bluuebunny/crossref_metadata_2025 huggingface dataset:
The Spatial Relationship of γ-Aminobutyric Acid (GABA) Neurons and Gonadotropin-Releasing Hormone (GnRH) Neurons in Larval and Adult Sea Lamprey, Petromyzon marinus
Authors: Reed Karen L. , MacIntyre Janet K. , Tobet Stuart A. , Trudeau Vance L. , MacEachern Lisa , Rubin Beverly S. , Sower Stacia A.
Published: April 2003

In this study we examined the spatial relationship of GABA-containing and GnRH-containing neurons by immunocytochemistry and in situ hybridization in larval and adult brains of sea lamprey, Petromyzon marinus. In immunocytochemical studies, GABA-containing neurons were detected early in lamprey development, by day 20 post-fertilization. At this time point, one population of GABA-containing neurons was visualized in the hypothalamus and preoptic area, and another population was located in the olfactory bulb of the telencephalon. By day 30 after fertilization, after the GABA neurons were detected, GnRH-containing neurons were visualized in the preoptic area/rostral hypothalamus region, adjacent to the GABA-containing neurons in the wall of the third ventricle. Similarly, in adult lamprey brains distinct populations of both GABA- and GnRH-containing neurons were located in the hypothalamus adjacent to the third ventricle. To further establish a proximate relationship between GABA and GnRH, the mRNA for glutamate decarboxylase (GAD), the enzyme catalyzing GABA synthesis from glutamate, and GnRH were examined by in situ hybridization in the brains of larval lamprey. These studies also showed that GnRH and GAD are produced in cell populations in and around the third ventricle of the hypothalamus. This close spatial relationship of GABA neurons and GnRH neurons provides a basis for a regulatory role of GABA on GnRH neurons in the sea lamprey.
Effects of Lesions of Nucleus taeniae on Appetitive and Consummatory Aspects of Male Sexual Behavior in Japanese Quail
Authors: Absil Philippe , Braquenier Jean Baptiste , Balthazart Jacques , Ball Gregory F.
Published: April 2003

Neurochemical, hodological and functional criteria suggest that the nucleus taeniae and parts of the adjacent archistriatum represent the avian homologue of parts of the mammalian amygdaloid complex. It has been proposed in particular that the nucleus taeniae is the homologue of the mammalian medial amygdala. In male quail, relatively large lesions to the posterior/medial archistriatum selectively decrease the expression of appetitive sexual behavior in a manner reminiscent of similar manipulations involving the medial amygdala in mammals. We investigated the effects of discrete lesions restricted to nucleus taeniae and of lesions to an adjacent part of the archistriatum (pars intermedium ventralis, AIv) on the expression of appetitive (ASB) and consummatory (CSB) aspects of male sexual behavior. ASB was measured by a learned social proximity response (after copulation a male quail stands in front of a window providing visual access to a female) and by the frequency of rhythmic cloacal sphincter movements. CSB was assessed by the frequency of mount attempts (MA) and cloacal contact movements (CCM). Lesions confined to nucleus taeniae and to AIv did not influence the acquisition or the maintenance of the two responses indicative of ASB. In contrast, lesions of nucleus taeniae significantly increased the occurrence frequencies of MA and CCM when administered before the beginning of behavior testing and increased the frequency of MA only when performed on sexually experienced subjects. No effect of AIv lesions could be detected. The discrepancy between these results and previous experiments in quail might reflect procedural differences, but more probably differences in locations of the lesions that were restricted in the current study to the anterior part of taeniae. Those in the Thompson study were in the posterior part of this nucleus. These findings indicate that there is a larger degree of functional heterogeneity in the nucleus taeniae than previously thought. The effects of taeniae lesions suggest that this nucleus, similar to the medial amygdala in mammals, might be implicated in the control of sexual satiety.
Primary Extramedullary Plasmacytoma of the Tongue Base
Authors: Webb Chris J. , Makura Zvoru G.G. , Jackson Shaun R. , Helliwell Tim
Published: April 2003

