bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystic Partially Differentiated Nephroblastoma
Authors: Tiryaki Tuğrul , Hücümenoğlu Sema , Livanelioğlu Ziya , Atayurt Halil
Published: April 2003

Cystic partially differentiated nephroblastoma is a rare cystic renal neoplasm of infancy. It should be distinguished from solid Wilms’ tumor with cystic change. Nephrectomy with a careful follow-up is the only adequate therapy for grade 1 tumor.
Primary Heterologous Carcinosarcoma of the Ureter with Necrotic Malignant Polyps
Authors: Johnin Kazuyoshi , Kadowaki Takashi , Kushima Mayumi , Ushida Hiroshi , Koizumi Shuichi , Okada Yusaku
Published: April 2003

Carcinosarcoma is a rare and aggressive disease characterized by biphasic neoplasms with distinct mesenchymal and epithelial components. We report a case of ureteral carcinosarcoma with malignant necrotic polyps. The patient was a 58-year-old woman with painless hematuria, who was later diagnosed as having ureteral carcinosarcoma. Three long pendulous polypoid-shape tumors consisting of high-grade transitional cell carcinoma with chondrosarcomatous and osteosarcomatous elements were found. Two months after nephroureterectomy, the tumor relapsed in the bladder. Despite anterior exenteration, the patient died of local recurrence 6 months after her initial visit. To our knowledge, only 10 cases of this disease have been reported in the literature.
Accurate Control of the Superficial and Deep Dorsal Veins during Radical Retropubic Prostatectomy: The Münster Clamp Technique
Authors: Schmid Hans-Peter , Semjonow Axel , Piechota Hans-Jürgen , Hertle Lothar
Published: April 2003

Objective: To better control the superficial and deep dorsal veins during radical retropubic prostatectomy and, thus, to reduce blood loss. Patients and Methods: A surgical technique is described which introduces a modified Babcock clamp to fully encompass all tissue above the prostatic capsule. In a prospective protocol, 30 consecutive patients (median age 64.5, range 57–76 years) were randomly assigned to either the standard technique or the Münster clamp method. Blood loss was estimated for the entire phase from teasing away the periprostatic fat until the apex had been mobilized. Results: Median hemorrhage was 950 (range 300–2,100) ml for the standard technique and 800 (range 200–1,750) ml for the clamp procedure (Wilcoxon rank sum test, p = 0.17). Conclusions: The Münster clamp technique can reduce hemorrhage during radical retropubic prostatectomy. This method is easy to apply and is also suitable for cystoprostatectomy.
Vesicourethral Anastomotic Suture Placement during Radical Prostatectomy Using Maniceps
Authors: Yamada Yoshiaki , Honda Nobuaki , Nakamura Kogenta , Mitsui Kenji , Hibi Hatsuki , Taki Tomohiro , Aoki Shigeyuki , Kato Keitaro , Kokubo Hiroto , Fukatsu Hidetoshi
Published: April 2003

Introduction: A new method of using a semiautomatic device (Maniceps) for precise vesicourethral anastomosis during radical retropubic prostatectomy is described. Methods: A total of 15 patients underwent radical retropubic prostatectomy with this technique. The follow-up period ranged from 6 to 16 months. The retrograde urethrocystography was performed at 2 weeks. Patients were evaluated specifically for anastomotic time, anastomotic obstruction and urinary continence. Results: The average anastomotic time was 8.1 (range 5–12) min. The catheter of all patients could be removed at 2 weeks. Anastomotic obstruction occurred in 1 patient (6.7%), and 14 patients (93.3%) were completely continent of urine. Conclusion: Maniceps is a useful procedure to carry out vesicourethral anastomosis safely, easily and surely, and it has provided good surgical results in our experience.
Demonstration of Acid Secretion in the Gastric Pouch through the Pentagastrin Stimulation Test
Authors: Acar O. , Schwizer W. , Hauri D.
Published: April 2003

Introduction: The aim of this study is to determine the relationship of hydrochloric acid secretion in gastric pouch (GP), an orthotopic neobladder using a stomach segment, to gastrin. Material and Method: Pentagastrin (PG) stimulation test (PGST) was applied in 10 patients who had had GP surgery 5–70 months ago, and their urinary pH changes in the next 2 h were observed. Results: Significant pH decreases (from 6.6 ± 0.6 to 2.9 ± 1.0 in the mean) 30–75 min after injection of PG, demonstrating gastrin-triggered acid secretion in GP were observed in all patients. The pH values were normalized in 2 h (6.6 ± 1.0 in the mean). Conclusion: In PGST, urinary pH decreases, demonstrating the close relationship between gastrin release and acid secretion in the GP. Inhibition of gastrin by any means may be useful in keeping the urinary pH on physiological levels.
Potential Value of Soluble Intercellular Adhesion Molecule-1 in the Serum of Patients with Bladder Cancer
Authors: Ozer Gokhan , Altinel Mert , Kocak Burak , Balci Mustafa , Altan Ali , Gonenc Faruk
Published: April 2003

