bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of gross anatomy, microscopic anatomy, neuroscience, and embryology courses in medical school curricula in the United States
Authors: Drake Richard L. , Lowrie D.J. , Prewitt Chantal M.
Published: October 2004

Directors of courses in the basic anatomical sciences in allopathic and osteopathic medical schools in the United States were surveyed regarding the present composition of their courses. Results indicate the majority of gross anatomy courses are in the range of 126 to 200 total course hours, and that laboratory dissection is a key component of these courses. The majority of microscopic anatomy courses are in the range of 61 to 100 total course hours, generally divided equally between lecture and laboratory components. Additionally, despite the availability of computer technology, microscopes are still used in the vast majority of microscopic anatomy courses. The majority of neuroscience courses are in the range of 71 to 90 total course hours, with most of these hours devoted to lectures. Embryology is usually taught in conjunction with gross anatomy, although some schools present it with the microscopic anatomy course or as a separate course. Most embryology courses are in the range of 6 to 20 total course hours, with only a few having a laboratory component. Anat Rec (New Anat) 269:118–122, 2002. © 2002 Wiley‐Liss, Inc.
S100P expression in human esophageal epithelial cells: Human esophageal epithelial cells sequentially produce different S100 proteins in the process of differentiation
Authors: Sato Nobuyuki , Hitomi Jiro
Published: October 2004

Extracellular calcium ions (Ca2+) are important in regulating the differentiation of keratinocytes and squamous epithelial cells. To clarify the mechanisms involved in the differentiation of human esophageal epithelial cells (EECs), we used the primary culture of human EECs, which can be differentiated by increasing the concentration of extracellular Ca2+, and tried to reveal the extracellular Ca2+ inducible genes using a differential display (DD) method. We found that the calcium‐binding protein S100P showed a Ca2+‐inducible expression in the EECs. Our immunohistochemical study demonstrated that differentiated large EECs expressing S100P overlie immature proliferating cells which lack S100P immunoreactivity. S100P was detected in vivo in the suprabasal layers of the epithelium. These findings indicate that S100P expression is closely associated with differentiation of human EECs. We also investigated the expression of other S100 proteins, including S100A2, S100A6, and CAAF1 (S100A12), in human EECs. Most of the immature EECs were positive for S100A2 and S100A6, whereas the S100A12‐producing cells were similar to the S100P‐producing cells. In vivo, S100A12 was strongly detected on all epithelial cells except for basal and proliferating cells. S100A2 was detected on all of the epithelial cells. S100A6 was preferentially seen in the cells of basal layers. These findings suggest that within EECs S100 proteins might play important roles in cell differentiation during specific stages. Among them, S100P expression is unique in that this protein is transiently expressed during the early stage of differentiation. Anat Rec 267:60–69, 2002. © 2002 Wiley‐Liss, Inc.
Cellular changes in experimental left heart hypoplasia
Authors: Sedmera David , Hu Norman , Weiss Karen M. , Keller Bradley B. , Denslow Stewart , Thompson Robert P.
Published: October 2004

Hypoplastic left heart syndrome (HLHS) is a rare but deadly congenital malformation, which can be created experimentally in the chick embryo by left atrial ligation (LAL). The goal of this study was to examine the cellular changes leading to the profound remodeling of ventricular myocardial architecture that occurs in this model. Hypoplasia of left heart structures was produced after 3H‐thymidine prelabeling by partial LAL at stage 24, thereby reducing its volume, and redistributing blood preferentially to the developing right ventricle (RV). Controls included both sham‐operated and intact stage‐matched embryos. Survivors were studied 4 days after the ligation, when the heart organogenesis was essentially complete. Paraffin sections of the hearts were subjected to autoradiography and immunohistochemistry to detect changes in history of cell proliferation and expression of myosin, and growth factors implicated in cardiomyocyte proliferation. Sampling for apoptosis detection using TUNEL assay was done at stages 29 and 34. LAL resulted in decreased levels of proliferation in the left ventricular compact layer and trabeculae. The right ventricular compact layer also showed a slight decrease, but the trabeculae showed no differences. Anti‐myosin staining was significantly reduced in all compartments. The expression levels of growth factors were altered as well. Apoptosis was increased in the right atrioventricular mesenchyme, with no changes in the working myocardium. These data suggest that changes in cardiomyocyte proliferation play a significant role in the pathogenesis of HLHS. Anat Rec 267:137–145, 2002. © 2002 Wiley‐Liss, Inc.
GAPs in Slit‐Robo signaling
Authors: Ghose Aurnab , Van Vactor David
Published: October 2004

Neuronal migration requires the integration of a number of diverse environmental cues and subsequent translation to specific responses such as directed cytoskeletal remodeling. Accurate knowledge of the signal transduction pathways linking activation of surface receptors to actin dynamics is necessary in order to understand the regulation of such processes. Activation of the Roundabout (Robo) receptor mediates a repulsive response in certain pioneering axons and migratory neurons. Recently, Wong et al.1 have described a signaling link between Robo activation and specific GTPase activity that appears to regulate neuronal migration. A novel family of GTPase regulators, responsive to Slit‐Robo engagement, has been identified and convincingly shown to alter the migration of neuronal cells. This study not only delineates a specific signaling route from guidance receptors to directed neuronal movement, but also offers clues towards potential regulatory mechanisms that ensure specificity of the Slit‐Robo response. BioEssays 24:401–404, 2002. © 2002 Wiley Periodicals, Inc.
Building the house around the plumbing*
Authors: Weinstein Brant
Published: October 2004

