bluuebunny/crossref_metadata_2025 huggingface dataset:
Tissue Trace Element Change after Total Body Irradiation
Authors: Cengiz Mustafa , Gurkaynak Murat , Vural Hüseyin , Aksoy Nurten , Cengiz Beyhan , Yildiz Ferah , Atahan I. Lale
Published: June 2003

Purpose: In this study, we examined the changes of tissue contents of trace elements and iron after total body irradiation (TBI) and their possible impact on late toxicities. Material and Methods: 20 female Wistar rats were randomly assigned to two groups – either radiation (n = 10) or control (n = 10). Rats in the radiation group received TBI of 5 Gy in a single fraction. Rats were sacrificed and tissue samples of heart, lung and kidney were taken 8 weeks after radiation. Tissue levels of zinc, copper, magnesium, manganese and iron analysis were performed with an atomic absorption spectrophotometer and suprapure grade standard solutions. One kidney of each animal was taken for electron microscopic analysis. Blood samples were collected from all animals and the blood chemistry related to kidney function was studied. Results: The kidney levels of Fe and Cu significantly increased 8 weeks after irradiation (p < 0.05). The Cu/Zn ratio did not reach statistical significance in any tissue, however in kidney, there was a tendency to rise (p = 0.08). Myocardium and lung content of trace elements and iron did not show any significant change 8 weeks after irradiation. Electron microscopic analysis showed significant injury in glomerular endothelial cells, renal tubules and thickening of basement membrane. Blood chemistry showed a significant rise in serum creatinine (p = 0.008) and calcium (p = 0.01) in the TBI group. Serum creatinine levels were 0.73 and 0.84 mg/dl, and serum calcium levels were 10.1 and 11.3 mg/dl in control and TBI groups, respectively. Conclusion: A sublethal dose of TBI causes deposition of Cu and Fe within the kidney after TBI. Deposition of these elements may have some additional role on the toxicity caused by direct radiation on the kidney.
Role of Cytochrome P450 2B1 in Puromycin Aminonucleoside-Induced Cytotoxicity to Glomerular Epithelial Cells
Authors: Liu Hua , Baliga Mithra , Bigler Steven A. , Baliga Radhakrishna
Published: June 2003

Puromycin aminonucleoside (PAN)-induced glomerular injury in rats mimics minimal-change nephrotic syndrome (NS) in humans. We have demonstrated an important role of cytochrome P450 (CYP) as a significant source of catalytic iron in this model of NS. The current study was designed to identify CYP isozyme(s) present in the rat glomerular epithelial cells (GEC) and to explore the role of the specific CYP isozyme in PAN-induced cytotoxicity. CYP2B1 was identified in GEC by immunocytochemistry and Western blot. Treatment of GEC with PAN resulted in a marked generation of hydrogen peroxide (H2O2) and reduction of CYP2B1 content associated with significant increase in catalytic iron and hydroxyl radical formation. Preincubating GEC with CYP2B1 inhibitors (piperine and cimetidine) and H2O2 scavenger (pyruvate) significantly reduced H2O2 generation, preserved CYP2B1 content, prevented the increase in catalytic iron and hydroxyl radical formation including PAN-induced cytotoxicity. We also observed the induction of heme oxygenase (HO-1) in PAN-treated GEC, and this up-regulation was reduced by pretreatment of the CYP inhibitors and pyruvate. Our data thus indicate an important role of CYP2B1 in PAN-induced cytotoxicity by serving as a site of reactive oxygen metabolite generation and a significant source of catalytic iron.
On the Horizon: Tailor-Made Immunosuppression in Renal Transplantation
Authors: Warrens Anthony N.
Published: June 2003

Immunosuppression for renal transplantation has undergone more changes over the last 8 years than at any other time in its history. It is now possible to be more selective in the matching of drugs with a given patient. This brings with it the option of improving graft outcome and also minimizing adverse effects. It is an ongoing process that will utilize agents working at different points in the activation cascade of the CD4+ ‘helper’ T lymphocyte. It may also be possible to manipulate the immune system such that the organ-specific immune response may be switched off, or rendered ‘tolerant’, thus removing the need for any immunosuppressive drugs. In this brief review, we shall address each of these approaches and discuss other therapeutic avenues being investigated.
Atheroembolic Renal Failure Requiring Dialysis: Potential for Renal Recovery?
Authors: Thériault Josée , Agharazzi Mohsen , Dumont Marc , Pichette Vincent , Ouimet Denis , Leblanc Martine
Published: June 2003