Introduction: The potential value of serum levels of intercellular adhesion molecule-1 (ICAM-1) in the staging and pathological nature of bladder cancer was investigated in this study. Materials and Methods: A total of 90 patients (mean age 64.5 ± 7.1) having transitional cell carcinoma of the bladder and 30 control patients (mean age 64.0 ± 5.5) were enrolled in the study. The serum samples of the patients were obtained on the day before surgery, at the same hour of the day. Results: The preoperative sICAM-1 levels were found to be 46.2 ± 14.7 and 28.0 ± 7.8 ng/ml in the tumor group and the control group respectively, which is significantly higher (p = 0.00). The ICAM-1 levels were not different in the invasive tumor group (36 patients) and the superficial tumor group (54 patients; 47.3 ± 13.8 ng/ml in the invasive group and 45.5 ± 15.3 ng/ml in the superficial tumor group; p = 0.520). The serum levels of sICAM-1 were significantly higher in grade III tumors than grade I and II tumors (62.0 ± 8.7, 38.4 ± 11.9 and 42.2 ± 8.2 ng/ml respectively; p = 0.000). The mean serum sICAM-1 levels in tumors >3 cm and <3 cm were found to be 52.6 ± 15.8 and 40.7 ± 11.0 ng/ml respectively which is statistically significant (p = 0.000). Conclusions: In this study, serum ICAM-1 levels were found to be related to tumor presence, grade and size. Larger series are needed for the thorough understanding of the role of ICAM-1 in bladder cancer.
Zerbrochene Zeit
Authors: Hölter Reinhild
Published: April 2003

Die Autorin beleuchtet die psychischen Folgen und Bewältigungsprozesse politischer Verfolgung und Inhaftierung in der jüngeren deutschen Geschichte mit der Traumatheorie und -therapie. Anhand von Beispielen aus einer Beratungsstelle für politisch Traumatisierte der DDR-Diktatur werden die Vorzüge und Grenzen einer analytischen Psychotherapie diskutiert. Um die hochorganisierten Abwehrprozesse verstehen zu können, die zu Therapieabbrüchen und Stagnationen in der therapeutischen Arbeit führen, wird u.a. auf John Steiners Konzept des seelischen Rückzugs zurückgegriffen. Anders als von Steiners Patienten geschildert, wird dieser Rückzugsort von politisch Verfolgten aber gerade nicht als angenehm beschrieben, da die mit brachialer Gewalt auftretenden traumatischen Erinnerungsbilder angenehme Rückzugsphantasien verhindern. Der narzisstische und somit rettende Gewinn dieses Rückzugs wird oft nur im Erleben des Therapeuten spürbar, wenn sich dieser an der undurchdringlichen Festung stösst. Als einen möglichen Zugang zum Verständnis bietet sich hier das Konzept der traumatisierenden Übertragung von Hans Holderegger an.
Extravascular Necrotizing Granuloma Induced by Mineral Wool in Circumscribed Scleroderma Lesions
Authors: Aberer Elisabeth , Dekan Gerhard , Mayr-Kanhäuser Sigrid , Aberer Werner
Published: April 2003

Cutaneous extravascular necrotizing (Churg-Strauss) granulomas have been described as a special tissue reaction pattern in patients with immunoreactive or infectious diseases. A patient with Borrelia burgdorferi s.l., genospecies Borrelia afzelii-induced circumscribed scleroderma developed symmetrical erythematous papules after exposure to mineral wool, a man-made silicon fibre. Histology of skin biopsies of papular skin lesions revealed vessel necrosis, eosinophilic collagen necrosis and extravascular palisading granulomas with high amounts of eosinophils. Amorphous vitreous particles, 1–10 µm in size and identical to agar-embedded mineral wool, were detected within necrotizing palisading granulomas by polarized light. Transmission electron microscopy and X-ray microanalysis revealed electron-dense particles showing spectra of silicates and silica consistent with mineral wool. The observation that exposure to mineral wool can induce Churg-Strauss-like granulomas in the skin of predisposed individuals can serve as a model for the pathogenesis of allergic granulomatosis.
A New Measure of the Alcohol Dependence Syndrome: The Severity Scale of Alcohol Dependence
Authors: John U. , Hapke U. , Rumpf H.-J.
Published: April 2003

The purpose was to develop a diagnostic instrument of the Alcohol Dependence Syndrome defined by Edwards and Gross (1976) since comparable scales show some limitations. The methods include three studies carried out in order to develop the SEverity Scale of Alcohol dependence (SESA; total n = 774 alcohol-dependent patients), and three further studies served for validation (total n = 603 alcohol dependents). The findings reveal that the SESA, a 33-item questionnaire including 7 subscales which cover the criteria of the Alcohol Dependence Syndrome, proved to be internally consistent. The subscales are correlated with respective information from internationally validated interview instruments for the diagnosis of alcohol dependence according to DSM and ICD (CIDI, SCAN): six subscales are correlated with six of eight CIDI items and with eight of nine SCAN items selected for the purpose of validation. In addition, there are positive correlations with the Munich Alcoholism Test, the Michigan Alcoholism Test as well as single items of the WHO Alcohol Use Disorders Identification Test. It is concluded from the results that the SESA shows good validity.
Distinguishing Intracerebral Hemorrhages Caused by Arteriovenous Malformations
Authors: Ko N.U. , Johnston S.C. , Young W.L. , Singh V. , Klatsky A.L.
Published: April 2003

Background: There is a shortage of data addressing the clinical characteristics of patients with arteriovenous malformations (AVMs) who present with intracerebral hemorrhages (ICH). Methods: A retrospective cohort study of members of a large, pre-paid health care program was conducted to identify factors that distinguish ICH secondary to cerebral AVMs from all other causes. Univariate and multivariate analysis was performed using Student’s t test, Wilcoxon rank-sum test, and logistic regression. Results: Patients with an underlying AVM were younger and more likely to be female, non-smokers with lower blood pressures, lower cholesterol, and lower white blood cell counts on presentation. Conclusions: These clinical characteristics may be useful in defining potential risk factors in future prospective studies as well as targeting candidates for additional imaging studies after ICH with no apparent etiology.
Phenylpropanolamine and Intracranial Hemorrhage Risk in a Mexican Population
Authors: Arauz Antonio , Velásquez Leora , Cantú Carlos , Nader Juan , López Mario , Murillo Luis , Aburto Yolanda
Published: April 2003