Signaling between growing blood vessels and the tissues that they innervate has traditionally been viewed as a one‐way conversation, with organs and tissues supplying important cues for the growth and anatomical patterning of the blood vessels supplying them, but not vice‐versa. Two recent papers1,2 now provide evidence that blood vessels can have an important role in promoting the assembly of organs and tissues. These papers show that proper formation of the pancreas1 and liver2 and induction of endocrine and hepatic cell types in these endodermal organs requires inductive signals from blood vessels. BioEssays 24:397–400, 2002. Published 2002 Wiley Periodicals, Inc.
Spectroscopic study on structure of horseradish peroxidase in water and dimethyl sulfoxide mixture
Authors: Maeda Yasushi , Fujihara Maki , Ikeda Isao
Published: October 2004

The structure of horseradish peroxidase (HRP) in phosphate buffered saline (PBS)/dimethyl sulfoxide (DMSO) mixed solvents at different compositions is investigated by IR, electronic absorption, and fluorescence spectroscopies. The fluorescence spectra and the amide I spectra of ferric HRP [HRP(Fe3+)] show that overall structural changes are relatively small up to 60% DMSO. Although the amide I band of HRP(Fe3+) shows a gradual change in the secondary structure and a decrease in the contents of α helices, its fluorescence spectra indicate that the distance between the heme and Trp173 is almost constant. In contrast, the changes in the positions of the Soret bands for resting HRP(Fe3+) and catalytic intermediates (compounds I and II) and the IR spectra at the CO stretching vibration mode of carbonyl ferrous HRP [HRP(Fe2+)‐CO] show that the microenvironment in the distal heme pocket is altered, even with low DMSO contents. The large reduction of the catalytic activity of HRP even at low DMSO contents can be attributed to the structural transition in the distal heme pocket. In PBS/DMSO mixtures containing more than 70 vol % DMSO, HRP undergoes large structural changes, including a large loss of the secondary structure and a dissociation of the heme from the apoprotein. The presence of the components of the amide I band that can be assigned to strongly hydrogen bonding amide CO groups at 1616 and 1684 cm−1 suggests that the denatured HRP may aggregate through strong hydrogen bonds. © 2002 John Wiley & Sons, Inc. Biopolymers (Biospectroscopy) 67: 107–112, 2002
Conformational preferences of substituted prolines in the collagen triple helix
Authors: Mooney Sean D. , Kollman Peter A. , Klein Teri E.
Published: October 2004

Researchers have recently questioned the role hydroxylated prolines play in stabilizing the collagen triple helix. To address these issues, we have developed new molecular mechanics parameters for the simulation of peptides containing 4(R)‐fluoroproline (Flp), 4(R)‐hydroxyproline (Hyp), and 4(R)‐aminoproline (Amp). Simulations of peptides based on these parameters can be used to determine the components that stabilize hydroxyproline over proline in the triple helix. The dihedrals F–C–C–N, O–C–C–N, and N–C–C–N were built using a N‐β‐ethyl amide model. One nanosecond simulations were performed on the trimers [(Pro–Pro–Gly)10]3, [(Pro–Hyp–Gly)10]3, [(Pro–Amp–Gly)10]3, [(Pro–Amp1+–Gly)10]3, and [(Pro–Flp–Gly)10]3 in explicit solvent. The results of our simulations suggest that pyrrolidine ring conformation is mediated by the strength of the gauche effect and classical electrostatic interactions. © 2002 Wiley Periodicals, Inc. Biopolymers 64: 63–71, 2002
Determination of intermolecular distance for a model peptide of Bombyx mori silk fibroin, GAGAG, with rotational echo double resonance
Authors: Kameda Tsunenori , Nakazawa Yasumoto , Kazuhara Junko , Yamane Tsutomu , Asakura Tetsuo
Published: October 2004

Rotational echo double resonance NMR spectroscopy is applied for the determination of the distance of intermolecular chains of pentapeptide, GAGAG (G: Gly, A: Ala), a model typical of the crystalline domain in Bombyx mori silk fibroin. 1:4 mixture of G[1‐13C]AGAG and GAG[15N]AG with antiparallel β‐sheet structure was used to determine the distance of intermolecular hydrogen bonding between adjacent molecules within pleated sheet and the 13C–15N interatomic distance was determined to be 4.3 Å. On the other hand, 1:4 mixture of GAG[1‐13C]AG and GAG[15N]AG gave information on the interpleated sheet arrangement. When we assumed the same distances between two interpleated sheets, the distance was calculated to be 5.3 Å and the angle 15N–13C–15N was 180°. © 2002 Wiley Periodicals, Inc. Biopolymers 64: 80–85, 2002
A novel model of solute transport in a hollow‐fiber bioartificial pancreas based on a finite element method
Authors: Dulong Jean‐Luc , Legallais Cécile , Darquy Sylviane , Reach Gérard
Published: October 2004