Background: Primary extramedullary plasmacytomas (PEMP) are rare malignant neoplasms with a predilection for the head and neck. Eighty percent of all PEMP are located in this area. Case Report: The authors present a case of lingual plasmacytoma in a 65-year-old man, diagnosed on biopsy and treated with external beam radiotherapy.
Tactile Hairs on the Postcranial Body in Florida Manatees: A Mammalian Lateral Line?
Authors: Reep R.L. , Marshall C.D. , Stoll M.L.
Published: April 2003

Previous reports have suggested that the sparsely distributed hairs found on the entire postcranial body of sirenians are all sinus type tactile hairs. This would represent a unique arrangement because no other mammal has been reported to possess tactile hairs except on restricted regions of the body, primarily the face. In order to investigate this issue further, hair counts were made systematically in three Florida manatees (Trichechus manatus latirostris), and hair follicle microanatomy was studied in 110 specimens gathered from 9 animals. We found that the postcranial body possesses approximately 1500 hairs per side, and hair density decreases from dorsal to ventral. External hair length ranged from 2–9 mm, and most hairs were separated from their nearest neighbor by 20–40 mm, resulting in an independent domain of movement for each hair. All hairs exhibited the anatomical characteristics of follicle-sinus complexes typical of tactile hairs, including a dense connective tissue capsule containing an elongated circumferential blood sinus and innervation by 20–50 axons which ascend the mesenchymal sheath. We conclude that this represents a unique distributed underwater tactile system capable of conveying detailed and significant external information concerning approaching animals, water currents and possibly the presence of large stationary features of the environment. Such a system would be analogous to the lateral line in fish, and would be particularly useful in the turbid habitat frequented by Florida manatees.
Ethical, Social and Legal Implications of Pharmacogenomics: A Critical Review
Authors: Møldrup Claus
Published: April 2003

Objective: My aim was to examine the ethical, social and legal implications of pharmacogenomics. Method: I performed a critical review of the literature. The primary focal point is the bioethical principle discussed. The second outcome measure is the perspective of the discussion. Results: This review documents that the pharmacogenomics issues of concern are comparable to issues concerning other genetic developments in general. However, two main issues are particular to the case of pharmacogenomics. Firstly, this review reveals that society, industry, groups and individuals appreciate the prospect of pharmacogenomics very differently. Secondly, there is a lack of research into the post-marketing implications of pharmacogenomics. Conclusion: An extensive focus on the ethical, social and legal implications of pharmacogenomics, in terms of both pre- as well as post-marketing issues, is essential. Also, a multidisciplinary approach which includes individual and group opinions in an upfront manner in the research and development process is essential. Otherwise, there is a substantial risk that the positive prospects of pharmacogenomics will not survive due to fear and a lack of acceptance and understanding on the part of the general public.
Bilio-Digestive Double Bypass for Nonresectable Pancreatic Cancer
Authors: Heinicke J.-M. , Büchler M.W. , Laffer U.T.
Published: April 2003

In spite of extensive preoperative investigation, surgical exploration is often the only way to determine whether a pancreatic cancer is curatively resectable. If curative resection is not possible, palliation of cholestasis and eventual duodenal obstruction is mandatory. This is best achieved by construction of a bilio-digestive double bypass. Many different techniques have been described but considerable rates of delayed gastric emptying have added high morbidity to the procedure. We propose a retrocolic construction technique combining an omega loop with a Roux-en-Y reconstruction which to our knowledge has not been published before.
Ultrapure Dialysis Fluid Lowers the Cardiovascular Morbidity in Patients on Maintenance Hemodialysis by Reducing Continuous Microinflammation
Authors: Lederer S.R. , Schiffl H.
Published: April 2003