Aims: Our objectives were to review the characteristics of patients who developed atheroembolic renal disease requiring dialysis as well as their renal function recovery and survival rates. Methods: All cases of atheroembolic disease with renal failure severe enough to require dialysis were reviewed from January 1984 to December 2000 in two centers. The diagnosis of atheroemboli was based on clinical presentation and/or biopsy. Acute renal failure was defined as a serum creatinine >200 µmol/l if normal at baseline or doubling from baseline if chronic renal failure, whereas renal function recovery was the ability to discontinue renal replacement therapy for ≧3 months. Results: Forty-three cases were identified (37 males and 6 females; mean age 67 ± 5 years); the average time to acute renal failure and to diagnosis was similar at 36 days. The majority of patients had at least one precipitating factor identified (58% coronary angiography, 26% angiography, 16% vascular surgery, 2% anticoagulation); 1 had a spontaneous presentation whereas 7 had more than one factor. More than 90% had underlying hypertension and chronic renal dysfunction with a baseline creatinine of 195 ± 81 µmol/l, approximately 80% had coronary artery disease, 80% were smokers, 60% had a history of abdominal aorta aneurysm, >50% presented with intermittent claudication, and 56% were anticoagulated at the time of the event. Most patients were nonoliguric (80%), had increased hypertension (71%), blue toes (67%), livedo reticularis (52%), whereas abdominal pain and central nervous system symptoms were present in 33 and 7% of the cases, respectively. Eosinophilia was found in 88%, while hypocomplementemia was present in less than 15%. When compared to the 12 patients with recovery of renal function (after a mean delay of 409 ± 336 days), the 31 patients who did not recover function presented with more severe intermittent claudication and underlying chronic renal dysfunction (p < 0.05). Indeed, the only variable found to unfavorably influence renal function recovery was the presence of intermittent claudication. Patients were mainly treated by intermittent hemodialysis except for 5 (2 on CRRT and 3 on peritoneal dialysis). Renal function recovery was associated with a higher chance of survival; 33% of patients died in the first year after diagnosis. Conclusion: Atheroembolic renal disease carries a high mortality rate reflective of the extensive cardiovascular disease of affected patients; nevertheless, the potential for renal function recovery appears greater than for other vascular causes of renal failure.
Non-Invasive Monitoring of Renal Transplant Recipients: Urinary Excretion of Soluble Adhesion Molecules and of the Complement-Split Product C4d
Authors: Lederer Stephan R. , Friedrich Nicole , Regenbogen Claudia , Getto Rainer , Toepfer Marcel , Sitter Thomas
Published: June 2003

Background: The number of inducible adhesion molecules known to be involved in cell-mediated allograft rejection is still increasing. In addition, recent data describe complement activation during acute humoral allograft rejection. The aim of this study was to assess whether specific molecules from either pathway are excreted into urine and whether they can provide useful diagnostic tools for the monitoring of renal transplant recipients. Methods: Urinary concentrations of soluble adhesion molecules (sICAM-1, sVCAM-1) and of the complement degradation product C4d were determined by standardized ELISA technique in 75 recipients of renal allografts and 29 healthy controls. Patient samples were assigned to four categories according to clinical criteria: group 1: acute steroid-sensitive rejection (ASSR, n = 14), group 2: acute steroid-resistant rejection (ASRR, n = 12), group 3: chronic allograft dysfunction (CAD, n = 20) and group 4: stable graft function (SGF, n = 29). Results: All patients with rejection episodes (groups 1–3) had significantly higher values of urinary sC4d compared with healthy controls and patients with stable graft function (p < 0.05). The urinary levels of sVCAM-1 were significantly higher in group 2 (ASRR) compared with all other groups (p < 0.001). Uniformly low amounts of s-VCAM-1 and complement-split product C4d were excreted by healthy controls (group 0). In contrast, urinary sICAM-1 concentration in healthy controls was almost as high as in group 2 (ASRR) whereas patients with a stable functioning graft (group 4) excreted significantly less sICAM-1 (p < 0.05). Conclusion: The evaluation of sVCAM-1 and sC4d excretion in urine can provide a valuable tool with regard to the severity and type of allograft rejection. With respect to long-term allograft survival, serial measurements of these markers should have the potential to detect rejection episodes and prompt immediate treatment.
Molecular Genetic and Endocrine Mechanisms of Hair Growth
Authors: Alonso Laura C. , Rosenfield Robert L.
Published: June 2003

The prenatal morphogenesis of hair follicles depends upon a precisely regulated series of molecular genetic processes. Hormones and their receptors play prominent roles in modulating postnatal hair cycling, which recapitulates some aspects of morphogenesis. The responses to androgen are the most obvious of these. The postnatal androgen sensitivity of pilosebaceous units in different skin areas is programmed during prenatal development to permit clinical outcomes such as hirsutism and pattern baldness. Thyroid hormone, glucocorticoids, insulin-like growth factor-I, and prolactin have clinically significant effects on specific aspects of hair growth. The nuclear receptors vitamin D receptor and retinoid X receptor are essential for postnatal hair cycling. Other hormones have less clear effects on hair growth. Advances in research on the interaction of hormone target genes with the biological processes involved in hair morphogenesis and cycling can be expected to improve management of hirsutism and alopecia.
IFN-γ Increases the hGH Gene Promoter Activity in Rat GH3 Cells
Authors: Gong Feng-Ying , Deng Jie-Ying , Shi Yi-Fan
Published: June 2003

Aim: To study the effect(s) of interferon gamma (IFN-γ) on the activity of human growth hormone (hGH) gene promoter in rat pituitary GH3 cells and the molecular mechanism underlying the effect(s). Methods: Cell transfection and luciferase reporter gene were used. Results: IFN-γ (102 and 103 U/ml) increased the activity of hGH in GH3 cells. The addition of the mitogen-activated protein kinase inhibitor PD98059 (40 µmol/l) to the cells blocked the stimulatory effect of IFN-γ. Neither overexpression of Pit-1 nor inhibiting Pit-1 expression affected IFN-γ induction of hGH promoter activity. To identify the DNA sequence that mediated the effect of IFN-γ, four deletion constructs of hGH gene promoter were created. The stimulatory effect of IFN-γ was abolished following deletion of the –250 to –132 fragment. Conclusions: IFN-γ increases the activity of hGH gene promoter in rat pituitary GH3 cells. This stimulatory effect of IFN-γ appears to require the intracellular mitogen-activated protein kinase-dependent signaling pathway. The effect of IFN-γ requires the promoter sequence that spans the –250 to –132 fragment of the gene, but is unrelated to Pit-1 protein.
Osteoporosis in Male Hypogonadism: Responses to Androgen Substitution Differ among Men with Primary and Secondary Hypogonadism
Authors: Schubert Markus , Bullmann Catharina , Minnemann Timo , Reiners Christoph , Krone Wilhelm , Jockenhövel Friedrich
Published: June 2003