Background and Purpose: Phenylpropanolamine (PPA) has been associated with an increased risk of intracranial hemorrhage (ICH). The aim of this study was to assess the association between PPA intake and ICH in a Mexican population. Methods: We included all patients with ICH aged 18 to 51 years, with no known structural etiology, diagnosed from January 1991 to December 2000. Three to 4 controls per patient matched by sex, age (within 5 years) and place of residence were included. Patients and controls were asked about use of cold medication or appetite suppressant medications within the previous year before the interview. We considered a PPA related hemorrhage when there was a temporal relationship between the use of medication and the development of the hemorrhage, and when other causes could be ruled out. Associated risks for PPA use and other possibly related variables were estimated. Results: 177 patients (mean age 39 ± 12 years) were included; 58 (33%) were diagnosed with subarachnoid hemorrhage (SAH) and 119 (67%) with ICH. 41.2% (73 of 177) of patients had documented use of PPA within the past year and 10 (5.7%) of them had a temporal relationship between ingestion of PPA and ICH. In control subjects 42.4% (422 of 996) had been exposed to PPA and none of them developed hemorrhage. The time from PPA exposure to the onset of ICH varied from 30 minutes to 24 hours. The risk of PPA exposure for hemorrhage was not significant in cases or controls, OR 0.95 (95% CI, 0.68 to 1.34; p = 0.77). No subjects (cases or controls) reported use of PPA as an appetite suppressant. Conclusions: We found no association between ingestion of PPA and cerebral hemorrhage with respect to ingestion of PPA in the previous year. When recent use was looked at an apparent risk was evident.
Increased Common Carotid Artery Intima media Thickness in Adolescent Hypertension
Authors: Páll Dénes , Settakis Georgios , Katona Éva , Csiba László , Kakuk György , Limburg Martien , Bereczki Dániel , Fülesdi Béla
Published: April 2003

Background: The aim of the present work was to investigate intima media thickness (IMT) in healthy and in hypertensive adolescents and its influencing factors. Methods: 103 hypertensive and 58 healthy adolescents were studied. IMT was measured in the common carotid artery using B-mode ultrasonography. Additionally, laboratory parameters (blood glucose, cholesterol, triglycerides, HDL- and LDL-cholesterols) and left ventricular mass indices were obtained. Results: IMT in the common carotid artery was higher in hypertensive adolescents (means ± SD: 0.55 ± 0.11 mm) than in healthy control subjects (0.48 ± 0.08 mm, p < 0.001). Similarly, a higher left ventricular mass index was measured in hypertensive (103.2 ± 30.6 g/m2) than in healthy teenagers (91.1 ± 25.2 g/m2, p < 0.001). In general, IMT in adolescents was associated with age, weight, body mass index, left ventricular mass index and average systolic and diastolic blood pressure values of the subjects. By assessing the multivariate association between IMT and other factors, intima-media thickness was only associated with age and left ventricular mass index of the hypertensive subjects and was independent from all the investigated factors in normotensive controls. Conclusions: Our data suggest an ongoing target-organ damage in adolescent hypertension. These patients need to be subjected to early diagnostic methods, treatment and a regular follow-up, in order to avoid severe clinical manifestations of secondary target-organ damage due to hypertension.
Incisional Hernias
Authors: Yahchouchy-Chouillard Elie , Aura Tamer , Picone Olivier , Etienne Jean-Charles , Fingerhut Abe
Published: April 2003

Incisional hernias represent one of the most frequent complications of abdominal surgery. The incidence is probably underestimated. The pathogenesis is complex and not fully understood, implying patient-related factors (i.e., collagen biochemistry, obesity, age) as well as technical factors, including, among others, wound infection, suture material, and types of incisions and closures. In this paper, the first of two, the authors review the literature emphasizing the current knowledge concerning the pathogenesis of incisional hernias. The second article is focused on the treatment.
A True Splenic Cyst Producing Carbohydrate Antigen 19-9 and Cancer Antigens 50 and 125, but Not Interleukin 10
Authors: Galizia Gennaro , Lieto Eva , Ferraraccio Francesca , Castellano Paolo , de Vita Ferdinando , Orditura Michele , Romano Ciro , Pignatelli Carlo
Published: April 2003

A giant cystic lesion of the left upper abdomen associated with a smaller ovarian cyst in a young female patient is reported. Laboratory data revealed elevated serum levels of carbohydrate antigen 19-9 (CA 19-9), carcino-embryonic antigen (CEA), cancer antigens 50 and 125, and tissue polypeptide antigen. In contrast, the serum levels of interleukin 10, a cytokine involved in modulating immune responses and produced by many cancer histotypes, were normal. Since ovarian cancer or cystic adenocarcinoma of the tail of the pancreas were not ruled out, the patient underwent laparotomy. After splenectomy and ovariectomy, the tumour marker serum levels normalized. Histology and immunohistochemical analysis revealed a true splenic cyst with the inner epithelium strongly positive for CA 19-9 and CEA and high levels of cancer antigens in the fluid. The ovarian lesion was a serous cystadenoma. The inner epithelium showed no immunoreactivity for tumour markers which were not measurable in the fluid. True cysts of the spleen are rare; in a few cases, high serum levels of CA 19-9 and CEA have been reported. In such instances, cyst resection or splenectomy is indicated to rule out malignant lesions and to remove the cancer antigen producing epithelium. The reported case shows that the epithelium lining true splenic cysts may produce, besides CA 19-9 and CEA, other tumour markers, in particular cancer antigens 50 and 125. In addition, normal serum values of interleukin 10 correctly predicted the benign nature of the lesion.
Flupenthixol versus Risperidone: Subjective Quality of Life as an Important Factor for Compliance in Chronic Schizophrenic Patients
Authors: Hertling I. , Philipp M. , Dvorak A. , Glaser T. , Mast O. , Beneke M. , Ramskogler K. , Saletu-Zyhlarz G. , Walter H. , Lesch O.M.
Published: April 2003