Extravascular bioartificial pancreas based on hollow fiber seems to be a promising treatment of diabetes mellitus. However, solutes mass‐transport limitations in such a device could explain its lack of success. To determine critical device parameters, we have developed a novel tridimensional model based on finite element method for glucose, insulin, and oxygen diffusion around an islet of Langerhans encapsulated in a hollow‐fiber section. A glucose ramp stimulation was applied outside the fiber and diffused to the islet. Concomitantly, a stationary oxygen partial pressure was applied outside the fiber, and determined local oxygen partial pressure on the islet environment. An insulin secretion model stimulated by a glucose concentration ramp and corrected by the local oxygen partial pressure was also implemented. Insulin secretion by the islet was thus computed as a response to glucose signal. The model predictions notably showed that the fiber radius had to be small enough to favor a fast response for insulin secretion and to ensure a maximal oxygen partial pressure in the islet environment. Besides the effect of fiber radius, a better islet oxygenation could be achieved by adjustments on the islet density, i.e., on the fiber length dedicated to a single islet. These hints should allow the future proposal of an optimal design for an implantable bioartificial pancreas. © 2002 Wiley Periodicals, Inc. Biotechnol Bioeng 78: 576–582, 2002.
Penicillin acylase‐catalyzed ampicillin synthesis using a pH gradient: A new approach to optimization
Authors: Youshko Maxim I. , van Langen Luuk M. , de Vroom Erik , van Rantwijk Fred , Sheldon Roger A. , Švedas Vytas K.
Published: October 2004

The penicillin acylase‐catalyzed synthesis of ampicillin by acyl transfer from D‐(–)‐phenylglycine amide (D‐PGA) to 6‐aminopenicillanic acid (6‐APA) becomes more effective when a judiciously chosen pH gradient is applied in the course of the process. This reaction concept is based on two experimental observations: 1) The ratio of the initial synthesis and hydrolysis rates (VS/VH) is pH‐dependent and exhibits a maximum at pH 6.5–7.0 for a saturated solution of 6‐APA; 2) at a fixed 6‐APA concentration below saturation, VS/VH increases with decreasing pH. Optimum synthetic efficiency could, therefore, be achieved by starting with a concentrated 6‐APA solution at pH 7 and gradually decreasing the pH to 6.3 in the course of 6‐APA consumption. A conversion of 96% of 6‐APA and 71% of D‐PGA into ampicillin was accomplished in an optimized procedure, which significantly exceeds the efficiency of enzymatic synthesis performed at a constant pH of either 7.0 or 6.3. © 2002 Wiley Periodicals, Inc. Biotechnol Bioeng 78: 589–593, 2002.
Effects of oxygen on engineered cardiac muscle
Authors: Carrier Rebecca L. , Rupnick Maria , Langer Robert , Schoen Frederick J. , Freed Lisa E. , Vunjak‐Novakovic Gordana
Published: October 2004

Concentration gradients associated with the in vitro cultivation of engineered tissues that are vascularized in vivo result in the formation of only a thin peripheral tissue‐like region (e.g., ∼100 μm for engineered cardiac muscle) around a relatively cell‐free interior. We previously demonstrated that diffusional gradients within engineered cardiac constructs can be minimized by direct perfusion of culture medium through the construct. In the present study, we measured the effects of medium perfusion rate and local oxygen concentration (p) on the in vitro reconstruction of engineered cardiac muscle. Neonatal rat cardiomyocytes were seeded onto biodegradable polymer scaffolds (fibrous discs, 1.1 cm diameter × 2 mm thick, made of polyglycolic acid, 24 × 106 cells per scaffold). The resulting cell‐polymer constructs were cultured for a total of 12 days in serially connected cartridges (n = 1–8), each containing one construct directly perfused with culture medium at a flow rate of 0.2–3.0 mL/min. In all groups, oxygen concentration decreased due to cell respiration, and depended on construct position in the series and medium flow rate. Higher perfusion rates and higher p correlated with more aerobic cell metabolism, and higher DNA and protein contents. Constructs cultured at p of 160 mm Hg had 50% higher DNA and protein contents, markedly higher expression of sarcomeric α‐actin, better organized sarcomeres and cell junctions, and 4.5‐fold higher rate of cell respiration as compared to constructs cultured at p of 60 mm Hg. Contraction rates of the corresponding cardiac cell monolayers were 40% higher at p of 160 than 60 mm Hg. The control of oxygen concentration in cell microenvironment can thus improve the structure and function of engineered cardiac muscle. Experiments of this kind can form a basis for controlled studies of the effects of oxygen on the in vitro development of engineered tissues. © 2002 Wiley Periodicals, Inc. Biotechnol Bioeng 78: 617–625, 2002.
Hybrid neural network modeling of a full‐scale industrial wastewater treatment process
Authors: Lee Dae Sung , Jeon Che Ok , Park Jong Moon , Chang Kun Soo
Published: October 2004

In recent years, hybrid neural network approaches, which combine mechanistic and neural network models, have received considerable attention. These approaches are potentially very efficient for obtaining more accurate predictions of process dynamics by combining mechanistic and neural network models in such a way that the neural network model properly accounts for unknown and nonlinear parts of the mechanistic model. In this work, a full‐scale coke‐plant wastewater treatment process was chosen as a model system. Initially, a process data analysis was performed on the actual operational data by using principal component analysis. Next, a simplified mechanistic model and a neural network model were developed based on the specific process knowledge and the operational data of the coke‐plant wastewater treatment process, respectively. Finally, the neural network was incorporated into the mechanistic model in both parallel and serial configurations. Simulation results showed that the parallel hybrid modeling approach achieved much more accurate predictions with good extrapolation properties as compared with the other modeling approaches even in the case of process upset caused by, for example, shock loading of toxic compounds. These results indicate that the parallel hybrid neural modeling approach is a useful tool for accurate and cost‐effective modeling of biochemical processes, in the absence of other reasonably accurate process models. © 2002 Wiley Periodicals, Inc. Biotechnol Bioeng 78: 670–682, 2002.
Danger of damaging the medial branches of the posterior rami of spinal nerves during a dorsomedian approach to the spine
Authors: Boelderl A. , Daniaux H. , Kathrein A. , Maurer H.
Published: October 2004