Background: No randomized study exists comparing the effects of different modes of androgen substitution on bone mineral density (BMD). Methods: We performed a prospective, randomized, trial assigning 53 hypogonadal men to the following treatment groups: mesterolone 100 mg p.o. daily, testosterone undecanoate 160 mg p.o. daily, testosterone enanthate 250 mg i.m. every 21 days, or a single subcutaneous implantation of 1,200 mg crystalline testosterone. The BMD was determined by peripheral quantitative computed tomography. Results: At baseline, men with secondary hypogonadism (n = 33) had a lower BMD (–1.52 ± 0.23 SDS; Z-scores) than men with primary hypogonadism (n = 20, –0.87 ± 0.23 SDS, p < 0.01). In men with primary hypogonadism, the BMD increased dose dependently (crystalline testosterone +7.0 ± 1.3%, testosterone enanthate +4.8 ± 0.2%, testosterone undecanoate +3.4 ± 2.5%, mesterolone +0.8 ± 1.6%) after 6 months of therapy. Only secondary hypogonadal men treated with testosterone enanthate experienced an increase of the BMD. Conclusions: In primary hypogonadal men the BMD responds dose dependently to testosterone substitution, whereas in secondary hypogonadism only testosterone enanthate treatment significantly increased the BMD.
Relations of Serum Interleukin 18 Levels to Serum Lipid and Glucose Concentrations in an Apparently Healthy Adult Population
Authors: Olusi S.O. , Al-Awadhi A. , Abraham M.
Published: June 2003

Aim: To investigate the associations between serum interleukin (IL) 18 concentrations and indices of lipid and carbohydrate metabolism in healthy adults. Methods: Fasting serum concentrations of IL-18, glucose, total cholesterol, triglyceride, and high- and low-density lipoprotein cholesterols were measured in 570 apparently healthy adults. Results: Univariate linear and partial regression analyses showed that the serum IL-18 concentration was positively correlated with serum triglyceride and glucose concentrations in both obese and diabetic subjects after controlling for the confounding effects of age, sex, and body mass index. Conclusion: IL-18 may be associated with obesity and glucose intolerance.
Low Levels of the 150-kD Insulin-Like Growth Factor Binding Protein 3 Ternary Complex in Patients with Anorexia nervosa: Effect of Partial Weight Recovery
Authors: Støving René K. , Hangaard Jørgen , Hagen Claus , Flyvbjerg Allan
Published: June 2003

Background/Aim: In healthy adults, serum insulin-like growth factor I (IGF), IGF-binding protein 3 (IGFBP-3), and acid-labile subunit (ALS) form a 150-kD ternary complex under the control of growth hormone (GH). Circulating IGF-I half-life, bioavailability, and endocrine actions depend on the ternary complex formation. Despite GH hypersecretion, serum IGF-I, IGFBP-3, and ALS levels have all been reported to be low in patients with anorexia nervosa (AN), while the degree of ternary complex formation in AN is unknown. Methods: Serum ALS and 150-kD ternary complex formation were measured in 6 women with AN at the time of diagnosis and after partial weight recovery and in 6 healthy age-matched women serving as controls. Results: Patients with AN had low levels of ALS and IGFBP-3 contained in the 150-kD ternary complex and in the non-150-kD fraction. Following partial weight recovery, the 150-kD IGFBP-3 ternary complex was fully normalized, despite only partial normalization of serum GH and IGF-I levels. Patients with AN did not present with IGFBP-3 proteolysis different from controls. Conclusion: The present data indicate a pivotal role of the nutritional status in the regulation of each of the three components of the 150-kDa ternary IGFBP-3 complex and in the formation of the complex itself.
Molecular Skin Barrier Models and Some Central Problems for the Understanding of Skin Barrier Structure and Function
Authors: Norlén L.
Published: June 2003

A better understanding of the structure and function of the human skin barrier is a prerequisite for a more rational design of transdermal drug administration systems. The study of biological structural organisation is, however, confronted with many difficulties, and interpretations of skin barrier-related data should therefore be done with caution. The recently developed ‘single gel-phase model’ constitutes an attempt to interpret structural and functional skin barrier data from a biophysical standpoint.
Bioavailability of Clobetasol Propionate in Different Vehicles
Authors: Franz T.J. , Lehman P.A. , Feldman S.R. , Spellman M.C.
Published: June 2003

Topical clobetasol propionate is widely used for the treatment of psoriasis. One formulation of clobetasol propionate, Skin Cap, was thought by some practitioners and patients to be more effective than other formulations. Differences in corticosteroid bioavailability could account for differences in efficacy. The purpose of this study is to compare the relative bioavailability of clobetasol propionate from Skin Cap to two FDA-approved formulations of clobetasol propionate (Olux foam and Temovate scalp application). The bioavailability was assessed by measuring the percutaneous absorption of clobetasol propionate in vitro on scalp skin, using the human cadaver skin model. There was no significant difference in the percutaneous absorption of clobetasol propionate between Olux foam and Skin Cap (2.09 and 1.93% at 48 h, respectively) or between Olux foam and Temovate scalp application (3.70 and 3.46%, respectively) when applied under unoccluded conditions. Under occluded conditions, there was greater absorption of clobetasol propionate from the Olux foam as compared with Skin Cap (4.94 and 1.57%, respectively; p < 0.05). The Skin Cap vehicle does not provide more bioavailable clobetasol propionate than currently available, FDA-approved products. Other differences, including those in patient compliance, could account for the perceived efficacy of the product.
UV/VIS Absorbance Allows Rapid, Accurate, and Reproducible Mass Determination of Corneocytes Removed by Tape Stripping
Authors: Weigmann H.-J. , Lindemann U. , Antoniou C. , Tsikrikas G.N. , Stratigos A.I. , Katsambas A. , Sterry W. , Lademann J.
Published: June 2003