The aims of our prospective 3-year investigation were (1) to clarify whether high C-reactive protein (CRP) levels are an intermittent or a continuous phenomenon in individual hemodialysis patients and (2) to evaluate a possible relationship between ultrapure dialysis fluid associated CRP levels and an increased prevalence of atherosclerosis in a group of 60 hemodialysis patients treated either with conventional (n = 38) or on-line-produced ultrapure dialysis fluid (n = 22). Primary end points of the study were angiographically confirmed cerebrovascular, cardiovascular, or peripheral vascular events. Measurements of the CRP levels were done every 3 months using a highly sensitive assay. The CRP levels were normal (<0.5 mg/dl) in 45 patients and raised in 15 patients at the time of recruitment. In 87% of the patients with normal CRP levels, ultrapure dialysis fluid was used. The CRP levels measured at recruitment and at various time points thereafter did not differ significantly within patient groups. However, patients with increased CRP concentrations experienced significantly more vascular events as compared with patients with normal CRP levels (11 events vs. 1 event; p < 0.001). The data indicate that continuous induction of acute-phase proteins represents a nontraditional vascular risk factor contributing to the development and progression of atherosclerosis in dialysis patients. Ultrapure dialysis fluid lowers cardiovascular morbidity by preventing/reducing chronic microinflammation.
Dietary Fatty Acid Supplementation Modulates the Urinary Excretion of Calcium and Oxalate in the Rat
Authors: Baggio Bruno , Budakovic Alessandro , Priante Giovanna , Gambaro Giovanni , Manzato Enzo , Khan Saeed
Published: April 2003

Background: An anomalous plasma phospholipid polyunsaturated fatty acid composition has been reported in calcium nephrolithiasis, and was proposed to play a crucial role in the pathogenesis of hypercalciuria and hyperoxaluria, well-known risk factors for lithogenesis. Methods: To confirm this hypothesis, we administered rats three different diets rich in coconut, soybean and fish oils, and evaluated their effect on plasma urinary calcium and oxalate excretion, since the quality of fatty acids represents an important factor able to influence the activity of delta-6-desaturase, the rate-limiting enzyme in the biosynthetic pathway of highly unsaturated fatty acids. Results: In comparison with coconut and fish oil, dietary supplementation with soybean oil increased plasma phospholipid arachidonic acid and serum 1,25-vitamin D3 values, as well as renal tissue calcium content and urinary excretion of sodium, oxalate and calcium. Conclusions: Our findings demonstrate that the quality of fatty acids may modify the urine excretion of calcium and oxalate, confirming our previous hypothesis of a pathogenetic link between cellular membrane phospholipid polyunsaturated fatty acid composition and calcium nephrolithiasis. In addition, our study provides new insights into the relationship between dietary, environmental factors and renal stone disease.
Cyclosporin A Treatment for Membranoproliferative Glomerulonephritis Type II
Authors: Kiyomasu Takahiro , Shibata Minoru , Kurosu Hideo , Shiraishi Kazuhiro , Hashimoto Hisako , Hayashidera Tadashi , Akiyama Yuichi , Takeda Nobuaki
Published: April 2003

A nephrotic patient with membranoproliferative glomerulonephritis type II (MPGN II) was treated with cyclosporin A (CSA) and alternate-day low-dose prednisolone. This patient developed the nephrotic syndrome twice. The second episode of the nephrotic syndrome was steroid resistant, and therefore this patient was treated with a CSA regimen. During treatments with alternate-day low-dose prednisolone and CSA, this patient recovered from the nephrotic syndrome. We conclude that CSA therapy may be effective for patients with the steroid-resistant nephrotic syndrome caused by MPGN II.
Gonadal Mosaicism of Frasier Syndrome in 3 Chinese Siblings with Donor Splice Site Mutation of Wilms’ Tumour Gene
Authors: Chak Wai Leung , To Ka Fai , Cheng Yuk Lun , Tsui Kan Ming , Lo Kwok Wai , Tong Hung Man , Lai Fernand Mac-Moune , Wong Francis Kin Ming , Choi Koon Shing , Chau Ka Foon , Li Chun Sang
Published: April 2003

Frasier syndrome is a rare human developmental disorder classically affecting 46,XY females and leading to male pseudohermaphroditism and chronic renal failure. We describe a family with both 46,XX and 46,XY females affected by the syndrome due to WT1 splice site mutations. The diagnosis of Frasier syndrome in 1 of the children led to the discovery of the syndrome in 2 other siblings, of whom 1 is asymptomatic. Since the mutation was not found in either parents, gonadal mosaicism was suggested. The implication of family screening for WT1 gene mutation in asymptomatic members is also discussed.
Effects of Vaginal Trauma and Oophorectomy on the Continence Mechanism in Rats
Authors: Kuo Hann-Chorng
Published: April 2003