Objective: The primary aim of this paper was to compare the effects of flupenthixol and risperidone on subjective quality of life and attitude towards medication in chronic schizophrenic patients with mainly negative symptoms. In a spectrum ranging from its typical end ‘haloperidol’ to its atypical end ‘clozapine’, flupenthixol has typical and atypical characteristics. Methods: The effects of flupenthixol versus risperidone were investigated in a multicenter, double-blind trial, whereas subjective quality of life was assessed by means of the EuroQuol-Visual Analogue Scale and the patient satisfaction questionnaire. The attitude towards medication was assessed by means of the Drug Attitude Inventory-30 (DAI-30). Results: Mean daily dose of study medication was 6.6 (SD 2.9) mg/day flupenthixol and 3.6 (SD 1.2) mg/day risperidone. Both groups showed a significant improvement regarding subjective quality of life and positive attitude towards medication. Especially the categories ‘control of their thoughts’, concentration and ‘feeling better in general’ ameliorated in both groups. In the flupenthixol group, the ‘ability to cope with stress’, ‘feel more relaxed’ and the ‘ability to achieve something’ improved significantly more than in the risperidone group. Conclusions: (1) The spectrum of schizophrenia can be treated effectively with different neuroleptic treatments. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. (3) Subjective quality of life significantly increased with no difference between the groups.
Lack of Association between Polymorphisms of the Dopamine D4 Receptor Gene and Personality
Authors: Strobel Alexander , Spinath Frank M. , Angleitner Alois , Riemann Rainer , Lesch Klaus-Peter
Published: April 2003

Recent studies have suggested a role of two polymorphisms of the dopamine D4 receptor gene (DRD4 exon III and –521C/T) in the modulation of personality traits such as ‘novelty seeking’ or ‘extraversion’, which are supposed to be modulated by individual differences in dopaminergic function. However, several replication studies have not provided positive findings. The present study was performed to further investigate whether DRD4 exon III and –521C/T are associated with individual differences in personality. One hundred and fifteen healthy German volunteers completed the NEO-Five-Factor Inventory (NEO-FFI) and were genotyped for the two DRD4 polymorphisms. We found no association between DRD4exon III and –521C/T, respectively, and estimated novelty seeking, NEO-FFI extraversion or other personality factors. Our findings are in line with several earlier studies which have failed to replicate the initial association results. Hence, our data do not provide evidence for a role of DRD4 exon III and the –521C/T polymorphism in the modulation of novelty seeking and extraversion.
The Capsular Organ of Chelyosoma productum (Ascidiacea: Corellidae): A New Tunicate Hydrodynamic Sense Organ
Authors: Mackie G.O. , Singla C.L.
Published: April 2003

Chelyosoma has about 200 sense organs in the atrial wall of the branchial sac that show structural features suggestive of a role in hydrodynamic sensing. They consist of a fluid-filled capsule with an acellular diaphragm spanning an opening in the top. The floor of the capsule is a sensory macula, with 5–6 primary sensory neurons whose cilia project into the capsular cavity and whose axons go to the brain. Animals were tested for vibrational sensitivity using a loudspeaker probe. They responded by muscular contractions of the siphons and/or arrests of the branchial cilia, both of which caused changes in water flow velocity through the siphons, which were monitored non-invasively using a thermistor flow meter. The animals showed peak sensitivity at 240–260 Hz. Subsequent calibration of the loudspeaker probe indicated that the animals could detect 104 decibels re 1 µPa from a source 80 cm away. The majority of axons leaving the capsular organs go to the brain via the visceral nerve. Cutting this nerve abolished or greatly reduced responses. Electrophysiological recordings from the distal nerve stump showed bursts of electrical events following vibrational stimulation. No such records could be obtained from other major nerves and cutting them did not affect responsivity. Corella inflata, a close relative of Chelyosoma, lacks capsular organs and failed to show any responses when the source was more than 3.5 cm away. We conclude that Chelyosoma’s vibration-sensing ability is due to its capsular organs and is adaptive in terms of detecting the movements of objects in the vicinity. The findings are discussed in relation to the evolution of hydrodynamic mechanoreceptors in tunicates, amphioxus and craniates.
Two-Year Follow-Up Study after Human Parvovirus B19 Infection
Authors: Seishima Mariko , Oyama Zuiei , Yamamura Mahiro
Published: April 2003

Background: Acute human parvovirus B19 (B19) infection induces systemic lupus erythematosus (SLE)-like symptoms. It has been controversial whether B19 infection causes SLE and rheumatoid arthritis (RA). Objectives: This study prospectively investigated whether symptoms of B19 infection persisted for more than 2 years and whether persistent symptoms contributed to the development of SLE and RA. Methods: In this prospective study, clinical findings were examined and laboratory examinations were performed in 42 adult patients 1, 2, 6, 12 and 24 months after the first consultation. Results: Most acute symptoms disappeared within 2 weeks. However, arthralgia continued for 2 months in 2 women, 6 months in 1 woman and more than 2 years in 1 woman with positive antinuclear antibody and hypocomplementemia. The clinical findings of the patient with persistent arthralgia did not fulfill the criteria for SLE and RA. Conclusion: The symptoms caused by B19 infection were transient in most cases but persisted in 1 case in our series.
Effect of Topical PPARβ/δ and PPARγ Agonists on Plaque Psoriasis
Authors: Kuenzli Stéphane , Saurat Jean-Hilaire
Published: April 2003