The accurate determination of the mass of the horny layer removed by tape stripping is a decisive prerequisite for the application of this technique in penetration studies. A novel method using optical spectroscopy to determine the amount of stratum corneum (SC) is presented. We could show that the absorbance measured in the visible spectral range accurately reflects the mass of the SC fixed on individual tapes. Furthermore, absorbance measurement allows determination of the absolute mass of corneocyte aggregates on the removed tape strips. Topically applied substances do not disturb the spectroscopic measurements in contrast to the conventionally employed weight determination. Identical results were obtained when performing spectroscopic horny layer quantification independently in two separate institutions. Taken together, this new method is rapid, sensitive, reproducible, and accurate. We anticipate a wide application in penetration studies as well as in dermatopharmacokinetics.
Evaluation of the Pseudo-Absorption Method to Quantify Human Stratum corneum Removed by Tape Stripping Using Protein Absorption
Authors: Lindemann U. , Weigmann H.-J. , Schaefer H. , Sterry W. , Lademann J.
Published: June 2003

Tape stripping is a well-known method to study the barrier function of the stratum corneum (SC) and penetration processes of topically applied substances into the horny layer. The quantification of the removed corneocytes for each tape strip is the prerequisite for these studies. The pseudo-absorption of the corneocytes was proposed as a measure for the quantification of the removed corneocyte aggregates. In this study, the pseudo-absorption of the corneocytes in the visible range (430 nm) is compared with the protein absorption in the UV range (278 nm) and an absorption at 652 nm obtained after staining of the SC proteins with Trypan blue. Both the protein absorption and the absorption measured after staining correlate well with the pseudo-absorption measured at 430 nm (R2 = 0.92 ± 0.04 and R2 = 0.95 ± 0.04, respectively).
Characteristics of Skin Wrinkling and Dermal Changes Induced by Repeated Application of Squalene Monohydroperoxide to Hairless Mouse Skin
Authors: Chiba K. , Kawakami K. , Sone T. , Onoue M.
Published: June 2003

We have studied the effect of squalene monohydroperoxides (Sq-OOH), initial products of UV-peroxidated squalene, on the skin of hairless mice. Repeated topical application of 10 mM Sq-OOH to hairless mice for 15 weeks induced definite skin wrinkling. When image analysis was used to compare wrinkle formation induced by ultraviolet B (UVB) irradiation and Sq-OOH treatment, the degree of wrinkling in exposed skin was seen to be similar. However, the characteristics of wrinkles induced by either method differed markedly with regard to direction and distribution. Biochemical analysis revealed a significant decrease in collagen content per unit area and mass in Sq-OOH-treated skin, whereas no changes per unit area and decrease in collagen per unit mass were observed in UVB-irradiated skin. As for glycosaminoglycan (GAG) content per unit area, significant increases were observed in both Sq-OOH-treated skin and UVB-irradiated skin. These changes were not induced by organic hydroperoxides such as tert-butylhydroperoxide or cumene hydroperoxide treatment. Histological observation revealed epidermal hyperplasia and dermal alterations such as collagen degradation and GAG increases in Sq-OOH-treated skin. Histological changes induced by Sq-OOH were not as pronounced as those induced by UVB irradiation. These results clearly suggest that the wrinkling and changes in dermal collagen content induced by Sq-OOH are qualitatively different to those induced by UVB exposure. This may provide a useful model for the study of skin aging, particularly with regard to collagen content.
Complications of Intrathecal Baclofen Pumps in Children
Authors: Gooch Judith L. , Oberg Wende A. , Grams Barbara , Ward Lorrie A. , Walker Marion L.
Published: June 2003

Intrathecal baclofen is increasingly being used to manage severe spasticity in children. Although substantial tone reduction with this treatment has been documented, complications also occur. In this study, we describe the device- and major non-device-related complications in a group of 100 consecutive children and young adults who received 117 intrathecal baclofen pumps for the management of severe spasticity. Twenty-four patients (24%) experienced a total of 48 complications. The most common complication was disconnection of the catheter at its connection to the pump, occurring in 9% of pumps implanted. This complication occurred more frequently in pumps with catheter access ports (16%) than in those without ports (2%). Catheter dislodgement from the intrathecal space was the next most common complication, occurring in 8% of pumps implanted (13% of pumps with ports, 4% of pumps without ports). To decrease the occurrence of the most common complications of intrathecal pumps, we now typically implant pumps without catheter access ports, and we use 2-piece catheters. Although the lack of an access port may be a disadvantage for troubleshooting, most complications can be detected in pumps without a port. Patient and family education is critical in preventing serious consequences of baclofen withdrawal resulting from catheter-related complications.
The First Description of a Device for Repeated External Ventricular Drainage in the Treatment of Congenital Hydrocephalus, Invented in 1744 by Claude-Nicolas Le Cat
Authors: Kompanje E.J.O. , Delwel E.J.
Published: June 2003

