bluuebunny/crossref_metadata_2025 huggingface dataset:
Forty-Five Years of Stereotactic Surgery for Parkinson’s Disease: A Review
Authors: Gillingham John
Published: April 2003

An overview of a large experience of the surgical management of parkinsonism from 1954 to 1999 is outlined – from the original open surgery of Fenelon to the sophisticated, motor-driven electrodes of stereotactic surgery using depth microelectrode recording. The definition of the best target sites for the relief of tremor, rigidity and bradykinesia evolved progressively as accuracy in siting of lesions developed. The significance of these targets in understanding the pathophysiology of the disease and the neurotransmitters involved gradually became clearer and a way forward in future management was suggested.
Microvascular Decompression in Trigeminal Neuralgia: A Correlation of Three-Dimensional Time-of-Flight Magnetic Resonance Angiography and Surgical Findings
Authors: Chang Jin Woo , Chang Jong Hee , Park Yong Gou , Chung Sang Sup
Published: April 2003

We analyzed 104 patients with trigeminal neuralgia who underwent microvascular decompression and who were followed up for more than 12 months during the period from January 1992 to June 1998. In this recent series, we utilized three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) for all patients with trigeminal neuralgia. A 3D-TOF MRA was beneficial in treatment planning and in predicting surgical outcome by demonstrating cranial nerve compression as well excluding other etiologies such as tumor or vascular lesions. The patients were followed up for 1–7 years (mean 5.7 ± 1.2 years). Initial pain relief was complete in 89 patients (85.6%) and partial in 12 patients (11.5%). There were three primary failures (2.9%). The acceptable pain relief rate (complete relief: 79.8%, partial relief: 11.5%) was determined in the long-term follow-up of surgical results. Pain recurred in 6 patients (5.8%). The mean time to recurrence was 48 months (36–93 months). There were no serious or annoying complications such as anesthesia dolorosa.
Multimodality Program Involving Stereotactic Surgery in Brain Tumor Management
Authors: Gildenberg Philip L.
Published: April 2003

Stereotactic and image-guided surgery is becoming increasingly important in the management of brain tumors. Although there are several stereotactic modalities that have been reported to be of value, it is the combination of techniques in a multimodality approach that seems to show the most promise. Both frame-based and frameless guidance may facilitate glioma resection, allowing the optimal amount of resection while permitting avoidance of surrounding eloquent areas. Not only does this optimize resection, but leaving a minimal amount of gross tumor may provide a better bed for intracavitary chemotherapy. Deep tumors may be localized and approached through a small channel, and surgical exposure may be minimized to protect uninvolved areas of the brain. There is increasing evidence that patients operated with imaging guidance have a more benign course and more rapid discharge, perhaps with a lower incidence of adverse neurological sequelae. Stereotactic conformal radiotherapy allows a higher tumor dose while sparing uninvolved brain from radiation more efficiently than conventional techniques, and residual tumor may be treated with a boost of stereotactic radiotherapy. Stereotactic instillation of radioisotopes may be used to treat cystic tumors. Stereotactic insertion of cannulae or radioisotope seeds permit efficient brachytherapy. Stereotactic surgery has moved beyond a subspeciality, so that every neurosurgeon might benefit from using stereotactic techniques in brain tumor management.
Miniature Multileaf Collimator as an Alternative to Traditional Circular Collimators for Stereotactic Radiosurgery and Stereotactic Radiotherapy
Authors: Urie Marcia M. , Lo Y.C. , Litofsky S. , FitzGerald T.J.
Published: April 2003

Purpose: To evaluate the miniature multileaf collimator (MMLC) as an alternative to traditional circular collimators for radiosurgery. Materials and Methods: ‘Circular’ fields were created with the Radionics MMLC (leaf width 3.53 mm at isocenter). Beam data, including tissue maximum ratios, output factors, penumbrae and isodose distributions of these fields were measured. These were compared to the Radionics circular collimators traditionally used for radiosurgery. The MMLC data were input to the XKnife Treatment Planning System. Treatment plans were completed and evaluated using both the MMLC ‘circular’ fields and the circular collimators. Results: MMLC fields using 3, 5, 7, 9, 11, and 13 leaves on each side of the Radionics MMLC were created to approximate circular fields. The TMRs are essentially identical to those of comparable-size circular collimators. Measured at isocenter at 5-cm depth for 6 MV, the 80–20% penumbra widths are comparable to circular collimators, but are increased by as much as 1 mm at the leaf intersections (steps) where scalloping occurs. Isodose distributions were matched to those of circular collimators with comparable 50% isodose widths. Treatment plans for the MMLC ‘circular’ fields with four arcs (totaling 360Conclusions: With the MMLC simulating circular fields, dose distributions may be obtained which are essentially identical to comparable-size circular collimators. The mechanical accuracy of the MMLC is as good as that of the circular collimators, and the leakage dose is less. The diameter of ‘circular’ fields is limited by the MMLC leaf width to 1 cm and greater in increments of 7 mm. Attention needs to be paid to mechanical collisions because the MMLC is bulkier than the circular collimators.
Is Distortion Correction Necessary for Digital Subtraction Angiography in the Gamma Knife Treatment of Intra-Cranial Arteriovenous Malformations?
Authors: Perks J. , St. George E.J. , Doughty D. , Plowman P.N.
Published: April 2003