Background: Ligands of nuclear hormone receptors such as glucocorticoid, retinoid and vitamin D are useful antipsoriatic drugs. Peroxisome proliferator-activated receptors (PPARs), which also belong to the nuclear hormone receptor superfamily, are pleiotropic regulators of growth and differentiation in many cell types, including the keratinocytes. Recent reports have dealt with the involvement of PPARα in epidermal processes such as barrier development, proliferation and differentiation. In a pilot study of topical clofibrate, a PPARα ligand, we did not find any antipsoriatic activity. No study on the effect of topical application of other PPAR subtype ligands (PPARβ/δ and γ) has been published. Objectives: The purpose of this pilot study is to explore the clinical efficacy of the topical application of potent PPARβ/δ and γ agonists on plaque psoriasis, tetradecylthioacetic acid (TTA) and rosiglitazone, respectively. Methods: In a pilot study on psoriatic patients, 8 individuals (5 male/3 female) were treated twice daily for 30 days with vehicle (n = 14 plaques), rosiglitazone 0.5% (n = 18) and TTA 0.5% (n = 18). Assessments of the PASI plaque score were carried out on days 0, 4, 7, 11, 14 and 30. Results: No statistically significant difference was found at any of the examination times, between vehicle, rosiglitazone and TTA in terms of reduction of the PASI plaque score for total, scale and infiltration scores. Treatments were well tolerated, and skin irritation, adverse drug-related symptoms and dropouts did not occur. Conclusions: With the reservations due to the limited nature of this pilot trial, it seems that these topical PPARβ/δ and γ agonists do not exert a strong antipsoriatic effect when used alone at 0.5%.
Transforming Growth Factor-Beta-Dependent Events in Vascular Remodeling following Arterial Injury
Authors: Ryan Sarah T. , Koteliansky Victor E. , Gotwals Philip J. , Lindner Volkhard
Published: April 2003

Constrictive remodeling has been identified as a major contributor to restenosis following angioplasty. Characterization of transforming growth factor-β (TGF-β)-mediated cellular events in the adventitia and their contribution to vascular remodeling, however, has not previously been studied in detail. The balloon catheter denudation model was performed on rat carotid artery, and groups of rats were treated with vehicle or a TGF-β inhibitor, a soluble TGF-β receptor type II (TGF-βR:Fc). Adventitial cell proliferation, which peaked 4 days after injury, was characterized by the de novo formation of several cell layers surrounding the outer adventitia and this process was not dependent upon TGF-β activity. These neoadventitial cells expressed an abundance of collagen type I and a fetal isoform of fibronectin containing the EIIIA domain, and the expression of both proteins was suppressed in the presence of TGF-βR:Fc. Lumenal narrowing was apparent 14 days after injury. Inhibition of TGF-β signaling promoted vessel enlargement. As a result, lumen size did not change despite neointima formation. In conclusion, adventitial fibrosis with abundant collagen matrix deposition but not adventitial cell proliferation is dependent upon endogenous TGF-β activity. Furthermore, inhibition of TGF-β signaling prevents injury-induced reduction in lumen area by promoting vessel enlargement.
Hyaluronan Synthases in Normal and Regenerating Joint Cartilage
Authors: Mrosek Eike , Erggelet Christoph , McDonald John A. , Kurz Haymo
Published: April 2003

Repair of full thickness joint cartilage defects is within reach of routine clinical practice. The quality of regenerating hyaline cartilage, however, is difficult to assess. Synthesis of an extracellular matrix with high hyaluronan content is crucial for its metabolic and functional properties. We studied hyaluronan synthase (HAS) expression in knee joints of adult sheep as a novel cellular marker for chondrocyte function. Six house-bred Merino sheep (age 4–6 years) underwent two-stage surgery of their femoral condyles for autologous chondrocyte transplantation (ACT). First, cells were isolated from biopsies and expanded in vitro for 2 weeks using standard culture techniques. In a second session, three defects were made and either left untreated, covered with periosteal flap alone, or in combination with chondrocyte suspensions injected under the flaps. After 16 weeks, biopsies were taken from the operated knees at the defect sites and from the untreated condyle. Specimens were processed for safranin O and electron microscopy, and for immunofluorescence using three different polyclonal anti-HAS antibodies recognizing one or all of the three known mammalian HAS. Control and regenerating tissues were compared regarding their morphology and the expression of HAS, in relation to collagens type I and II, and adult cartilage proteoglycan core protein. In comparison with untreated defects or with periosteal flap alone, ACT provided a neocartilage with better-differentiated morphology. In healthy joint cartilage, about 50% of the chondrocytes expressed HAS, independent of antibody. Following ACT, a higher density of chondrocytes was observed, of which more than 75% expressed HAS, whereas the regenerates without ACT showed a lower density of HAS-expressing cells. We propose to use HAS immunofluorescence as an additional marker of matrix synthesis by chondrocytes and joint cartilage regeneration.
Surfactants Enhance the Tight-Junction Permeability of Food Allergens in Human Intestinal Epithelial Caco-2 Cells
Authors: Mine Yoshinori , Zhang Jie Wie
Published: April 2003