Postoperative atrophy of the deep back muscles may be caused by denervation during a dorsomedian approach to the thoracolumbar spine; ensuing instability of the spine with poor clinical results, perhaps due to such muscle loss, has been observed in 11.7% of cases (Sihvonen et al., 1993, Spine 18:575–581). More specifically, this complication may be caused by damaging the medial branches of the posterior rami of the spinal nerves during lateral retraction of the muscles. To investigate the anatomic topography of the medial branches of the posterior rami of the spinal nerves, 18 carbol‐formol‐fixed specimens were dissected using an operation microscope; also, 3 fresh cadavers were cut in horizontal and vertical planes with a rotary cryotome to confirm the anatomic topography observed in the fixed specimens. In the thoracolumbar spine the medial branch of the posterior ramus of the spinal nerve is subject to ligamentous fixation by the strong fibers of the mammillo‐accessory ligament, which extends between the mammillary process and accessory process infero lateral to the superior articular process. When the dorsomedian approach to the thoracolumbar spine is enlarged laterally to the articular processes by retracting the paraspinous muscles, the medial branches of the posterior rami of the spinal nerves are endangered. This may cause postoperative pain as well as dynamic instability beyond the corresponding segments. The results of our anatomic study suggest that the posterior surgical midline approach to the thoracolumbar spine should not be enlarged laterally to the articular processes to prevent injury to the medial branches of the posterior rami of the spinal nerves. Clin. Anat. 15:77–81, 2002. © 2002 Wiley‐Liss, Inc.
Measuring movement at the low back
Authors: Rice J. , Walsh M. , Jenkinson A. , O'Brien T.M.
Published: October 2004

The clinical importance of movements of the human spine is increasingly being realized but their measurement is difficult to carry out. Traditionally, measurement of spinal motion focuses on the lumbar spine as the mobile region and movement at the lower thoracic spine is largely ignored. The aim of this study was to test the hypothesis that sagittal movement at the low back is not confined to the lumbar spine. The range of sagittal movement and the amount of skin distraction during trunk flexion was studied in 10 normal subjects. Angular movement in the sagittal plane between the vertebra prominens and S2 ranged between 40° and 83° among the subjects. Concomitant skin distraction showed that a mean of 32% (range 20–41%) of the movement between the upper thorax and sacropelvis occurred cranial to T12. We therefore suggest that the term “low back” should be applied to a series of mobile vertebrae in the lower thoracic and lumbar spines and that motion of this region in the sagittal plane should be considered as the movement of an immobile upper thoracic spine relative to the sacropelvis. Clin. Anat. 15:88–92, 2002. © 2002 Wiley‐Liss, Inc.
Morphometric analyses of the mandible in prepubertal craniofacial microsomia patients treated with an inverted‐L osteotomy
Authors: Cerajewska Tanya L. , Singh G.D.
Published: October 2004

To analyze changes in mandibular form associated with an inverted‐L osteotomy and autogenous bone graft, preoperative, early postoperative (EPO), and late postoperative (LPO) lateral cephalographs of 14 children (mean age ≈9 years) with unilateral craniofacial microsomia (CFM) were scanned and nine mandibular landmarks digitized. Average mandibular geometries, scaled to an equivalent size, were generated using Procrustes superimposition. Cephalometry, Euclidean distance matrix analysis (EDMA), and thin‐plate spline (TPS) analyses were carried out on mean mandibular configurations. Cephalometric results showed increases in oblique mandibular length (≈9% on average, P < 0.05) and increased ramus height (P < 0.05). Similarly, using EDMA there were also significant differences (P < 0.05) between the mean preoperative, EPO, and LPO configurations. The most demonstrable EPO change in the mandibular configuration using EDMA was increased oblique length (≈11%). This improvement depended on ramus oblique lengths increasing by ≈26%, ramus height increasing by ≈25%, and mandibular body length increasing by ≈5%. For TPS analysis, affine and nonaffine changes contributed to the total spline. In all three comparisons the affine transformation showed an antero–inferior rotation of the mandibular configuration. For nonaffine changes the EPO configuration indicated a supero–inferior stretch of the mandibular configuration. The nonaffine LPO changes maintained the supero–inferior stretch of the mandibular configuration. It is concluded that improvements in the lateral facial profile of CFM patients can be achieved using an inverted‐L osteotomy, with little relapse ≈2 years postoperatively. Clin. Anat. 15:100–107, 2002. © 2002 Wiley‐Liss, Inc.
Posterior dislocation of the sternoclavicular joint: A case report and review of the clinical anatomy of the region
Authors: Rajaratnam S. , Kerins M. , Apthorp L.
Published: October 2004

Posterior dislocation of the sternoclavicular joint is an uncommon injury. Since 1824, when Sir Astley Cooper described the injury, little more than 100 cases have been described, and the majority of these have been in the last decade, identified by computed tomography. The significant morbidity and mortality associated with this injury is based upon serious damage to important anatomical structures found in the vicinity of the joint. We present a case report, describe the relevant clinical anatomy of this region, and review associated complications. Clin. Anat. 15:108–111, 2002. © 2002 Wiley‐Liss, Inc.
Relative positions of the arteries and veins on the dorsolateral surface of the human cerebrum
Authors: Yasutaka Satoru , Kominami Rieko , Taniguchi Yutaka , Shinohara Harumichi
Published: October 2004