Objective: The published literature maintains that distortion correction of digital subtraction angiography is essential for accurate definition of the arteriovenous malformation (AVM) nidus when performing Gamma Knife radiosurgery. However, as Gamma Knife treatments usually involve small volume targets, which are purposely positioned as close to the centre of the frame as possible, we postulated that the angiographic target images should be minimally distorted. Thus, the use of uncorrected images would not significantly compromise the accuracy of the treatment. We investigated this postulate. Design: Patient and phantom images with and without distortion correction were assessed. The errors measured in the angiograms were compared to those of MR and CT images of the same subjects. Any errors less than 0.5 mm in any modality were accepted as intrinsic. Results: All errors measured in the study were sub-millimetre. In the patient group, errors with distortion correction averaged 0.13 mm (range 0– 0.3 mm). Without distortion correction, errors averaged 0.34 mm (range 0.1–0.6 mm). By comparison, the average error for intracranial MR imaging was 0.3 mm, with a maximum of 0.6 mm. Conclusion: For small, intracranial AVMs distortion correction did not significantly reduce the errors associated with the definition of the stereotactic co-ordinates. We suggest that prior to the purchase of this software, similar in-house testing should be performed.
Cryoablation of Localized Prostate Cancer: Neoadjuvant Downsizing of Prostate Cancer with LH-RH Analogue Depot before Cryosurgery
Authors: Derakhshani P. , Zumbé J. , Neubauer S. , Engelmann U.
Published: April 2003

Radical prostatovesiculectomy, radiation therapy, and complete androgen deprivation are acknowledged therapeutic concepts in the treatment of organ-confined prostate cancer. With cryoablation of the prostate, minimal invasive therapy has become available since 1991. Improvements in cryotechnique and progress in transrectal high-resolution ultrasound permit thermo-induced damage to the whole gland to be curative. Downstaging of prostate cancer by hormone ablative therapy remains a controversial issue at this time, but the use of androgen ablation decreases the size of the prostate gland which facilitates cryosurgery and improves the results. The freezing equipment has a limited capacity, and in certain instances large gland volumes prevent adequate freezing of the prostate. Since percutaneous prostate cryosurgery leaves dead tissue in situ to be resorbed over time, downsizing reduces the amount of necrotic tissue to be resorbed, reducing the potential for complications, particularly abscesses. The use of androgen ablation also increases the deposition of fat in the area of the Denonvillier’s fascia, making freezing of the rectum less likely during the procedure. In our study androgen ablative therapy was completed before performing cryosurgery in 26 of 43 patients (58%). The 17 patients not given androgen ablation therapy had gland volumes <40 ml, tumor volumes <3 ml, and no evidence of extracapsular tumor. The neoadjuvant therapy consisted of a 3- to 10-month course of leuprolide acetate combined with an antiandrogen.
Enhancing the Efficacy of Radical Prostatectomy in Locally Advanced Prostate Cancer
Authors: Altwein J.E.
Published: April 2003

Locally advanced prostate cancer patients comprise those with iatrogenic capsular injury, extracapsular extension resulting in positive surgical margins following radical prostatectomy, and tumors with lymph node metastases, thus representing stage T3,N0,M0 or T1–4,N1–2,M0 disease. Parameters can be combined, as shown below, in a nomogram to predict advanced prostate cancer: if, for example, stage T2c is coupled with a PSA of 16 ng/ml and a high Gleason grade, the patient will have an approximately 70% likelihood of having extracapsular extension; then again, if the Gleason score is known from biopsies and a PSA of 10–20 ng/ml is given, then a stage T2c prostate cancer patient with a Gleason of 7 will have a 39% probability of having positive lymph nodes. The following therapeutic considerations may be used to enhance the chance of eradicating advanced disease through radical prostatectomy: (1) Neoadjuvant hormonal therapy helps downsize the tumor and may eventually reduce the number of positive margins by almost 50%. However, it is a moot point if this will lead to a prolonged survival period. (2) Technical refinements on radical prostatectomy may be achieved through the principle of wide extension excision, a modification of current apical dissection procedures, which involves the use of panoramic magnifying loupes, and an examination of resection margins during surgery using repetitive frozen sections. (3) If positive (not simply ‘equivocal’ as defined by Epstein) margins are found, radical prostatectomy alone is not curative. Among the various options available is postoperative irradiation with or without adjuvant hormonal therapy. The latter should probably be reserved for patients with extracapsular extension, a high Gleason score or positive lymph nodes. Hormonal therapy may be used continuously or intermittently. The value of adjuvant treatment is currently being tested in phase-III trials. (4) Hormonal therapy may be commenced at the time of biochemical or clinical progression, although it is not clear whether this modality is inferior to adjuvant forms of treatment. Technical expertise in radical prostatectomy accumulated at major institutions can be used to the advantage of patients with locally advanced prostate cancer. In this regard, results of ongoing phase-III trials testing various options including this procedure are eagerly awaited.
Hereditary Prostate Cancer and Other Genetic Predispositions to Prostate Cancer
Authors: Cussenot O. , Valeri A. , Berthon P. , Fournier G. , Mangin P.
Published: April 2003