Background: Food additives are responsible for certain allergic types of symptoms. Here Caco-2 cell monolayers were used as a model of the intestinal epithelium for the study of the effect of a food grade surfactant. We determined whether or not the presence of a surfactant enhances the transportation of food allergens across human intestinal epithelial Caco-2 cells. Methods: This study investigated sucrose monoester fatty acids, which are a food grade surfactant. As an in vitro model of human epithelial cells, Caco-2 cells were grown in monolayers and exposed to different doses of the surfactant in conjunction with ovomucoid, a major egg white allergen. The integrity of the monolayer was assessed by measuring transepithelial electrical resistance (TEER). The permeability of tight junctions and transport of the antigen were studied. Results: TEER correlated with the permeability of tight junctions. TEER significantly decreased upon exposure to a surfactant, indicating anincrease in ovomucoid permeability without degradation. The surfactant induced shortening in microvilli, actin disbandmentand structural separation of tight junctions. The results indicate that food grade surfactants can increase the paracellular uptake of food allergens.
Expansion and Proliferation of Skin-Homing T Cells in Atopic Dermatitis as Assessed at the Single Cell Level
Authors: Jung Thomas , Schulz Stephanie , Zachmann Karolin , Neumann Christine
Published: April 2003

Background: Sensitization to aeroallergens is a frequent event in patients with atopic dermatitis (AD). The role of allergen-specific T cells in the pathogenesis of AD is, however, not fully clear. A detailed immunological characterization of allergen-specific T cells able to migrate to inflamed skin might therefore be helpful in determining the relevance of allergen-specific T cells to clinical symptoms. Objective: To establish a simple assay to simultaneously monitor the expression of skin-related homing molecules and their proliferative response to an allergen on peripheral T cells. To evaluate whether this assay is able to identify AD patients in whom exposure to an allergen induces dermatitis. Methods: The expression of CLA, CD7 and CD4 was simultaneously measured by flow cytometry with the DNA content as a parameter of proliferation at the single cell level. House dust mite antigen (DerP) and tetanus toxoid (TT) were used as antigens. Results: CD4+ CLA+ CD7–, but not CLA– T cells from patients with AD proliferated and expanded following DerP stimulation. In contrast, TT stimulation resulted in proliferation of both, CLA+ and CLA– T cells from both, atopic and healthy donors. Conclusions: Single cell analysis revealed a predominant localization of allergen-reactive T cells within the CD7– CLA+ CD4+ T cell subset in AD. Thus, this simple assay not only confirms previously published results, but also extends our knowledge on the biology of CLA and CD7 cells in AD. Ultimately, this will be helpful in classifying those patients who might benefit from allergen avoidance therapies.
Dental Caries Related to Plasma IgG and Alpha1-Acid Glycoprotein
Authors: de Soet J.J. , Schriks M.C.M. , Kratz E. , Poland D.C.W. , van Dijk W. , van Amerongen W.E.
Published: April 2003

This study was aimed at determining whether dental caries is associated with induction of the systemic immune system or cytokine response. For this purpose, 85 children from Den Pasar, Bali, Indonesia, aged 6–7 years, were examined clinically and blood plasma was obtained via finger puncture. The concentrations of the acute-phase protein α1-acid glycoprotein (AGP), total IgG and the specific IgG and IgM immunoglobulins against Streptococcus mutans were determined. Immunoelectrophoresis was used for the determination of the AGP concentration and ELISA for IgG and IgM detection. The mean dmft of the whole group was 8.8 ± 2.9, the mean number of infected pulps was 3.9 ± 2.2 and the mean number of abscesses was 0.5 ± 0.8. The plasma concentration of AGP ranged between 0.13 and 1.6 mg/ml serum (mean 0.86 ± 0.26 mg/ml). Stepwise regression analysis revealed that the concentration of IgG against S. mutans (log-transformed) was significantly correlated with dmft (adjusted r2 = 0.083, standardized β coefficient = 0.31, p = 0.008). When the concentration AGP was included in the model the correlation improved significantly (for IgG: adjusted r2 = 0.157, standardised β coefficient = 0.36, p = 0.002; for AGP: β coefficient = –0.30, p = 0.009). The results suggest a relationship between caries and systemic parameters of inflammation. On the basis of this, severe caries might have consequences on the general health of the subject.
Systematic Review of Studies Comparing the Anti-Caries Efficacy of Children’s Toothpaste Containing 600 ppm of Fluoride or Less with High Fluoride Toothpastes of 1,000 ppm or Above
Authors: Ammari A.B. , Bloch-Zupan A. , Ashley P.F.
Published: April 2003

Objective: To determine the clinical effectiveness of low fluoride (F) toothpastes, containing 600 ppm or less, with toothpaste containing 1,000 ppm or more fluoride in preventing dental caries. Design: Systematic review of randomised controlled trials comparing low fluoride toothpastes containing 600 ppm F or less with toothpastes containing 1,000 ppm or more in children or adults. Results: Seven randomised controlled trials were included. These were categorised into two groups depending on the fluoride concentration in the low fluoride group (250 and 500 ppm) and analysed separately. 250 ppm: Results of the meta-analysis were statistically significant (p = 0.002 and 0.0005) and in favour of the control group (1,000 ppm). DFS increments in the 250-ppm group were 0.6–0.7 greater than the 1,000-ppm group. 500 ppm: Only two studies were in this category, and one of them failed to present the baseline caries levels, so a meta-analysis was not carried out. Conclusion: 250 ppm fluoride dentifrice was not as effective in caries prevention in permanent dentition as dentifrice containing 1,000 ppm F or more. More studies have to be carried out to test the anticaries efficacy of 500 against 1,000 ppm and above.
In vitro and in vivo Study of 5-Methoxypsoralen Skin Concentration after Topical Application
Authors: Colombo G. , Zucchi A. , Allegra F. , Colombo P. , Zani F. , Santi P.
Published: April 2003