Purpose: To establish an animal model for studying the effects of vaginal trauma and oophorectomy on the continence mechanism in rats. Methods: Ninety-six female rats were used in the experiments. The rats were divided into 8 groups that received either no treatment (control), or single vaginal trauma at 0 day and 4 weeks, multiple vaginal traumas, oophorectomy at 4 and 12 weeks, and combined oophorectomy and single vaginal trauma or multiple vaginal traumas at 4 weeks. In vivo experiments were performed to determine abdominal leak point pressure (ALPP) by recording the intravesical pressure obtained during compression of the lower abdomen. In vitro urethral contractility experiments were then performed using isolated urethra and electrical field stimulation, acetylcholine, and norepinephrine. Finally, histological study of the urethral muscles and paraurethral structures was performed. Results: Single or multiple vaginal traumas resulted in a significant reduction of ALPP. The reduced ALPP recovered at 4 weeks after single vaginal trauma. Oophorectomy did not significantly affect ALPP compared to controls; however, when oophorectomy was combined with multiple vaginal traumas, a significant reduction in ALPP occurred. Urethral contractility was reduced after multiple vaginal traumas but was not significantly different from the control after oophorectomy. Histological studies revealed disruption of the ventral part of striated muscles after single or multiple vaginal traumas. Degenerative and hyalinization changes were noted in submucosal and muscle layers after oophorectomy combined with multiple vaginal traumas. Conclusions: Vaginal trauma can injure the urethral muscles and nerves. Single or multiple vaginal traumas can induce denervation of periurethral muscles and reduce ALPP. With a period of recovery, the urethral resistance increases and ALPP returns. Oophorectomy mainly affected the intrinsic urethral closure mechanism and resulted in a nonsignificantly reduced ALPP; however, a significant reduction of ALPP developed when oophorectomy was combined with multiple vaginal traumas.
Smooth Muscle within Incomplete Obliterations of Processus vaginalis Lacks Apoptotic Nuclei
Authors: Tanyel F. Cahit , Erdem Sevim , Büyükpamukçu Nebil , Tan Ersin
Published: April 2003

Introduction: Incomplete obliteration of processus vaginalis (PV) has been suggested to result from the persistence of smooth muscle, which should normally disappear after taking part in the descent of testis. Since apoptosis is the mechanism of disappearance, the presence or absence of apoptotic nuclei was evaluated within sacs that result from failed obliteration of PV. Materials and Methods: Twenty sacs associated with female inguinal hernia (n = 5), male inguinal hernia (n = 6), hydrocele (n = 5), hydrocele of the cord (n = 2), and undescended testis (n = 2) were evaluated. 10-µm sections were cut from the snap-frozen samples and stained for nuclear DNA fragmentation. Results: Apoptotic nuclei were detected within the vascular structures and mesothelium. However, none of the samples from different diagnostic sources have revealed any apoptotic nucleus within the smooth muscle component. Conclusions: While the vascular and mesothelial structures within the sacs reveal evidence of apoptosis, the smooth muscle component lacks apoptotic process. The failed apoptosis of smooth muscle may have a role in the persistence of PV.
Axonal Collateral Branching of Neurones in the Inferior Olive Projecting to the Cerebellar Paramedian Lobule in the Rabbit
Authors: Bukowska Dorota , Zguczyński Leszek , Mierzejewska-Krzyżowska Barbara
Published: April 2003