We investigated whether arteries pass superficial to veins or whether veins pass superficial to arteries at artery‐vein crossings on the anterior, dorsolateral, and posterior surfaces of the human cerebrum. We examined a total of 2,266 artery‐vein crossings on 40 sides of 20 cadavers. At 2,059 crossings (91%), the vein passed superficial to the artery. Thus, vein (V), artery (A), and nerve (N), if we regard the cerebrum as nerve, were generally arranged in the order VAN from the superficial to the deep layers. This concept is important for a positional understanding of blood vessels on the cerebrum and it is useful for the understanding of fluid‐drainage pathways from the cerebral cortex in various pathological conditions. Clin. Anat. 15:112–115, 2002. © 2002 Wiley‐Liss, Inc.
Martin‐Gruber anastomosis revisited
Authors: Rodriguez‐Niedenführ Marc , Vazquez Teresa , Parkin Ian , Logan Bari , Sañudo José R.
Published: October 2004

Based on a study of 70 human cadavers (31 male, 39 female) and on cases described previously, we propose a new classification of the Martin‐Gruber anastomosis, a neural connection between the median and ulnar nerves in the forearm. The anastomosis was found in 16 (22.9%) cadavers, being bilateral in three (18.7%) and unilateral in 13 (81.3%), five right and eight left. It occurred in eight (25.8%) of the 31 male cadavers and in eight (20.5%) of the 39 females. Therefore, the anastomosis was found in 19 (13.6%) of the 140 forearms. In Pattern I (89.5%) the anastomosis was made by only one branch, whereas in Pattern II (10.5%) it was made by two. The individual branches were classified as Types a, b, and c based on the nature of their origin from the median nerve. Type a (47.3%) arose from the branch to the superficial forearm flexor muscles, Type b (10.6%) from the common trunk, and Type c (31.6%) from the anterior interosseous nerve. Pattern II was a duplication of Type c (10.5%). The anastomotic branch took an oblique or arched course before joining the ulnar nerve, undivided in 15 cases, but divided into two branches in four cases. The anastomosis passed in front of the ulnar artery in four cases, behind it in six, and in nine cases it was related to the anterior ulnar recurrent artery. Clin. Anat. 15:129–134, 2002. © 2002 Wiley‐Liss, Inc.
The relationship between premedical coursework in gross anatomy and histology and medical school performance in gross anatomy and histology
Authors: Forester Joseph P. , McWhorter David L. , Cole Maria S.
Published: October 2004

Many premedical students enroll in courses whose content will be encountered again during their medical education. Presumably, students believe this practice will lead to improved academic performance in corresponding medical school courses. Therefore, this study was undertaken to determine whether a premedical gross anatomy and/or histology course resulted in increased performance in corresponding medical school courses. A second aim of the study was to examine whether the type of premedical gross anatomy and/or histology course differentially affected medical school performance. A survey that assessed premedical gross anatomy and histology coursework was administered to 440 first‐year medical students. The results from this survey showed that students with premedical gross anatomy (n = 236) and/or histology (n = 109) earned significantly more points in the corresponding medical school course than students without the premedical coursework (P < 0.05). Analysis of premedical course types revealed that students who took a gross anatomy course with prosected specimens (n = 35) earned significantly more points that those students without premedical gross anatomy coursework (P < 0.05). The results from this study suggest: 1) premedical gross anatomy and/or histology coursework improves academic performance in corresponding medical school courses, and 2) a premedical gross anatomy course with prosected specimens, a specific type of undergraduate course, significantly improves academic performance in medical gross anatomy. Clin. Anat. 15:160–164, 2002. © 2002 Wiley‐Liss, Inc.
Intra‐aortic balloon pump placement following aorto‐iliac angioplasty and stent placement
Authors: Colyer William R. , Burket Mark W. , Ansel Gary M. , Ramee Stephen R. , Minor Robert L. , Gibson C. Michael , Cooper Christopher J.
Published: October 2004

Approximately 20% of patients are unable to receive an intra‐aortic balloon pump (IABP) due to aorto‐iliac atherosclerotic disease. Aorto‐iliac stenoses can be managed with angioplasty or stent placement; however, there are limited data about this strategy to facilitate IABP placement. Thirty‐seven IABPs were placed in 35 patients. A total of 45 revascularization procedures were performed. With revascularization, the minimal lumen diameter increased from 2.78 ± 1.46 to 6.75 ± 2.36 mm (P < 0.0001). Limb ischemia occurred following 2/37 (5%) IABP insertions. Limb ischemia was managed with IABP removal and angioplasty. The mortality rate was 32%. Mortality was more common with chronic renal insufficiency (8/11, 73%; P = 0.0014), dialysis‐dependent renal failure (3/3, 100%; P = 0.028), and presentation with acute myocardial infarction (8/15 patients, 53%; P = 0.036). Although no patients required vascular surgery for limb ischemia, one patient required surgery for bleeding. Angioplasty or stenting to facilitate IABP placement in patients with peripheral vascular disease is safe and effective. Cathet Cardiovasc Intervent 2002;55:163–168. © 2002 Wiley‐Liss, Inc.
Severe intravascular hemolysis after transcatheter closure of a large patent ductus arteriosus using the Amplatzer duct occluder: Successful resolution by intradevice coil deployment
Authors: Joseph George , Mandalay Asishkumar , Zacharias T.U. , George Biju
Published: October 2004