The aim of this work was to study the skin distribution of 5-methoxypsoralen (5-MOP) after application of topical gels, in vitro and in vivo, in both healthy and psoriatic skin sites of 6 psoriatic patients. Drug skin distribution was determined using the thin slicing technique and subsequent HPLC analysis. In the presence of dermatological disease, i.e. psoriasis, the permeability of the tissue changed considerably, leading to an important increase in the cumulative amount of 5-MOP recovered in the skin after topical application. The amount of 5-MOP found in vitro in the human skin was intermediate between those cumulated in healthy and psoriatic skin sites during an in vivo experiment. The gel formulation is an efficacious carrier for the topical photochemotherapy of psoriasis with 5-MOP, since it allows drug penetration in psoriatic skin.
Formulation Study and Anti-Inflammatory Efficacy of Topical Semi-Solids Containing a Nitro Ester of Flurbiprofen
Authors: Minghetti P. , Casiraghi A. , Cilurzo F. , Tosi L. , Montanari L. , Trespidi L.
Published: April 2003

A new nitro-oxybutylester of flurbiprofen (NO-FP) is a promising anti-inflammatory drug in the treatment of dermatological disorders, and the feasibility of its cutaneous administration was evaluated. Four different semi-solid formulations were evaluated in order to assess the influence of the composition on the drug amount retained in the stratum corneum and epidermis (SCE). The lipophilic ointment induced the highest NO-FP amount retained in the SCE and, therefore, skin permeation enhancers (Transcutol®, Lauroglycol®, oleic acid and isopropyl myristate) were added to this formulation. The in vitro NO-FP amounts retained in the SCE were correlated with the solubility parameters, and a good linear correlation was found (r2 = 0.925). The formulation of the lipophilic ointment was optimized, and the activity of this preparation was verified in methyl-nicotinate-induced contact urticaria and UV-induced erythema obtaining good results in terms of efficacy and safety.
Anti-Acne Effects of Oriental Herb Extracts: A Novel Screening Method to Select Anti-Acne Agents
Authors: Nam C. , Kim S. , Sim Y. , Chang I.
Published: April 2003

The acne-therapeutic effects of Oriental herb extracts were investigated in terms of antichemotactic effect on polymorphonuclear leucocytes, antilipogenic actions, antibacterial activity against Propionibacterium acnes and resistance induction potency in the bacteria. The ethanol extract (0.01%) of Angelica dahurica markedly suppressed neutrophil chemotaxis, comparable to the effect of erythromycin (0.01%), whereas a strong antilipogenic effect was obtained with rhizoma coptidis (Coptis chinensis) extract (0.01%), leading to a higher efficacy than that of retinoic acid (0.01%). Interestingly, only Glycyrrhiza glabra showed a remarkable antibacterial activity against P. acnes, resulting in negligible induction of resistance, in comparison with a marked development of resistance in the bacteria treated with erythromycin. We suggest that an appropriate formulation containing A. dahurica, rhizoma coptidis and G. glabra could be helpful for the prevention and treatment of acne lesions.
Evidence that p38 Mitogen-Activated Protein Kinase Contributes to Neonatal Hypoxic-Ischemic Brain Injury
Authors: Hee Han Byung , Choi Junjeong , Holtzman David M.
Published: April 2003

We tested the response of stress-activated mitogen-activated protein kinases (MAPKs) – p38 MAPK and c-JUN NH2-terminal kinase (JNK) – following hypoxia-ischemia (H-I) induced by unilateral carotid artery ligation and hypoxia (8% O2 and 92% N2) for 2.5 h in postnatal-day-7 rats. Phosphorylation of p38 MAPK increased in the hippocampus and cortex immediately following H-I and returned to a basal level 6 h later. In contrast to p38 MAPK, phosphorylation of JNK decreased in the hippocampus and cortex immediately following H-I. Intracerebroventricular administration of two different p38 MAPK inhibitors prior to H-I significantly protected the neonatal brain from H-I injury. Interestingly, p38 MAPK inhibitors did not attenuate caspase-3 activation 24 h after H-I. Thus, these data suggest that p38 MAPKs contribute to the rapid, early component of brain injury following neonatal H-I.
Timing Is Everything – Delaying Therapy for Delayed Cell Death
Authors: Ferriero Donna M.
Published: April 2003

Damage after a hypoxic-ischemic (HI) insult is both region and cell population specific [Johnston, 1998]. This observation is critically evident in, and important to, the pathogenesis of the insult in the immature central nervous system. In the term human neonate, damage to the deep grey nuclei is seen using magnetic resonance imaging (MRI) modalities such as diffusion tensor imaging, MR spectroscopy, and structural MRI [Barkovich et al., 1999, 2001]. The loss of T2-weighted signal in the posterior limb of the internal capsule has become the gold standard in predicting neurological injury with MRI [Rutherford et al., 1995]. Early spectroscopic changes of a variety of metabolites like lactate, N-acetyl aspartate, choline and creatine using single-voxel techniques, coupled with the presence of clinical neonatal seizures can aid in the accurate prediction of neurodevelopmental outcome after HI in the term newborn [Miller et al., 2002]. Neonatal physiological profiles in the first 24 h of life also contribute to a better prediction of outcome in the mildly and severely affected newborn [Newton et al., 2001].
Hypoxic Preconditioning Increases Brain Glycogen and Delays Energy Depletion from Hypoxia-Ischemia in the Immature Rat
Authors: Brucklacher Robert M. , Vannucci Robert C. , Vannucci Susan J.
Published: April 2003