The incidence of prostate cancer (CaP) and its increase in the last 10 years vary both from country to country and according to the ethnic group, with the highest incidence reported for Afro-Americans and the lowest for Asian men. To date, only three risk factors have been established for CaP: age; familial aggregation of CaP, and ethnic origins. No dietary or environment-related cause has been established. However, some variations in endogenous genetic factors may help explain differences in risk among ethnic groups or geographic areas. Similarly, certain genetic polymorphisms of genes encoding for 5α-reductase, androgen receptor or vitamin D, have been associated with different levels of CaP risk, and could explain the variations observed between populations. Different studies support the view that familial CaP may truly be hereditary, and not due to a similar lifestyle. Thus, familial inheritance is a parameter that needs to be considered in recommending screening for high-risk families. Indeed, when 1, 2, and 3 first-degree relatives are affected, the relative risk of first-degree relatives of CaP patients may increase to 2, 5, and 11%, respectively. Some familial forms appear to be associated with transmission of a rare putative dominant gene with a high penetrance (88% at age 85), with the cumulative proportion of CaP attributable to this gene being more marked for younger patients (a 43 versus a 34% risk of CaP appearing before the age of 55 versus 70 years). Using this transmission model and linkage analysis, a predisposing locus on chromosome 1q24–25 (HPC–1) has been described. Moreover, recessive and X-linked transmission has been suggested, showing that a large proportion of familial CaP may not be due to segregation of a few major gene mutations, but rather to familial sharing of alleles at many loci, each contributing to a small increase in cancer risk. Candidate genes may be the same suppressor genes that are involved in other cancers and in sporadic CaP.
The Incidence of Pharmacologically Induced Priapism in the Diagnostic and Therapeutic Management of 685 Men with Erectile Dysfunction
Authors: Perimenis P. , Athanasopoulos A. , Geramoutsos I. , Barbalias G.
Published: April 2003

Objective: To evaluate the incidence of pharmacologically induced priapism in the diagnostic and therapeutic management of erectile dysfunction. Patients and Methods: Over a period of 7 years, 685 men were investigated for erectile failure. They underwent a simple test with vaso-active drugs, and the nonresponders were further investigated. Eventually, 83 men began autoinjections and 45 still continue. Results: Eight (1.2%) cases of priapism presented during the simple test with vaso-active drugs in these patients, while none occurred during self-injection treatment. Three were prolonged erections induced by prostaglandin E1 (PGE1) and 5 by papaverine (Pap). Six were treated safely with intracavernosal injection of etilephrine without blood aspiration. Conclusion: Priapism is always a potential phenomenon where no individual, no particular drug and no specific dose are completely safe. It may be caused even with 5 µg of PGE1 or 7.5 mg of Pap. Auto-injection therapy however is a safe kind of treatment in well-experienced patients. Careful regulation of the doses and practice in the use of vaso-active drugs may reduce the priapism rate.
Mycotic Abdominal Aortic Aneurysm: A Fatal Sequel to Concomitant Prostatic and Renal Aspergillosis
Authors: Ansari M.S. , Nabi Ghulam , Singh Iqbal , Hemal A.K. , Bhan Anil
Published: April 2003

We report the first case of aspergillus mycotic aneurysm as a sequel to concomitant prostatic and renal aspergillosis. The patient had undergone left nephrectomy and transurethral resection of prostate for aspergillus infection one year ago. He again presented with LUTS and backache and clinical examination showed visible pulsations in the epigastrium. CT-scan abdomen showed a pseudoaneurysm of the abdominal aorta. The aneurysm was repaired in situ with homografting and omental wrap. However, the patient succumbed to septicemia on the tenth postoperative day. Adjunctive surgery is usually essential as medical management alone has been unsatisfactory. It is imperative that these cases should be followed closely to detect the disease recurrence and complications at the earliest.
Urethral Hemangioma
Authors: Parshad Sanjeev , Yadav S.P. , Arora B.
Published: April 2003

Urethral hemangioma is an exceedingly rare, benign tumor which commonly presents as urethral bleeding. Urethroscopy is the best diagnostic procedure. There are various treatment modalities and appropriate therapy is individualised depending upon site, size and number of hemangiomas. We report a case of solitary urethral hemagioma present in the bulbar urethra. The patient presented with spontaneous profuse hematuria and was managed by wide excision of the hemangioma.
Double Infundibular Obliteration with Abscess Formation after Percutaneous Nephrolithotomy
Authors: Buchholz Niels-Peter
Published: April 2003

A case of an unusual complication after percutaneous nephrolithotomy. After removal of an infectious staghorn calculus followed by SWL, the patient developed a double infundibular stricture leaving the kidney divided into three separate compartments. In spite of the absence of clinical symptoms of infection, this was further complicated by abscess formation and finally, function loss of the upper part of the kidney. Combined retro- and anterograde endoscopic surgery failed to re-establish the complete continuity of the uretero-caliceal system and the patient had to undergo partial nephrectomy. Possible etiologies, contributing factors and means of prevention for this rare complication are discussed.
Segmental Multicystic Dysplastic Kidney in an Adult Woman
Authors: Suzuki K. , Kurokawa S. , Muraishi O. , Tokue A.
Published: April 2003