An 18th century report of a device for repeated extracranial drainage of cerebrospinal fluid in the treatment of congenital hydrocephalus is reviewed. On 15th October 1744, the French surgeon Claude-Nicolas Le Cat (1700–1768) introduced a specially invented canula into the lateral ventricle of a newborn boy with hydrocephalus. The canula was used as a tap and was left in place for 5 days, until the death of the child. This procedure should be seen as the first documented description of a device for repeated ventricular taps in the treatment of hydrocephalus.
Intramedullary Schistosomiasis
Authors: Labeodan O.A. , Sur M.
Published: June 2003

A case study of intramedullary schistosomiasis in a 10-year-old child is reported. The patient presented with a short history of ascending paraparesis with no sensory loss. Sphincter dysfunction was rapid. She had surgical exploration and removal of a conus medullaris mass. Schistosomiasis was confirmed histologically. Combined steroid and praziquantel therapy improved her sphincter function and paraparesis.
Frontal and Occipital Horn Width Ratio for the Evaluation of Small and Asymmetrical Ventricles
Authors: Jamous Mohammad , Sood Sandeep , Kumar Ravi , Ham Steven
Published: June 2003

The aim of this study was the introduction of a new linear ventricular measurement which has a better correlation with ventricular volume than the commonly used linear measurements, especially in chronically shunted patients with small and/or asymmetrical ventricles. Ventricular volume, brain volume, Evans ratio, Schierman index, cella media index and frontal and occipital horn ratio were measured from CT scans of 57 shunted hydrocephalic patients and 20 normal control children. Four groups of patients were identified with regards to the ventricular size and symmetry (small, large, symmetrical and asymmetrical). A new linear measurement was defined as half of the ratio of the frontal and occipital ventricular width to that of the skull (frontal and occipital horn width ratio; FOHWR) and compared to other linear measurements in different patient groups. FOHWR showed better correlation with ventricular size and ventricular brain ratio than the ventricular linear measurements currently in use, especially in chronically shunted patients with small and/or asymmetrical ventricles.
Alternative Uses for the Subgaleal Shunt in Pediatric Neurosurgery
Authors: Tubbs R. Shane , Smyth Matthew D. , Wellons III John C. , Blount Jeffrey P. , Grabb Paul A. , Oakes W. Jerry
Published: June 2003

The subgaleal shunt has been used for the temporary bypass of the normal cerebrospinal fluid (CSF) pathways. We retrospectively reviewed all subgaleal shunts placed at the Children’s Hospital, Birmingham, Ala., USA, from 1997 to the present and examined all uses (e.g. indication, length of follow-up) of the subgaleal shunt outside its use for temporary CSF diversion in premature infants with intraventricular hemorrhage and subsequent hydrocephalus. The average length of survival of the primary subgaleal shunt in this population was 32.2 days. We have had good success with subgaleal shunts in children with malignant brain tumors, intraventricular abscesses, chronic truncal wounds, chronic subdural hygromas and meningitis. However, the greatest utility has been in those scenarios in which the peritoneal cavities were not currently, but with time would be, candidates for distal shunt implantation. Examples of these instances are patients with hydrocephalus and necrotizing enterocolitis or hydrocephalus and preoperative abdominal wall pathology such as omphalocele.
Nonclosure of the Peritoneum at Shunt Insertion
Authors: Musharbash Awni
Published: June 2003

To evaluate the nonclosure of the peritoneum during insertion of the distal end of a ventriculoperitoneal shunt in the peritoneal cavity, 43 patients in whom a ventriculoperitoneal shunt was inserted using laparotomy with nonclosure of the peritoneum for insertion of the distal catheter were reviewed. No morbidity occurred during a follow-up period of 3–9 months. We think that nonclosure of the peritoneum is safe in shunt surgery, but needs to be evaluated in further studies.
Hemorrhagic Complications of Intracranial Pressure Monitors in Children
Authors: Blaha Martin , Lazar Daniel , Winn Richard H. , Ghatan Saadi
Published: June 2003

Intracranial pressure (ICP) monitoring plays a valuable role in the management of head injuries and other causes of raised ICP in the pediatric population. The purpose of this study was to investigate the incidence of hemorrhage after ICP monitor insertion, and to classify these complications in a clinically relevant manner. Hospital charts of 431 children (ages 0–16 years) admitted to a level I trauma center over a 2-year period were reviewed and 112 patients (134 insertions) who underwent intraparenchymal ICP monitoring were identified. The authors reviewed postoperative neuroradiological studies. One hundred and nineteen procedures were carried out without any hemorrhage (grade 0). After 10 insertions, a small punctate hemorrhage or localized subarachnoid hemorrhage occurred (grade 1). Three patients sustained an intracerebral hemorrhage that did not require evacuation or manifest as a new neurological deficit (grade 2). There were no hemorrhagic complications that necessitated evacuation or resulted in a noticeable change in the patient’s clinical condition (grade 3). We propose a new grading system for hemorrhage after ICP monitor insertion. We found a complication rate close to 10% in our pediatric patients. Fortunately, these hemorrhages were clinically silent and no neurosurgical intervention was necessary. However, grade 1 and grade 2 hemorrhages may manifest with a false reading of high ICP, and the long-term consequences of these complications are not known. Of note, only 23% of these complications were reflected in the patients charts, which may explain the low complication rates reported in other studies that did not analyze postoperative neuroradiological studies.
Recurrence of Pediatric Cerebral Arteriovenous Malformations after Angiographically Documented Resection
Authors: Ali M. Jafer , Bendok Bernard R. , Rosenblatt Sami , Rose James E. , Getch Christopher C. , Batjer H. Hunt
Published: June 2003