A 21‐year‐old female developed severe unremitting intravascular hemolysis following closure of a large patent ductus arteriosus using an Amplatzer duct occluder. Percutaneous deployment of fibered platinum coils within the nitinol wire cage of the Amplatzer duct occluder abolished the residual shunt through the device and resulted in cessation of intravascular hemolysis and reversal of its adverse sequelae. Cathet Cardiovasc Intervent 2002;55:245–249. © 2002 Wiley‐Liss, Inc.
Drug‐eluting stents for coronary bifurcations: Insights into the crush technique
Authors: Ormiston John A. , Currie Erin , Webster Mark W.I. , Kay Patrick , Ruygrok Peter N. , Stewart James T. , Padgett Richard C. , Panther Monique J.
Published: October 2004

Sirolimus‐eluting stents appear to reduce substantially restenosis following percutaneous coronary bifurcation intervention. The crush technique was devised to reduce restenosis further by improving stent and drug application to the side‐branch ostium. We aimed to investigate the performance of drug‐eluting stent (DES) platforms with the crush technique, to identify deployment pitfalls, and to clarify the best deployment strategies. Each stage of the crush technique was photographed in a bifurcation phantom. Simultaneous side‐ and main‐branch dilatation (kissing balloons) fully expanded the stent in the side‐branch ostium, widened the gaps between stent struts covering the side branch, and eliminated main‐branch distortion. With side branches angled at > 70°, sequential (side‐ then main‐branch) inflations may be needed to achieve best results. Postdilatation of the main branch with a balloon of narrower diameter than the deploying balloon caused main‐branch stent distortion. These principles applied to all the bifurcation strategies and stent designs tested. Cathet Cardiovasc Interv 2004;63:332–336. © 2004 Wiley‐Liss, Inc.
Combined catheter ventricular septal defect closure and multivessel coronary stenting to treat postmyocardial infarction ventricular septal defect and triple‐vessel coronary artery disease: A case report
Authors: Anantharaman Rajaram , Walsh Kevin P. , Roberts David H.
Published: October 2004

Ventricular septal defect following acute myocardial infarction is a rare but life‐threatening complication. Early surgical closure improves survival but carries a considerable risk. Percutaneous transcatheter closure is an alternative but experience to date is limited. We report a case of successful transcatheter closure of postmyocardial infarction ventricular septal defect (VSD) in a 55‐year‐old male with the Amplatzer muscular VSD occluder device and complete percutaneous revascularization with successful multivessel coronary stenting for three‐vessel disease as a staged procedure. The technique and its potential use as an alternative to surgical approach for treatment of acute myocardial infarction and its complication (VSD) are discussed. Catheter Cardiovasc Interv 2004;63:311‐313 © 2004 Wiley‐Liss Inc.
Hemodynamic abnormalities across an anomalous left main coronary artery assessment: Evidence for a dynamic ostial obstruction
Authors: Lim Michael J. , Forsberg Michael J. , Lee Richard , Kern Morton J.
Published: October 2004

Anomalous left main coronary arteries have been associated with sudden cardiac death, especially when arising from the right coronary cusp and following an anterior course. To date, imaging procedures have been the mainstay of the decision‐making process in determining which patients should undergo surgery for correction of this anomaly and which patients are presumed to be at low risk. We report on the hemodynamic evaluation of an anomalous left main performed in support of elected surgical correction in a young patient. Catheter Cardiovasc Interv 2004;63:294–298. © 2004 Wiley‐Liss, Inc.
The tail of myosin reduces actin filament velocity in the in vitro motility assay
Authors: Guo Bin , Guilford William H.
Published: October 2004

It has been observed that heavy meromyosin (HMM) propels actin filaments to higher velocities than native myosin in the in vitro motility assay, yet the reason for this difference has remained unexplained. Since the major difference between these two proteins is the presence of the tail in native myosin, we tested the hypothesis that unknown interactions between actin and the tail (LMM) slow motility in native myosin. Chymotryptic HMM and LMM were mixed in a range of molar ratios (0–5 LMM/HMM) and compared to native rat skeletal myosin in the in vitro motility assay at 30°C. Increasing proportions of LMM to HMM slowed actin filament velocities, becoming equivalent to native myosin at a ratio of 3 LMM/HMM. NH‐ATPase assays demonstrated that HMM concentrations on the surface were constant and independent of LMM concentration, arguing against a simple displacement mechanism. Relationships between velocity and the number of available heads suggested that the duty cycle of HMM was not altered by the presence of LMM. HMM prepared with a lower chymotrypsin concentration and with very short digestion times moved actin at the same high velocity. The difference between velocities of actin filament propelled by HMM and HMM/LMM decreased with increasing ionic strength, suggesting that ionic bonds between myosin tail and actin filaments may play a role in slowing filament velocity. These data suggest the high velocities of actin filaments over HMM result from the absence of drag generated by the myosin tail, and not from proteolytic nicking of the motor domain. Cell Motil. Cytoskeleton 59:264–272, 2004. © 2004 Wiley‐Liss, Inc.
TNM residual tumor classification revisited
Authors: Wittekind Christian , Compton Carolyn C. , Greene Frederick L. , Sobin Leslie H.
Published: October 2004

BACKGROUND

For cancer patients, prognosis is strongly influenced by the completeness of tumor removal at the time of cancer‐directed surgery or disease remission after nonsurgical treatment with curative intent. These parameters define the relative success of definitive treatment and can be codified by an additional subclassification within the TNM system, the residual tumor (R) classification. Despite the importance of residual tumor status in designing clinical management after treatment, misinterpretation and inconsistent application of the R classification frequently occur that diminish or abrogate its clinical utility.