We report a case of unilateral segmental multicystic dysplastic kidney (SMCDK) in an adult woman. A 42-year-old woman presented with abdominal distension and gross hematuria. The preoperative diagnosis was cystic renal cell carcinoma, and a radical nephrectomy was performed. Histopathologically, the resected kidney was SMCDK with severe hydronephrosis.
Comparison of Ultrasound-Guided Biopsies and Prostatectomy Specimens: Predictive Accuracy of Gleason Score and Tumor Site
Authors: Gregori Andrea , Vieweg Johannes , Dahm Philip , Paulson David F.
Published: April 2003

Objective: To critically evaluate the accuracy of sextant biopsies in predicting Gleason score and the site of tumor location in patients with clinically localized prostate cancer treated by radical perineal prostatectomy. Methods: The case records of 289 patients with clinically localized prostate cancer who underwent radical perineal prostatectomy were reviewed, comparing the Gleason score and tumor site location as determined by sextant ultrasound-guided core biopsies with the Gleason score and tumor distribution within the surgical specimens. The prostatectomy specimens were further characterized by extent of disease as organ-confined, specimen-confined or margin-positive. Results: The Gleason score was identical in 126 (43.5%) patients. An upgrading in the surgical specimen occurred in 118 (40.8%) cases, a downgrading in 43 (14.8%). Overall, 193 (66.7%) patients had a unilateral positive biopsy, while 96 (33.2%) patients had bilateral positive biopsies. Sixty-four (33.1%) patients with a unilateral positive biopsy had cancer confined to one side of the gland, while 127 (65.8%) showed bilateral disease; 142 (73.5%) patients had organ-confined tumors versus 51 (26.4%) patients with capsular penetration. In the 96 patients with bilateral positive biopsies, 64 (66.6%) patients had intracapsular cancer versus 32 (33.3%) patients with either specimen-confined or margin-positive disease. The overall rate of positive margins was 14%. Fifty-one (61.4%) of the 83 patients with non-organ-confined disease had posterolateral capsular penetration in the region of the superior pedicle of the neurovascular bundle, while 28 (33.7%) patients had apical capsular penetration, in the region of the inferior neurovascular pedicle. Conclusions: The ability of sextant ultrasound-guided biopsies to estimate the pathological grading is satisfactory: when we consider a difference of ± 1 in the final Gleason score, the overall correlation is 80%. In 66% of the cases, sextant biopsies predicted unilateral disease when bilateral disease existed. A unilateral positive biopsy does not predict unilateral disease.
Discontinuation of Alpha-Blockade after Initial Treatment with Finasteride and Doxazosin for Bladder Outlet Obstruction
Authors: Baldwin Kelly C. , Ginsberg Phillip C. , Harkaway Richard C.
Published: April 2003

Objectives: Patients with symptomatic bladder outlet obstruction and moderately enlarged prostates can receive durable relief from finasteride. However, the delayed onset of action has led many clinicians to prescribe an α-blocker in addition to finasteride early in therapy for more rapid symptom relief. Our goal was to determine when to discontinue the α-blocker in this group of patients. Methods: We enrolled 100 consecutive men with an estimated prostate size of >40 g and an AUA symptom score of ≧20, who reported an initially favorable response to combination therapy with 5 mg finasteride and 2 mg doxazosin daily. The average symptom score reduction at 1 month was 3.3. We discontinued the doxazosin at 3, 6, 9, or 12 months, while continuing finasteride, then reevaluated patients 1 month later to determine if the patients reported any worsening of symptoms. Results: Twenty-five patients discontinued doxazosin at 3 months. Five (20%) were successfully discontinued, reporting no change in symptom score. Twenty reported worsening symptoms. Twenty-five patients discontinued doxazosin at 6 months. Twelve (48%) were successfully discontinued, reporting no change in symptom scores. Thirteen (52%) reported worsening symptoms. Twenty-five patients discontinued doxazosin at 9 months. Twenty-one (84%) were successfully discontinued, reporting no change in symptom scores. Four (16%) reported worsening symptoms. Twenty-five patients discontinued doxazosin at 12 months. Twenty-one (84%) were successfully discontinued, reporting no change in symptom scores. Four (16%) reported worsening symptoms. Conclusion: Patients with symptomatic bladder outlet obstruction and moderately enlarged prostates who are placed initially on combination therapy using finasteride and an α-blocker are likely to tolerate discontinuation of the α-blocker after 9 months of combination therapy.
Pressure-Flow Studies in Men with Benign Prostatic Hypertrophy before and after Treatment with Transurethral Needle Ablation
Authors: Minardi D. , Garofalo F. , Yehia M. , Cristalli A.F. , Giammarco L. , Galosi A.B. , Muzzonigro G.
Published: April 2003

Background/Aims: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the effects on erectile and ejaculatory function. Materials and Methods: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 ± 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. Results: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. Conclusions: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of <60 cm H2O, with a baseline detrusor pressure at maximum flow of <60 cm H2O, with a pretreatment residual volume of <100 ml and with a QOL score of <5.
Idiopathic Calcification of the Seminal Vesicles: A Rare Cause forProstate Cancer Oversta ging
Authors: Pannek Jürgen , Senge Theodor
Published: April 2003

Calcification of the seminal vesicles is a rare phenomenon. We present 2 cases in whom calcification of the seminal vesicles led to preoperative overstaging of prostate cancer. Although idiopathic calcifications are extremely rare, calcifications appear more frequently in diabetic patients. Therefore, knowledge of these formations is essential to prevent overstaging, namely infiltration of the seminal vesicles.
Malignant Priapism Associated with Metastatic Urethral Carcinoma
Authors: Hettiarachchi Janaka A. , Johnson G. Blake , Panageas Ellen , Drinis Sophia , Konno Sensuke , Das Akhil K.
Published: April 2003

