PCR). Four of 33 (12%) samples of colorectal cancer showed amplification of the c-met gene. Twelve of 43 (30%) exhibited overexpression of the c-met gene. The patients with c-met overexpression showed greater tumor size, compared to those without c-met overexpression (p < 0.05). However, there were no differences in clinical stage, histological differentiation, tumor markers, or overall survival between two groups. The findings of the present study suggest that overexpression of c-met gene plays an important role in growth of colorectal cancer.
Extrahepatic Hodgkin’s Disease with Intrahepatic Cholestasis: Report of Two Cases
Authors: Yalçın Şuayib , Kars Ayşe , Sökmensüer Cenk , Atahan Lale
Published: April 2003

Liver is involved in about 5–8% of newly diagnosed Hodgkin’s disease (HD) cases. The incidence reaches up to 50–60% in postmortem studies. In the literature only a few cases of idiopathic cholestatic jaundice have been described without an apparent cause and a paraneoplastic etiology has been suggested. We report 2 cases with HD presenting with obstructive jaundice without obvious liver involvement. The first case died soon after diagnosis; the second case received chemotherapy and radiotherapy, and she is well at 26 months’ follow-up. Extrahepatic HD with intrahepatic cholestasis is an extremely rare situation without an established approach. Such cases like the present ones may help to understand the pathogenesis of the liver involvement of HD and determine the best management of these cases.
Detection of Transforming Growth Factor-α in the Serum of Gastric Carcinoma Patients
Authors: Choi Jin-Hyuk , Kim Hugh Chul , Lim Ho-Yeong , Nam Dong Ki , Kim Hyun Soo , Yi Sun Young , Shim Kang-Sup , Han Woon Sup
Published: April 2003

Transforming growth factor-α (TGF-α) is a ligand for epidermal growth factor receptor (EGFR) and it is overexpressed in various malignancies including lung, esophageal, colorectal, ovarian and gastric carcinomas. In patients with gastric carcinoma, its overexpression may be associated with advanced stage or poor prognosis. We have recently demonstrated that the mean serum level for EGFR in gastric carcinoma patients was significantly elevated compared with that of healthy controls. Using the enzyme-linked immunosorbent assay, the levels of TGF-α were determined in serum from 40 patients with gastric carcinoma (5 patients with stage I, 2 stage II, 4 stage III, and 29 stage IV patients) and 33 healthy controls. The mean serum level for TGF-α in the gastric carcinoma patients was significantly elevated as compared with that of healthy controls (104 ± 235 vs. 22 ± 16 pg/ml; p = 0.03). Eleven patients with gastric carcinoma (27.5%) showed elevated serum TGF-α levels above the cutoff value of 54 pg/ml (defined as 2 standard deviations above the mean of the control group). No significant association was noted between the positivity of TGF-α and clinicopathologic characteristics including gender, age and stage. However, poorly differentiated adenocarcinoma showed a higher positivity of serum TGF-α (43.8%) compared with other histologic types, which was marginally significant (p = 0.06). These results suggest that serum TGF-α could be useful as a tumor marker of gastric carcinoma for predicting prognosis and follow-up after surgery in patients whose initial serum TGF-α levels are elevated.
Analysis of Prognostic and Survival Factors Related to Treatment of Low-Grade Astrocytomas in Adults
Authors: Nakamura Mitsutoshi , Konishi Noboru , Tsunoda Shigeru , Nakase Hiroyuki , Tsuzuki Toshihide , Aoki Hideo , Sakitani Hiroyuki , Inui Takuo , Sakaki Toshisuke
Published: April 2003

Prognostic factors for low-grade astrocytomas have been proposed, but optimal treatment remains controversial. Eighty-eight consecutive adult patients with supratentorial low-grade astrocytomas were retrospectively reviewed to determine specific factors influencing outcome. All underwent craniotomy (43 radical resections, 45 nonradical resections). Sex, age at diagnosis, preoperative Karnofsky performance status (KPS), tumor location, estimated extent of resection, radiation, chemotherapy, histological type, p53 status, MIB-1 staining and the apoptotic index were assessed as parameters for prognostic significance. KPS (p = 0.03), tumor location (p < 0.001), extent of surgical resection (p < 0.001) and radiotherapy (p = 0.01) were significantly assoicated with longer survival rates by univariate analysis. Multivariate analysis also showed a significant correlation between radiation therapy after surgical removal and survival time (p < 0.001). p53 status was not of importance in determining the necessity for radiotherapy. Radical surgical removal is the most important factor in the management of low-grade astrocytomas. Radiation therapy appears to be effective in improving the prognosis regardless of the extent of surgical resection or the p53 status.
Loss of p27KIP1 Expression Predicts Poor Prognosis in Patients with Esophageal Squamous Cell Carcinoma
Authors: Shamma Awad , Doki Yuichiro , Tsujinaka Toshimasa , Shiozaki Hitoshi , Inoue Masatoshi , Yano Masahiko , Kawanishi Kensyu , Monden Morito
Published: April 2003