Angiographically confirmed surgical resection is believed to be the ‘gold standard’ for cure in the treatment of intracranial arteriovenous malformations (AVMs). However, rare exceptions of recurrent AVMs have been documented. We are aware of 11 reported cases of recurrent AVMs in which complete resection of the initial lesion was confirmed by postoperative angiography. Eight of these cases were in the pediatric population. In this report, we present 2 additional cases of such recurrent lesions, review the clinical and scientific literature on this rare phenomenon and provide suggested management guidelines.
Application of Diffusion Tensor Imaging to Magnetic-Resonance-Guided Brain Tumor Resection
Authors: Tummala Ramachandra P. , Chu Ray M. , Liu Haiying , Truwit Charles L. , Hall Walter A.
Published: June 2003

Interventional magnetic resonance imaging (MRI) continues to make a profound impact on the practice of neurosurgery. We describe a new MRI modality, diffusion tensor imaging (DTI), which uses the diffusion energy of water to map white matter fibers. DTI has been established in other disorders such as metabolic, demyelinating and ischemic diseases. We describe the use of DTI in identifying white matter tracts such as optic radiations and avoiding them intraoperatively in 2 children with low-grade glial tumors.
Gonadotropin-Releasing Hormone Activates the 12-Lipoxygenase Pathway in the LβT2 Gonadotrope Cell Line
Authors: Limor Rona , Naor Zvi , Weisinger Gery , Naidich Michal , Knoll Esther , Sharon Orly , Stern Naftali
Published: June 2003

Previous studies have indicated that arachidonic acid and its lipoxygenase (LO) metabolites play a role in the post-receptor effects of gonadotropin-releasing hormone (GnRH) but the exact role and nature of these putative eicosanoids remain unclear. The potential role of arachidonic acid and LO in GnRH receptor-mediated signaling was investigated in the LβT2 gonadotrope cell line, which expresses gonadotropins (LH and FSH) and GnRH-receptor mRNAs. Western immunobloting of LβT2 cell extracts, performed with a murine leukocyte polyclonal antibody against 12-LO, showed a 70-kD band, suggesting the presence of 12-LO protein in these cells. GnRH nearly doubled the release of 12-hydroeicosatetraenoic acid, a product of the 12-LO enzyme, within 10 min. A specific reverse transcriptase polymerase chain reaction with a set of primers based on the reported sequence of rat brain 12-LO yielded a 170-bp band which showed 100% homology with the expected rat brain 12-LO sequence. Exposure of LβT2 cells to pulsatile GnRH treatment (10 nM, 90-min interpulse, one and three pulses) led to a ∼3-fold increase in 12-LO mRNA levels. In conclusion, we provide evidence for the presence of a 12-LO enzyme in LβT2 cells, the expression and activity of which are increased by short-term/pulsatile exposure to GnRH. LβT2 cells represent a potential model to further study the involvement of 12-LO in GnRH receptor signaling.
Evidence for a GABAergic System in Rodent and Human Testis: Local GABA Production and GABA Receptors
Authors: Geigerseder Christof , Doepner Richard , Thalhammer Andrea , Frungieri Monica B. , Gamel-Didelon Katia , Calandra Ricardo S. , Köhn Frank M. , Mayerhofer Artur
Published: June 2003

The major neurotransmitter of the central nervous system, gamma-aminobutyric acid (GABA), exerts its actions through GABAA, GABAB and GABAC receptors. GABA and GABA receptors are, however, also present in several non-neural tissues, including the endocrine organs pituitary, pancreas and testis. In the case of the rat testis, GABA appears to be linked to the regulation of steroid synthesis by Leydig cells via GABAA receptors, but neither testicular sources of GABA, nor the precise nature of testicular GABA receptors are fully known. We examined these points in rat, mouse, hamster and human testicular samples. RT-PCR followed by sequencing showed that the GABA-synthesizing enzymes glutamate decarboxylase (GAD) 65 and/or GAD67, as well as the vesicular GABA transporter vesicular inhibitory amino acid transporter (VIAAT/VGAT) are expressed. Testicular GAD in the rat was shown to be functionally active by using a GAD assay, and Western blot analysis confirmed the presence of GAD65 and GAD67. Interstitial cells, most of which are Leydig cells according to their location and morphological characteristics, showed positive immunoreaction for GAD and VIAAT/VGAT proteins. In addition, several GABAA receptor subunits (α1–3, β1–3, γ1–3), as well as GABAB receptor subunits R1 and R2, were detected by RT-PCR. Western blot analysis confirmed the results for GABAA receptor subunits β2/3 in the rat, and immunohistochemistry identified interstitial Leydig cells to possess immunoreactive GABAA receptor subunits β2/3 and α1. The presence of GABAA receptor subunit α1 mRNA in interstitial cells of the rat testis was further shown after laser microdissection followed by RT-PCR analysis. In summary, these results describe molecular details of the components of an intratesticular GABAergic system expressed in the endocrine compartment of rodent and human testes. While the physiological significance of this peripheral neuroendocrine system conserved throughout species remains to be elucidated, its mere presence in humans suggests the possibility that clinically used drugs might be able to interfere with testicular function.
Differential Expression of Estrogen Receptors Alpha and Beta in the Spinal Cord during Postnatal Development: Localization in Glial Cells
Authors: Platania Paola , Laureanti Floriana , Bellomo Maria , Giuffrida Rosario , Giuffrida-Stella Anna Maria , Catania Maria Vincenza , Sortino Maria Angela
Published: June 2003