We present a 40-year-old man with malignant priapism secondary to urethral squamous cell carcinoma. Magnetic resonance imaging revealed the tumor originating from the bulbous urethra, extending into the penile urethra and corpora spongiosa and cavernosa. A penile biopsy confirmed poorly differentiated squamous cell carcinoma of the urethra. Despite administration of systemic chemotherapy, the prognosis of the patient has worsened due to the extensive metastatic disease.
Vesico-Ileal Fistula Caused by a Foreign Body
Authors: Wyczółkowski Marek , Klima Włodzimierz , Łabza Henryk , Kasprzyk Jan
Published: April 2003

An enterovesical fistula due to an intestinal foreign body is presented and the therapeutic aspects of the lesion are discussed.
Intrathoracic Kidney in an Adult
Authors: Sidhu R. , Gupta R. , Dabra A. , Duseja A.
Published: April 2003

An intrathoracic kidney, although rare, should be considered in a patient with a mass at the base of the lung on a chest radiograph. Excretory urography is diagnostic and may eliminate the need for further extensive investigation and operation.
Intracellular Electrical Activity in Human Urinary Bladder Smooth Muscle: The Effect of High Sucrose Medium
Authors: Visser Anna J. , van Mastrigt Ron
Published: April 2003

Introduction: The primary key to pharmacotherapy of bladder instability is in the excitation-contraction coupling of detrusor smooth muscle cells. To study this process, simultaneous recordings of mechanical and electrical activity are required. However, recording of mechanical activity induces movement, which may affect the quality of intracellular recordings. Materials and Methods: We therefore compared the electrical activity of human detrusor smooth muscle cells in normal Krebs’ solution and in a hypertonic solution, which immobilizes the tissue, enabling us to study the effect of movement on the membrane potential. Carbachol and KCl were applied to induce contractions. Results: Sucrose in the medium made the tissue rigid and abolished its movement, while the electrical response was not affected. When compared with recordings in normal Krebs’ solution, the average resting membrane potential was not altered. However, the membrane potential was more stable, with far less spike-shaped potentials. The spike-shaped potential amplitude was larger, while the duration was decreased. Conclusions: Impairing the ability of tissue movement resulted in changes in the electrophysiological properties of detrusor smooth muscle cells. The results suggest that stretch has an effect on L-type Ca2+ channels.
MALT-Type Primary Lymphoma of the Urinary Bladder: Clinicopathological Study of 2 Cases and Review of the Literature
Authors: Wazait Hassan D. , Chahal R. , Sundurum S.K. , Rajkumar G.N. , Wright D. , Aslam M.M.
Published: April 2003

Primary lymphoma of the bladder is a rare non-epithelial bladder tumour. It is usually non-Hodgkin’s lymphoma with mucosa-associated lymphoid tissue (MALT) lymphoma being its predominant subtype. Most of the literature has been limited to individual sporadic case reports. We present 2 cases of the MALT-type primary lymphoma of the urinary bladder which were treated in our unit. Both patients were females with a history of recurrent urinary tract infections. They were treated successfully with chemotherapy alone. We also present a review of the literature emphasising the clinical presentation, the morphological and immunophenotypic features and the various treatment modalities of this rarely seen bladder pathology.
An Unusual Cause of Irritable Urinary Bladder Symptoms
Authors: Reisman Y. , de Reijke T.M.
Published: April 2003

A metastasis from a renal cell carcinoma to a seminal vesicle is extremely rare. This pattern of metastatic disease has been reported once previously in the Japanese literature. We describe a patient with irritability symptoms of the urine bladder and involuntary loss of stool caused by obstruction of the bladder by a large metastasis from a renal cell carcinoma to the seminal vesicle. The mode of diagnosis and treatment of this patient are described.
HP1γ associates with euchromatin and heterochromatin in mammalian nuclei and chromosomes
Authors: Minc E. , Courvalin J.-C. , Buendia B.
Published: April 2003

Heterochromatin protein 1 (HP1) is a nonhistone chromosomal protein, first identified in Drosophila, that plays a dose-dependent role in gene silencing. Three orthologs, HP1α, HP1β, and HP1γ, have been characterized in mammals. While HP1α and HP1β have been unambiguously localized in heterochromatin by immunocytochemical methods, HP1γ has been found either exclusively associated with euchromatin or present in both euchromatin and heterochromatin. Here, using an antibody directed against a peptide epitope at the carboxyl-terminal end of the molecule, we localize HP1γ in both euchromatin and heterochromatin compartments of interphase nuclei, as well as in the pericentromeric chromatin and arms of mitotic chromosomes of 3T3 cells. This dual location was also observed in nuclei expressing HP1γ as a fusion protein with green fluorescent protein. In contrast, when the distribution of HP1γ was analyzed with antibodies directed against an amino-terminal epitope, the protein was detectable in euchromatin and not in heterochromatin, except for transient heterochromatin staining during the late S phase, when the heterochromatin undergoes replication. These data suggest that the controversial immunolocalization of HP1γ in chromatin is due to the use of antibodies directed against topologically distinct epitopes, those present at the amino-terminal end of the molecule being selectively masked in nonreplicative heterochromatin.
Hypothesis: chemical carcinogenesis mediated by a transiently active carcinogen receptor
Authors: Frowein J.
Published: April 2003