Immunohistochemical studies of cell cycle-regulating proteins were conducted on tissue samples from 106 patients with esophageal squamous cell carcinoma. Reduction of p27KIP1 was observed in 41 (39%) cases and was significantly associated with a poor prognosis by univariate and multivariate analyses (p = 0.015). In contrast, p16INK4 expression was reduced in 55 (52%) of the cases and was not correlated with prognosis. p27KIP1 was not correlated with the PCNA index, while p16INK4 expression was inversely correlated with the PCNA index (p = 0.01). The expression of these two proteins was not correlated with the clinicopathological parameters of the patients. Nodal status was shown by univariate analysis (p = 0.01) to be a prognostic factor, and poorly differentiated tumors were significantly associated with a poor prognosis by multivariate analysis (p = 0.027). Thus, reduction of p27KIP1 plays an important role in the progression of esophageal squamous cell carcinomas and is considered to be an independent prognostic indicator of this disease.
The Intermediary Metabolism of the Prostate: A Key to Understanding the Pathogenesis and Progression of Prostate Malignancy
Authors: Costello L.C. , Franklin R.B.
Published: April 2003

This review emphasizes the importance and role of altered intermediary metabolism of prostate cells in the pathogenesis of prostate adenocarcinoma (PCa) and the progression of malignancy. The focus of the presentation is a summary of the overwhelming evidence which implicates the metabolic transformation of citrate-producing sane cells to citrate-oxidizing malignant cells in the process of malignancy. The evidence now demonstrates that altered zinc accumulation is an important factor in this transformation. These metabolic relationships are uniquely different from the metabolic alterations associated with tumorigenesis of other mammalian cells. The metabolic transformation of zinc-accumulating citrate-producing normal prostate epithelial cells to citrate-oxidizing malignant cells has important implications on cellular bioenergetics, cell growth and apoptosis, lipogenesis, angiogenesis. Based on the metabolic considerations new concepts concerning the pathogenesis, diagnosis and treatment of prostate malignancy are presented. Unfortunately the metabolism of the prostate has been a seriously neglected and largely ignored area of prostate research. The importance of expanded research into the intermediary metabolism of normal and neoplastic prostate is essential to future significant advances in understanding and dealing with PCa.
Psychological Features of Acromegaly
Authors: Furman Keli , Ezzat Shereen
Published: April 2003

Acromegaly is a serious but often undiagnosed condition that is often unrecognized for many years. The delay from onset of symptoms until the time of diagnosis results in a unique constellation of physical and mental problems for patients and health care professionals. The purpose of this chapter is to identify the psychological consequences experienced by individuals affected with pituitary tumors which alter growth hormone release. As little research has been completed on the subject, very little is known, or has been applied, in the treatment of these patients. To identify the presence of psychological features, the research which exists and an in-depth qualitative analysis of the personal experience of one of the authors (K.F.), having suffered a pituitary macroadenoma with accompanying acromegaly, is described. Our findings are compared with those from an earlier series and the few published reports.
Quality of Life and Cognitive Function in Patients with Pituitary Insufficiency
Authors: Burman Pia , Deijen Jan Berend
Published: April 2003

This review is concerned with the psychosocial functioning and the quality of life in patients with pituitary insufficiency who are receiving conventional hormone replacement therapy. The possible negative effects of pituitary surgery, treatment with irradiation, and suboptimal replacement regimens with hormones other than growth hormone on mood, behaviour and cognitive functioning are discussed. The influence of growth hormone deficiency per se, and the outcome of growth hormone therapy in adult patients are addressed in detail. A possible mechanism for a direct effect of growth hormone on the brain is presented.
Psychiatric Syndromes in Persian Gulf War Veterans: An Association of Handling Dead Bodies with Somatoform Disorders
Authors: Labbate Lawrence A. , Cardeña Etzel , Dimitreva Juliette , Roy Michael , Engel Charles C.
Published: April 2003

Background: Traumatic combat experience has been associated with the development of posttraumatic stress disorder, but there have been few studies about the association of military combat experience and the development of somatoform disorders. Methods: The authors evaluated 131 referred Gulf War veterans for medical and psychiatric syndromes thought related to their involvement in the Gulf War. Patients completed questionnaires regarding their traumatic experiences and were interviewed using the Structured Clinical Interview for DSM III-R. Results: For the sample, 69% had axis I conditions. Major depression, undifferentiated somatoform and posttraumatic stress disorders were the most common diagnoses. Reports of traumatic events were associated with both posttraumatic stress disorder (p < 0.05) and somatoform diagnoses (p < 0.05). Veterans who handled dead bodies had a 3-fold risk of receiving a somatoform diagnosis (p < 0.05). Conclusions: Psychiatric syndromes may explain some medical complaints following involvement in the Persian Gulf War. The results suggest that some psychological and nonspecific somatic symptoms persisting since the Gulf War may be related to exposure to psychological trauma.
Raising Questions about Antidepressants
Authors: Antonuccio David O. , Danton William G. , DeNelsky Garland Y. , Greenberg RogerP. , Gordon James S.
Published: April 2003

Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the ‘true’ antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.