Estrogens are recognized as neuroprotective and neurotrophic agents in the central nervous system. They are involved in neuronal differentiation and survival and promote neural development. Estrogen receptors alpha (ER-α) and beta (ER-β) are predominantly expressed in neurons, whereas their presence in glial cells in vivo is more controversial. Changes in their expression during development have been described in different brain areas, but little is known about their presence in the spinal cord. We have carried out an immunohistochemical study in an attempt to analyze the expression of both ERs in astrocytes and oligodendrocytes of the rat spinal cord and their modifications during postnatal development. RT-PCR analysis of whole spinal cord extracts from 4-, 12-, and 25-day-old and adult rats indicated changes in the expression of both receptors during maturation. Immunohistochemistry of slices of the lumbar tract revealed that in an area of the ventral spinal cord that does not contain neuronal cell bodies, but mainly fibers and glial cells, both ER-α and ER-β can be detected. Immunostaining is clearly nuclear, and, in the case of ER-α, both markedly positive and weakly labeled cells can be identified. ER-α is expressed during early development to progressively decline in the adult stage. In contrast, the ER-β signal is low and peaks at postnatal day 25, whereas it is almost undetectable at other ages. Colocalization studies revealed that, at postnatal day 25, ER-α and ER-β are expressed in astrocytes (identified by the specific marker glial fibrillar acidic protein) and oligodendrocytes (labeled by antimyelin 2′,3′-cyclic nucleotide 3′-phosphodiesterase). The present results confirm the expression of ER-α and ER-β in glial cells in vivo and suggest that, also in the spinal cord, glial cells may contribute to the effects of estrogen during development.
Experiences of a Short Vocal Training Course for Call-Centre Customer Service Advisors
Authors: Lehto Laura , Rantala Leena , Vilkman Erkki , Alku Paavo , Bäckström Tom
Published: June 2003

It is commonly known that occupational voice users suffer from voice symptoms to varying extents. The purpose of this study was to find out the effects of a short (2-day) vocal training course on professional speakers’ voice. The subjects were 38 female and 10 male customer advisors, who mainly use the telephone during their working hours at a call centre. The findings showed that although the subjects did not suffer from severe voice problems, they reported that the short vocal training course had an effect of some of the vocal symptoms they had experienced. More than 50% of the females and males reported a decrease in the feeling of mucus and the consequent need to clear the throat, and diminished worsening of their voice. Over 60% thought that voice training had improved their vocal habits and none reported a negative influence of the course on their voice. Females also reported a reduction of vocal fatigue. The subjects were further asked to respond to 23 statements on how they experienced the voice training in general. The statements ‘I learned things that I didn’t know about the use of voice in general’ and ‘I got useful and important knowledge concerning my work’ were highly assessed by both females and males. The results suggest that even a short vocal training course might affect positively the self-reported well-being of persons working in a vocally loading occupation. However, to find out the long-term effects of a short training course, a follow-up study would need to be carried out.
Effects of Two Types of Tongue Strengthening Exercises in Young Normals
Authors: Lazarus Cathy , Logemann Jeri A. , Huang Cheng-Fang , Rademaker Alfred W.
Published: June 2003

This pilot study examines the effects of two types of tongue strengthening exercises on tongue function measures of strength and endurance in a group of 31 healthy young subjects. Subjects underwent baseline and 1 month post-baseline assessments of tongue function and were randomized to one of three groups, including: (1) no exercise; (2) exercise group receiving standard tongue strength exercises using a tongue depressor, and (3) exercise group receiving tongue strengthening exercises using the Iowa Oral Performance Instrument. Results revealed a significantly greater change in maximum tongue strength in the group that received any treatment compared with the group receiving no treatment (p = 0.04). Results provide support for the theory that tongue strengthening exercises improve tongue strength in healthy young subjects.
Identification of a New Member of Type I Na/Phosphate Co-Transporter in the Rat Kidney
Authors: Ishibashi Kenichi , Matsuzaki Toshiyuki , Takata Kuniaki , Imai Masashi
Published: June 2003

Aim: To clone new phosphate transporters from the kidney. Methods: EST bank was screened for new members of Na-dependent inorganic phosphate (Pi) co-transporter. To obtain a full-length clone, a rat kidney cDNA library was screened with the EST clone as a probe. Results: We isolated a cDNA that encodes a type I Na/Pi co-transporter. Based on the sequence homology and tissue distribution, it will be the rat ortholog of human NPT4 (Solute Carrier family 17, member A3, SLC17A3) and is designated rNPT4. When expressed in Xenopus oocytes, Na/Pi co-transport activity was demonstrated. In Northern blotting analysis, rNPT4 was selectively expressed in the liver and kidney. In immunohistochemical analysis, rNPT4 was localized at the apical membrane of the proximal tubules (S2, S3) in the rat kidney. The electron microscopic studies confirmed this finding. Conclusion: The present study revealed the expression of a new type I Na/Pi co-transporter at the brush border membrane of the proximal tubules in the kidney.
The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial
Authors: Baan A.H. , Vermeulen H. , van der Meulen J. , Bossuyt P. , Olszyna D. , Gouma D.J.
Published: June 2003