METHODS

An analysis of the relevant literature regarding the use and prognostic importance of the R classification was undertaken.

RESULTS

In the current study, the prognostic importance of the R classification for different kinds of tumors is discussed. Problems that arise in using the R classification are described. Special issues regarding the use of the R classification are addressed.

CONCLUSIONS

The R classification is a strong indicator of prognosis and facilitates the comparison of treatment results if applied in a consistent manner. Uniform use and interpretation of this classification is essential for the standardization of posttreatment data collection. Cancer 2002;94:2511–9. © 2002 American Cancer Society.

DOI 10.1002/cncr.10492
The prevalence of high‐grade prostatic intraepithelial neoplasia in surgical resection specimens
Authors: Desai Sangeeta B. , Borges Anita M.
Published: October 2004

BACKGROUND

To the authors' knowledge there is a paucity of literature regarding the prevalence of high‐grade prostatic intraepithelial neoplasia (HGPIN) in the Indian subcontinent. The objective of the current study was to document the prevalence of HGPIN in a low‐risk Indian population.

METHODS

A total of 110 prostate specimens (61 taken from the test group and 49 taken from the control group) were studied to document the prevalence of HGPIN in a low‐risk Indian population.

RESULTS

None of the benign prostate samples were found to harbor HGPIN, whereas 85.24% of the samples from malignant prostates did so.

CONCLUSIONS

A strong correlation between HGPIN and invasive carcinoma was observed, a finding that reinforces the view that HGPIN is a strong indicator of concurrent invasive prostate carcinoma. Cancer 2002;94:2350–2. © 2002 American Cancer Society.

DOI 10.1002/cncr.10495
Randomized study of single early instillation of (2″R)‐4′‐O‐tetrahydropyranyl‐doxorubicin for a single superficial bladder carcinoma
Authors: Okamura Kikuo , Ono Yoshinari , Kinukawa Tsunero , Matsuura Osamu , Yamada Shin , Ando Tadashi , Fukatsu Toshiaki , Ohno Yoshiyuki , Ohshima Shinichi
Published: October 2004

BACKGROUND

Although transurethral resection of a bladder tumor (TUR‐Bt) alone has been standard treatment for single superficial bladder carcinoma, some authors reported a certain prophylactic effect of a single immediate intravesical instillation of chemotherapeutic agent after TUR‐Bt. A prospective randomized study was conducted to determine whether a single (2″R)‐4′‐O‐tetrahydropyranyl‐doxorubicin (THP) instillation immediately after TUR‐Bt is beneficial to patients with a single superficial bladder carcinoma.

METHODS

One hundred seventy patients with a single resectable superficial bladder carcinoma (Ta‐1, primary or recurrent with no recurrence during the last 1 year) were enrolled in this study. THP (30 mg/30 mL of normal saline) was administered into the bladder within 6 hours after TUR‐Bt in arm A, while TUR‐Bt alone was done in arm B.

RESULTS

Of the 170 patients, 160 (94.1%) were eligible and were followed up for a median time of 40.8 months. There was a significant difference in the recurrence free curve between the 2 arms (log‐rank test; P = 0.0026), with 92.4% recurrence free rate at 1 year, 82.7% at 2 years, and 78.8% at 3 years in arm A (84 patients) and 67.0%, 55.7%, and 52.6%, respectively, in arm B. The recurrence rate per year was 0.11 ± 0.22 in arm A and 0.24 ± 0.36 in arm B, with a significant difference (P = 0.007). Toxicity included pain with micturition in 9 patients (10.7%), urinary frequency/urgency in 5 patients (6.0%), and macroscopic hematuria in 7 patients (8.3%).

CONCLUSIONS

These data indicate that a single THP instillation immediately after TUR reduces the recurrence of superficial bladder carcinoma. Cancer 2002;94:2363–8. © 2002 American Cancer Society.

DOI 10.1002/cncr.10496
Activation of Stat‐3 as one of the early events in tobacco chewing‐mediated oral carcinogenesis
Authors: Nagpal Jatin K. , Mishra Rajakishore , Das Bibhu R.
Published: October 2004

BACKGROUND

The Jak/Stat signaling pathway transmits signals from many cytokines and growth factor receptors to target genes in the nucleus. Constitutive activation of Stat‐3 recently has been observed in many tumor cells, and dysregulation of the Stat signaling pathway has been proposed to be implicated in malignant transformation. In the current study for the first time to the authors's knowledge, the expression of STAT‐3 was analyzed in various stages and sites of squamous cell carcinoma of the head and neck (HNSCC).

METHODS

Tissue samples from 90 patients of tobacco chewing‐mediated HNSCC representing various stages, sites, and differentiation states were selected for studying STAT‐3 protein and RNA expression. In vivo localization of STAT‐3 was studied by immunohistochemistry of paraffin embedded sections. The presence of STAT‐3 and its phophorylated and activated form pSTAT‐3 was checked by Western blotting. mRNA expression was analyzed by reverse transcriptase‐polymerase chain reaction (RT‐PCR). Apoptosis analysis was conducted by in situ ENA nick end labeling assay and hematoxylin and eosin staining.