Biologically active small-molecular-weight compounds are actively transported into the cell nucleus by a specific receptor. This has been widely demonstrated for retinoids, polycyclic hydrocarbons (such as steroids), and dioxin. Thus, it is reasonable to assume that genotoxically active polycyclic hydrocarbons, and possibly all genotoxically active small-molecular-weight substances, exert their transformational effect in the cell nucleus via a specific receptor. I propose that the receptor is activated only at the end of the G1 phase of the cell cycle and that the carcinogen receptor complex interferes directly with DNA synthesis, leading to mutations. This hypothesis may account for various characteristics of malignant growth, such as the organ specificity of carcinogens and the relationship between cell proliferation and malignant transformation. If so, it could form the basis for establishing a radioreceptor assay for carcinogens.
Distribution of HOX genes in the chicken genome reveals a new segment of conservation between human and chicken
Authors: Ladjali-Mohammedi K. , Grapin-Botton A. , Bonnin M.A. , Le Douarin N.M.
Published: April 2003

Homeobox genes play an important role in the regulation of early embryonic development. They represent a family of evolutionarily highly conserved transcription factors. In this work, several genes that belong to the four HOX gene clusters are assigned by in situ hybridization to four distinct chicken chromosomes. The four gene clusters are mapped to 2p2.1 (HOXA), 3q3.1 (HOXB), 1q3.1 (HOXC) and 7q1.3→ q1.4 (HOXD). We confirm partial homologies already detected by genetic mapping between chicken chromosomes 1, 2 and 7 and human chromosomes 12, 7 and 2 and we describe a new conserved segment between chicken chromosome 3 and human chromosome 17. These results represent the first data that confirm the physical linkage between chicken HOX genes and may improve our understanding of phylogenetic relationships and genome evolution.
Gene for the human transmembrane-type protein tyrosine phosphatase H (PTPRH): genomic structure, fine-mapping and its exclusion as a candidate for Peutz-Jeghers syndrome
Authors: Marneros A.G. , Mehenni H. , Reichenberger E. , Antonarakis S.E. , Krieg T. , Olsen B.R.
Published: April 2003

Mutations in the serine/threonine kinase STK11 lead to Peutz-Jeghers syndrome (PJS) in a subset of affected individuals. Significant evidence for linkage to a second potential PJS disease locus on 19q13.4 has previously been described in one PJS family (PJS07). In the current study, we investigated this second locus for PJS gene candidates. We mapped the main candidate gene in this region, the gene for the transmembrane-type protein tyrosine phosphatase H (PTPRH), within 15 kb telomeric to the marker D19S880. We determined its genomic structure, and performed mutation analysis of all exons and the exon-intron junctions of the PTPRH gene in the PJS07 family. No disease causing mutation was identified in PTPRH in affected individuals, suggesting the existence of an as yet not identified gene on 19q13.4 as a second PJS gene.
Structure, sequence and function of a marsupial LIF gene: Conservation of IL-6 family cytokines
Authors: Cui S. , Hope R.M. , Rathjen J. , Voyle R.B. , Rathjen P.D.
Published: April 2003

Leukaemia Inhibitory Factor (LIF) is a multifunctional cytokine with an obligate role in the mouse in embryonic implantation. In this paper we demonstrate the existence of a functional LIF gene in the marsupial Sminthopsis crassicaudata, and the presence of LIF-related sequences in the monotreme Tachyglossus aculeatus (Australian echidna). Isolation of genomic and cDNA clones from S. crassicaudata, indicated that the LIF gene is highly conserved between marsupials and monotremes in terms of sequence and genomic organisation. Critical functional residues within the LIF sequence were also conserved including residues implicated in intracellular LIF activity, and in interaction with the receptor subunits LIFR and gp130. These findings suggest that the structure and biochemical function of the protein is likely to be conserved. Consistent with this, purified recombinant S. crassicaudata LIF interacted functionally with mouse receptor components and was sufficient for maintenance of mouse embryonic stem (ES) cells in the undifferentiated state. Conservation of LIF outside eutherians is intriguing given the markedly divergent reproductive strategies which include, for some marsupial species, embryonic diapause, and in monotremes, the absence of implantation. The availability of marsupial LIF probes provides an opportunity to investigate conservation of expression and function in these mammals.
Fine-mapping of cytogenetically undetectable EWS/ERG fusions on DNA fibers of Ewing tumors
Authors: Hattinger C.M. , Rumpler S. , Kovar H. , Ambros P.F.
Published: April 2003