Background/Aim: Transurethral catheterization is generally associated with a higher incidence of urinary tract infections than suprapubic catheterization; however, suprapubic catheterization is associated with other disadvantages such as higher costs and a more difficult technique, and at the moment there is no consensus about the use of both catheter systems. Therefore, a prospective randomized study was performed to investigate the effects of suprapubic catheterization and transurethral catheterization in patients undergoing surgery on the incidence of urinary tract infections and patient satisfaction. Methods: Patients who underwent an elective laparotomy were randomized and received a suprapubic or transurethral catheter. The primary end point was urinary tract infection. Other parameters of urinary tract infection, as well as duration of catheterization, hospital stay, and number of recatheterizations and of relaparotomies were monitored. Treatment ‘per protocol’ was also analyzed after exclusion of patients receiving another catheter than randomized for. Patients were asked for their satisfaction with the catheters and complaints during and after catheterization. Results: 165 patients were eligible, of whom 19 patients had to be excluded. 75 patients were allocated to receive the suprapubic catheter and 71 the transurethral catheter. There was no difference in the incidence of a urinary tract infection between the suprapubic group (n = 9/75; 12%) and the transurethral group (n = 8/71; 11%). Most patients (6/9) who developed a urinary tract infection in the suprapubic group, however, underwent recatheterization because of postoperative complications/sepsis and relaparotomy. The incidence of urinary tract infections in patients who received a suprapubic catheter and not a transurethral catheter was 3/59 (5%). The patients did not differ with respect to satisfaction and complaints. Being a men, recatheterization and duration of catheterization are risk factors. Conclusions: The incidence of a urinary tract infection between a suprapubic catheter and a transurethral catheter in patients undergoing major surgery was not different. A potential advantage of the suprapubic catheter (reduction of urinary tract infections) is probably partly negated, because transurethral catheters were used if recatheterization was indicated during the postoperative stay or due to complications.
Alveolar Echinococcosis in Turkey
Authors: Emre Ali , Özden Ilgin , Bilge Orhan , Arıcı Cumhur , Alper Aydın , Ökten Attila , Acunas Bülent , Rozanes Izzet , Acarlı Koray , Tekant Yaman , Arıogul Orhan
Published: June 2003

Background: Radical resection is the only potentially curative treatment for hepatic alveolar echinococcosis (AE). Although Turkey is an endemic region, population screening is not performed and early diagnosis is rare. Consequently, surgeons are compelled to explore possibilities such as near-total resection and biliodigestive anastomosis for palliation of jaundice. Methods: Surgery was performed in 32 patients with hepatic AE with the following indications: (1) resection; (2) palliation of jaundice; (3) definite assessment of operability; (4) failure in the management of cavity infection by percutaneous methods. Curative resection (R0 = complete resection of all parasitic mass [n = 9], and R1 = a resection in which a small remnant was left on a vital structure [n = 8]) were performed in 17 patients, intrahepatic cholangiojejunostomy in 7, laparotomy-external drainage in 7, and debulking in 1. Results: Perioperative mortality rates were 2/17, 0/7, 2/7 and 1/1, respectively. Twelve patients in the curative resection group are alive without recurrence/progression of the small remnant during a median follow-up of 59 (range 27–116) months. One patient developed an inoperable recurrence that was treated with albendazole. One patient was lost to follow-up. Long-term albendazole treatment was effective in all R1 patients except a patient who had slow asymptomatic progression. Successful palliation of jaundice was achieved in 5 of the 7 intrahepatic cholangiojejunostomy patients. Conclusions: The results of R1 resection in alveolar hydatid disease are similar to those of R0 resection; a small remnant is successfully controlled by albendazole. In patients with jaundice due to hilar invasion, biliary diversion from segment 3 or 5 is effective for palliation of the jaundice and facilitates albendazole treatment.
Portal Venous Gas Detected by Computed Tomography: Is Surgery Imperative?
Authors: Iannitti David A. , Gregg Shea C. , Mayo-Smith William W. , Tomolonis Richard J. , Cioffi William G. , Pricolo Victor E.
Published: June 2003

Background: Portal vein gas (PVG) has historically been associated with mortality rates of 75% or higher and mandatory abdominal exploration. The following study reassesses the clinical significance of gas in the portal venous system detected by computed tomography (CT) and reevaluates the need for surgical intervention in that setting. Methods: We performed a retrospective chart review of 26 patients presenting with gas in the portal venous system as imaged by CT between August 1, 1993 and April 8, 2001. Characteristics assessed included age, sex, clinical presentation and course, additional CT findings, diagnosis, surgical versus non-surgical management, surgical findings, pathologic correlation, and mortality. Results: Of the 26 patients who had gas in the portal venous system by CT, 11 underwent surgery to determine underlying pathology. Of those who underwent surgery, 8 survived to be discharged while 3 died (73% surgical survival). The survivors presented with gastrointestinal related signs/symptoms and were found at the time of surgery to have adhesions, non-surgically treated inflammation, unclear pathology, or resectable lesions. Those who died all demonstrated marked bowel ischemia intraoperatively. Among patients who did not undergo surgery, 9 survived and 6 died (60% nonsurgical survival). Those who survived presented either asymptomatically or with pathology including acute pancreatitis, recent hypotensive episode, uncomplicated diverticulitis, unresectable colon cancer, or infectious etiology. Those who died were poor surgical candidates or status postvascular procedure. The overall survival in patients with portal venous gas by CT was 65%. Conclusion: Portal venous gas on CT is associated with a wide range of pathologies that do not necessarily warrant surgical management. Clinical presentation should be correlated with the presence of PVG and other associated CT findings prior to deciding whether surgery should be performed.