RESULTS

Overall, 58.9% of HNSCC tumors showed very high Stat‐3 protein accumulation, and 23.3% showed intermediate accumulation whereas 17.8% of HNSCC tumors were negative for Stat‐3. No Stat‐3 was detected in normal samples, and only one of eight premalignant lesions showed intermediate Stat‐3 accumulation. On immunoblotting, very high protein accumulation was detected in T1 and T2 classification, moderate in T3 and T4 (P = 0.033, chi‐square test), whereas no Stat‐3 was detected in normal samples. Similar trend also was found in Stat‐3 mRNA expression by RT‐PCR analysis which was high in T1 and T2 (early stages), moderate in T3 and T4 (late stages), and no expression in normal samples. The mean apoptotic indices were 1.75, 1.88, and 1.66 for normal, premalignant lesions, and HNSCC cases, respectively.

CONCLUSIONS

Stat‐3 activation is an early event in head and neck carcinogenesis though its role in blocking the apoptosis in vivo in solid tumors was not observed. Cancer 2002;94:2393–400. © 2002 American Cancer Society.

DOI 10.1002/cncr.10499
High frequency of microsatellite instability and loss of mismatch‐repair protein expression in patients with double primary tumors of the endometrium and colorectum
Authors: Planck Maria , Rambech Eva , Möslein Gabriela , Müller Wolfram , Olsson Håkan , Nilbert Mef
Published: October 2004

BACKGROUND

Patients with the familial syndrome hereditary nonpolyposis colorectal carcinoma (HNPCC) exhibit an increased risk for several tumor types, of which the greatest lifetime risk is for colorectal and endometrial carcinoma. HNPCC is caused by a germline mutation in one of several identified mismatch repair (MMR) genes and typically presents with microsatellite instability (MSI) and frequent loss of MMR protein expression in the tumor tissue. The objective of this study was to estimate the proportion of double primary tumors of the endometrium and colorectum that displays tumor characteristics suggestive of MMR deficiency.

METHODS

The authors used the southern Sweden regional population‐based Cancer Registry to identify women who developed double primary tumors of the endometrium and colorectum. Of the 256 women who were diagnosed with carcinoma at both of these sites during the period 1958–1998, 39 women had developed their first tumor before age 50 years. The authors successfully retrieved 67 tumors from 36 of these patients and analyzed them for MSI and immunohistochemical expression of the MMR genes, MLH1, MSH2, and MSH6.

RESULTS

The MSI status of the 67 tumors was high MSI in 37 tumors, low MSI in 13 tumors, and microsatellite stable (MSS) in 17 tumors. Immunohistochemical loss of MMR protein expression was correlated with MSI status and was demonstrated in 29 high MSI tumors, in 1 low MSI tumor, and in 1 MSS tumor. A concordant loss of the same MMR protein in both tumors was found in 12 of 27 patients.

CONCLUSIONS

The authors demonstrated a high frequency of MSI (75%) in tumors from women with endometrial and colorectal carcinoma who had their first tumor diagnosed before age 50 years and observed concordant immunohistochemical loss of MMR protein expression, suggestive of a possible underlying germline mutation, in 12 of 27 patients (44%). They concluded that double primary malignancies of the colorectum and endometrium at a young age should make the clinician suspect HNPCC. Cancer 2002; 94:2502–10. © 2002 American Cancer Society.

DOI 10.1002/cncr.10501
Outcome of suprarenal localized masses diagnosed during the perinatal period
Authors: Sauvat Frederique , Sarnacki Sabine , Brisse Herve , Medioni Jacques , Rubie Herve , Aigrain Yves , Gauthier Frederic , Audry Georges , Helardot Pierre , Landais Paul , Michon Jean , Hartmann Olivier , Nihoul‐Fékété Claire
Published: October 2004

BACKGROUND

The growing use of abdominal ultrasonography during pregnancy and in the postnatal period is leading to the discovery of an increasing number of suprarenal masses. The optimal diagnosis and treatment of these masses has not yet been determined.

METHODS

The authors reviewed the files of patients with suprarenal masses detected prenatally or during the first 3 months of life, between 1986 and 1999, in the pediatric surgery and oncology departments of Paris hospitals.

RESULTS

Thirty masses were detected prenatally and 23 postnatally. In the latter group of patients, the diagnosis was based on ultrasound in 8 cases and on the palpation of a mass in 15 cases, 13 of which were neuroblastoma. At birth, the masses were cystic in 19 cases, solid in 17, and mixed in 13. Sensitivities of methyliodobenzylguanidine and urinary catecholamine assay were 70% and 52% respectively. Surgery was performed in 38 cases with a median age of 42 days. Histologic analysis showed 31 neuroblastomas, 1 adrenal hemorrhage, 2 necrotic masses, 1 bronchogenic cyst, and 3 sequestrations. All the patients were alive and disease free, at a follow‐up ranging from 3 months to 13 years.

CONCLUSIONS

In this series, 58% of the suprarenal masses diagnosed perinatally were localized neuroblastoma with a favorable outcome. All other cases either regressed spontaneously or turned out to be benign lesion. Thus, the management of these masses must strike a compromise between aggressive treatment and a wait‐and‐see attitude. This requires appropriate initial assessment and a close follow‐up in a specialized center. Cancer 2002;94:2474–80. © 2002 American Cancer Society.

DOI 10.1002/cncr.10502