Recent studies have shown a protection from cerebral hypoxic-ischemic (HI) brain damage in the immature rat following a prior systemic hypoxic exposure when compared with those not exposed previously. To investigate the mechanism(s) of hypoxic preconditioning, brain glycogen and high-energy phosphate reserves were measured in naïve and preconditioned rat pups subjected to HI. Groups in this study included untouched (naïve) controls, preconditioned controls (i.e., hypoxia only), preconditioned with HI insult, and naïve pups with HI insult. Hypoxic preconditioning was achieved in postnatal-day-6 rats subjected to 8% systemic hypoxia for 2.5 h at 37°C. Twenty-four hours later, they were subjected to unilateral common carotid artery ligation and systemic hypoxia with 8% oxygen at 37°C for 90 min. Animals were allowed to recover from HI for up to 24 h. At specific intervals, animals in each group were frozen in liquid nitrogen for determination of cerebral metabolites. Preconditioned animals showed a significant increase in brain glycogen 24 h following the initial hypoxic exposure, corresponding to the beginning of the HI insult. Measurement at the end of 90 min of HI showed a depletion of high-energy phosphates, ATP and phosphocreatine, in all animals although ATP remained significantly higher in the preconditioned animals. Thus, the energy from increased glycogen following preconditioning slowed high-energy phosphate depletion during HI, thereby allowing for long-term protection.
Inhibition of Growth Hormone Excess Reduces Insulin Resistance and Ovarian Dysfunction in a Lean Case of Polycystic Ovary Syndrome with a Growth-Hormone-Producing Pituitary Adenoma
Authors: Hashimoto Shigeatsu , Yatabe Jun-ichi , Midorikawa Sanae , Sanada Hironobu , Watanabe Tsuyoshi
Published: April 2003

A 23-year-old female with polycystic ovary syndrome (PCOS) and a growth-hormone (GH)-producing pituitary adenoma is described. A reduction in the elevated GH levels to normal levels following the administration of dopaminergic agents decreased plasma insulin-like growth factor (IGF)-1 and ovarian dysfunction. Menstrual cycles were therefore restored and the number of ovarian cysts reduced, suggesting that insulin and/or IGF-1, stimulators of theca cell proliferation, may be pathogenetic factors in PCOS.
Tumor- and Pregnancy-Derived Isoforms of Human Chorionic Gonadotropin: Biological and Diagnostic Relevance
Authors: Lottersberger C. , Hoermann R. , Mann K. , Schwarz S. , Berger P.
Published: April 2003

Objectives: Human chorionic gonadotropin (hCG) and hCG variants are of high clinical importance for the diagnosis of pregnancy, monitoring of abnormal and ectopic pregnancies, testing for Down’s syndrome or monitoring therapy of hCG-secreting malignancies. In serum and urine, hCG appears in microheterogeneous isoforms with respect to protein backbone structure and the extent of glycosylation. The present study reports on the identification, immunological characterization, biological activity of glycosylation isoforms of pregnancy (preg) and tumor-derived (tu) hCG, and the impact of glycosylation on diagnostic immunoassays. Methods: Twenty-two urinary preg- and tu-hCG isoforms were separated by preparative isoelectrofocusing (hCG-pI variants) and characterized by Western blot. Number, topography and accessibility pattern of epitopes on their surface was evaluated by two-site radioimmunoassays using 14 different monoclonal antibodies (mabs). Binding of hCG isoforms to four different LH/CG receptors was investigated in radioreceptor assays, and their biological activity determined by measuring cAMP elevation. Results: All 22 hCG glycosylation variants appeared immunologically intact: each isoform, even when highly acidic, expressed all 14 surface epitopes which were arranged in a topographical manner indistinguishable from crude hCG. hCG isoforms were able to bind to four different receptor variants, with slightly varying affinities, but orientations indistinguishable from each other as shown by identical epitope accessibility patterns. Each of the hCG-pI variants was able to activate the LH/CG-Rs, but with varying reactivities. Conclusions: We conclude that in contrast to deglycosylated hCG, all hCG glycosylation isoforms investigated act as receptor agonists. Moreover, there is no overspecificity of mabs to certain hCG isoforms due to carbohydrate variability that exclude others from diagnostic measurement.
Decompressive Hemicraniectomy in a 6-Year-Old Male after Unilateral Hemispheric Stroke
Authors: Lee Mac C. , Frank Jeffrey I. , Kahana Madelyn , Tonsgard James H. , Frim David M.
Published: April 2003

We report the case of a 6-year-old male who underwent a hemicraniectomy after a right-sided middle cerebral arterial infarct. This is the youngest patient reported to have undergone this procedure for stroke-associated brain swelling. This case illustrates that hemicraniectomy for stroke can be performed safely in pediatric patients, with potential brain- and lifesaving benefits.
Pediatric Idiopathic Pulmonary Hemosiderosis Diagnosed by Sputum Analysis: Plain Radiography and Computed Tomography Findings
Authors: Kocakoc Ercan , Kiris Adem , Sen Yasar , Bozgeyik Zulkif
Published: April 2003

Objective: Idiopathic pulmonary hemosiderosis (IPH) is an uncommon disorder, which is characterized by recurrent hemoptysis, iron deficiency anemia and diffuse parenchymal infiltration on chest radiographs in pediatric patients. We wish to present clinical and radiological (plain radiography and CT) findings of this rare pathology. Clinical Presentation and Intervention: A 14-year-old girl was admitted to the pediatric emergency department with complaints of cough, dyspnea, fatigue and bloody sputum for 6 months. She had been hospitalized 3 times during this period and received antibiotics and blood transfusion. Chest X-rays revealed prominent perihilar and bibasilar consolidation. CT showed a ground glass pattern and consolidated areas with increased density. Sputum analysis yielded hemosiderin-laden macrophages. With presumptive diagnosis of IPH, prednisolone was administered. Her symptoms improved on the 5th day of treatment and 1 month later, plain chest radiography demonstrated marked improvement. Conclusion: Although IPH is a rare condition, the diagnosis of IPH should be considered, among others, in a patient with hemoptysis and bilateral infiltration in the chest X-ray. This may prevent antibiotic misuse and risk of death due to severe hemorrhage.