In contrast to the EWS/FLI1 fusion which is represented by a t(11;22)(q24;q12), EWS/ERG fusions are frequently cytogenetically not detectable. Three Ewing tumors (ET), two with apparently normal chromosomes 21 and 22, and one ET with a t(2;22)(p25;q12), were studied by FISH on interphase nuclei, metaphase chromosomes and on DNA fibers. EWS/ERG transcripts were detected by RT-PCR in all cases. FISH, using cosmids located proximally (F10, G9) and distally (F7) to the EWS breakpoint region, revealed no detectable separation of these probes in two cases. In contrast, co-hybridization of probe PT1526 containing the ERG breakpoint region with G9 revealed the juxtaposition of two signals per interphase nucleus in all three cases indicating the EWS/ERG fusions. Chromosome preparations displayed the juxtaposed signals on the der(22), and hybridization signals of the probes PT1526 and G9 on the non-rearranged chromosomes 21 and 22 in all cases, respectively. The PT1526 signal on the der(21) was seen only in cases 1 and 2. These results were confirmed by triple-target FISH on tumor DNA fibers. In all three cases, the hybridization pattern F10 – G9 – PT1526 indicates a centromere to telomere orientation. This finding suggests that EWS/ERG fusions in ETs may be generated by an inversion of the ERG gene or a part thereof followed by an insertion into the EWS gene on the der(22). Double-target FISH on interphase nuclei using probes flanking the EWS breakpoint region and probe PT1526 enables the detection of virtually all 22q12 rearrangements in ETs, thus providing a reliable diagnostic assay.
Assignment of eight additional genes from human chromosome 11 to bovine chromosomes 15 and 29: refinement of the comparative map
Authors: Gautier M. , Hayes H. , Taourit S. , Laurent P. , Eggen A.
Published: April 2003

A comparative mapping approach was applied in order to refine the extent and the distribution of conserved segments between human chromosome 11 (HSA11) and cattle chromosomes 15 and 29 (BTA15 and BTA29 respectively). Eight genes from HSA11 were mapped using a bovine-hamster somatic cell hybrid panel and seven represent new assignments. Adding these assignments to those present in human, mouse and cattle databases, a new conserved segment was identified between the telomeric region of HSA11 and BTA29. This brings to seven the number of conserved segments identified between HSA11 and BTA15 and 29, and our study refines their boundaries to the level of the human cytogenetic band.
Mouse paracentric inversion In(3)55Rk mutates the urate oxidase gene
Authors: Cook S.A. , Akeson E.C. , Calvano C. , Johnson K.R. , Mandell J. , Hawes N.L. , Bronson R.T. , Roderick T.H. , Davisson M.T.
Published: April 2003

The paracentric inversion In(3)55Rk on mouse Chromosome 3 (Chr 3) was induced by cesium irradiation. Genetic crosses indicate the proximal breakpoint cosegregates with D3Mit324 and D3Mit92; the distal breakpoint cosegregates with D3Mit127, D3Mit160, and D3Mit200. Giemsa-banded chromosomes show the inversion spans ∼80% of Chr 3. The proximal breakpoint occurs within band 3A2, not 3B as reported previously; the distal breakpoint occurs within band 3H3. Mice homozygous for the inversion exhibit nephropathy indicative of uricase deficiency. Southern blot analyses of urate oxidase, Uox, show two RFLPs of genomic mutant DNA: an EcoRI site between exons 4–8 and a BamHI site 3′ to exon 6. Mutant cDNA fails to amplify downstream of base 844 at the 3′ end of exon 7. FISH analysis of chromosomes from inversion heterozygotes, using a cosmid clone containing genomic wild-type DNA for Uox exons 2–4, shows that a 5′ segment of the mutated Uox allele on the inverted chromosome has been transposed from the distal breakpoint region to the proximal breakpoint region. Clinical, histopathological, and Northern analyses indicate that our radiation-induced mutation, uoxIn, is a putative null.
Organization and chromosomal localization of the human and mouse genes coding for LanC-like protein 1 (LANCL1)
Authors: Mayer H. , Bauer H. , Prohaska R.
Published: April 2003

We have determined the organization and chromosome location of the human LANCL1 and mouse Lancl1 genes encoding LANCL1, the lanthionine synthetase component C (LanC)-like protein 1. LANCL1 is related to the bacterial LanC family which is involved in the biosynthesis of antimicrobial peptides. The human and mouse genes span 45 kb and 38 kb, respectively, each comprising ten exons. Within the potential promoter regions, several consensus sequences for ubiquitous and tissue-specific transcription factors are present, reflecting the expression data. The nucleotide sequence of the previously unknown mouse full-length transcript is also reported here. Fluorescence in situ hybridization analyses assigned the LANCL1 gene to human chromosome 2q34 and the Lancl1 gene to mouse chromosome 1, region C2–C5, in accordance with the known homology.
Genomic structure and chromosome location of the human gene encoding the zinc finger autoantigen ZNF330
Authors: Bolívar J. , García-Cozar F.J. , Astola A. , Iglesias C. , Pendón C. , Valdivia M.M.
Published: April 2003

We have recently described a novel zinc finger cDNA, ZNF330, which was immunologicaly characterized as a new human autoantigen, highly conserved during evolution from nematodes to humans. The protein was found at the nucleolus and the cytoplasm in interphase and transiently associates with centromeres in mitosis as determined by immunofluorescence analysis. We now describe that the association of ZNF330 with the nucleolus but not with the cytoplasm is RNA-dependent as shown by RNAse treatment of fixed culture cells, since ZNF330 localization was unaffected by DNAse treatment. We also report the cloning, structural organization and chromosome location of the human ZNF330 gene. The gene is comprised of 10 exons and spans approximately 16 kb of genomic DNA. The conserved residues forming nine CXXC motifs are contained in exons 3 to 9. Several major transcription initiation sites were located 126, 124 and 121 bp upstream of the translation initiation codon ATG, as determined by primer extension analysis. The human ZNF330 gene was mapped by FISH to chromosome 4q31.1→q31.2, the site of the FRA4C locus previously described as a common fragile site for acquired chromosome instability in humans.
Primed in situ labeling: sensitivity and specificity for detection of α-satellite DNA in the centromere regions of chromosomes 13 and 21
Authors: Yang J. , Schwinger E. , Mennicke K.
Published: April 2003

The centromeric α-satellite DNA subfamilies from chromosomes 13 and 21 are almost identical in sequence. So far it has proven difficult to discriminate between sequence variations in the chromosome 13 and 21 α-satellite regions using in situ techniques. To analyze whether the method of modified single-color and double-color PRINS could be used to detect single nucleotide polymorphisms within this region, we used previously published primers D13Z and D21Z that differ in the terminal 3′-nucleotide and an additionally constructed primer “D13/21-test” lacking the final nucleotide at the 3′ end. The results show that a one-base pair mismatch at the 3′ end is sufficient to be detected by PRINS. Surprisingly, only about 35% of our samples exhibited the expected combination of two chromosomes 13 specifically labeled with only primer D13Z and two chromosomes 21 specifically labeled with only primer D21Z. The rest of the samples showed a polymorphic distribution of the target sequence for the primers, therefore these primers are not suited for routine detection of chromosomes 13 and 21 during interphase. Our data indicate that an interchromosomal exchange of α-satellite DNA takes place between chromosomes 13 and 21, possibly due to a concerted evolution process.
Characterization of the human ribonucleotide reductase M2 subunit gene; genomic structure and promoter analyses
Authors: Zhou B. , Yen Y.
Published: April 2003

Ribonucleotide Reductase (RR) is a rate-limiting enzyme in DNA synthesis and repair consisting of two subunits, M1 and M2. RRM2 plays a role in cell proliferation, tumorgenicity, metastasis and drug resistance. To better understand the regulation of RRM2, we have sequenced the entire human RRM2 gene. Approximately 10.3 kb of genomic DNA was sequenced and deposited to GenBank (accession number AY032750). Intron/exon junctions were identified and the gene was found to consist of ten exons. Two transcription initiation sites were identified and correspond to mRNA transcripts of 3.4 kb and 1.65 kb. Deletion analysis of the 5′-flanking region showed that there was promoter activity consistent with the presence of two separate promoters driving expression of the two RRM2 transcripts. A thorough analysis of the genomic sequence and promoter regions of the RRM2 gene will provide insight into the processes involved in tumor transformation and drug resistance.
Chromosome map of cosmid clones constructed with Chinese hamster genomic DNA
Authors: Ono T. , Sonta S.
Published: April 2003

By fluorescence in situ hybridization (FISH), we constructed a chromosome map of 324 site-specific clones and 119 painting clones, which were isolated from a cosmid library of Chinese hamster genomic DNA. The site-specific clones were distributed among all chromosomes except chromosome 10 and the Y chromosome. On the other hand, FISH signals of painting clones were mainly found in heterochromatic regions. First, the various combinations of clones painting centromeric regions suggest that the centromeric heterochromatin of Chinese hamster chromosomes is extremely diverse in its repetitive sequence composition. Second, the long arm of the X chromosome and the whole Y chromosome, both heterochromatic regions, were simultaneously painted by many clones. The pattern of co-localization indicated that a proximal segment of the long arm of the X chromosome matches the complete long arm of the Y chromosome, whereas a distal segment of the long arm of the X chromosome is comparable to the whole short arm of the Y chromosome. Thus, these findings suggest that the corresponding segments of the X and Y-chromosomes have common repeated DNA elements.
Rethinking ‘Acculturation’ in Relation to Diasporic Cultures and Postcolonial Identities
Authors: Bhatia Sunil , Ram Anjali
Published: April 2003

In this article, we reexamine the concept of ‘acculturation’ in cross-cultural psychology, especially with respect to non-western, non-European immigrants living in the United States. By drawing primarily on postcolonial scholarship, we specifically reconsider the universalist assumption in cross-cultural psychology that all immigrant groups undergo the same kind of ‘psychological’ acculturation process. In so doing, (1) we consider some of the historical and political events related to immigration in the United States; (2) we question the conflation of nation with culture that emerges in many theories of acculturation; (3) we use the notion of diaspora as theorized in postcolonial studies to rethink the concept of ‘integration strategy’ as developed in cross-cultural psychology. Our article has implications for general issues of culture and self in human development, and particular issues in the area of acculturation.
Economic Impact of Treating Inhibitor Patients
Authors: Lacey Loretto
Published: April 2003

A literature review of the economics of managing haemophilia patients with inhibitors was conducted. It showed that haemophilia with inhibitors places a burden on the healthcare system and on the patient. Use of rFVIIa compared to ‘usual therapy’ is associated with improvements on a number of outcomes, including speed of bleed resolution, duration of pain, and quality of life. The extra costs of rFVIIa can be justified by the additional benefits achieved: For example, the extra costs required to achieve a gain of one quality adjusted life year (QALY) in children with inhibitors has been shown to be comparable with that for other reimbursed healthcare strategies. Future research could focus on expanding our understanding of the impact of accelerated bleed resolution on long-term sequelae, including need for surgery and quality of life.