The double fluorescent retrograde technique was employed to examine the distribution of the inferior olive (IO) neurones projecting to the cortex of the rostral and caudal parts of the paramedian lobule (PML) in the rabbit cerebellum, known to be the face-forelimb and hindlimb receiving areas, respectively. Moreover, this technique was also used to investigate the possibility that IO projections reaching these two somatotopically non-homologous PML regions are collaterals of the same axones. No other reports have addressed this question. After non-overlapping unilateral injections of the cytoplasmic tracer fast blue (FB) and the nuclear dye diamidino yellow (DY) into the rostral and caudal PML, respectively, numerous single FB- or DY-labelled cells were found in the defined regions of the contralateral IO. These regions showed considerable overlap, apart from the dorsal accessory olive where a clear spatial separation of labelled cell groups was observed. Furthermore, double FB + DY-labelled neurones (n = 310) were seen in the medial accessory olive, the dorsal and ventral laminas of the principal olive, in the dorsomedial cell column and the β nucleus. It suggests that IO neurones may branch to supply the two functionally different PML regions and in this way participate in the mechanisms of forelimb-hindlimb coordination.
Signals That Instruct Somite and Myotome Formation Persist in Xenopus laevis Early Tailbud Stage Embryos
Authors: Dali Lisa A. , Gustin Jean , Perry Kathleen , Domingo Carmen R.
Published: April 2003

Somite formation is a lengthy process that begins at gastrulation and continues through tailbud stages to form approximately 50 pairs of somites in the frog, Xenopus laevis. In Xenopus, the somite primarily gives rise to myotome. We sought to determine whether the formation of somites and myotome requires a transient signal active during gastrulation or a constitutive signal active throughout development to instruct dorsal mesodermal cells to form the posterior somites. Previous work from our lab revealed that cells from the neural ectoderm are capable of responding to mesoderm-inducing signals [Domingo and Keller: Dev Biol 2000;225:226–240]. Thus, to test for the presence of somite-inducing signals, we performed a series of grafting experiments in which we used gastrula cells from the anterior neural ectoderm (ANE). Fluorescently labeled ANE cells were grafted to the posterior paraxial mesoderm of progressively older host embryos between stages 11 (mid gastrula) and 23 (early tailbud). Our results showed that signals within the paraxial mesoderm can instruct prospective ANE cells, which normally give rise to head structures, to instead differentiate into myotome cells. We found that the grafted cells adopted the local paraxial mesoderm cell behaviors, which consists of mediolateral intercalation, segmentation, somite cell rotation, and differentiation to myotome. In addition, we show that the grafted ANE cells that adopt a myotome morphology also express the muscle-specific marker, 12/101. Through a series of heterochronic grafts, we determined that the duration of somite-inducing signals extends from the early gastrula (stage 11) through the early tailbud (stage 23) stage embryos. These results demonstrate that somite induction is not a transient event that occurs during gastrulation, but that it is instead a continuous event that can occur as new somites are added to the posterior axis.
Sustained Increases in Activating Transcription Factor-2 and Activator Protein-2 in the Rat Supraoptic Nucleus during Water Deprivation
Authors: Meeker Rick B. , Fernandes Alda
Published: April 2003

During increases in plasma osmolality, extrinsic and intrinsic stimuli converge on the neuroendocrine cells within the supraoptic nucleus (SON) and paraventricular nucleus and evoke the release of vasopressin (VP). This release is accompanied by an increase in VP synthesis, but the signal transduction pathways that coordinate these two processes are still poorly understood. Several transcription factors have been suggested to be intermediates in this process, but their expression is often transient in spite of continued VP synthesis. Transcription factor expression during chronic neuroendocrine cell stimulation has rarely been examined. In an effort to identify sustained increases, we examined the expression of several transcription factors in the SON of normal rats and rats deprived of water for 44 h. Alpha and beta isoforms of activator protein-2 (AP-2α; AP-β), activating transcription factor-2 (ATF-2), the phosphorylated form of cyclic AMP response element binding protein and phospho-cJun were all expressed in the rat SON under basal conditions. Increases in AP-2α and ATF-2 were sustained throughout the SON during water deprivation, suggesting that these transcription factors could play a role in the maintenance of VP and oxytocin gene transcription in response to dehydration.
Hypothalamic Somatostatin and Growth Hormone-Releasing Hormone mRNA Expression Depend upon GABAA Receptor Expression in the Developing Mouse
Authors: Pannell Catherine , Simonian Sharon X. , Gillies Glenda E. , Luscher Bernhard , Herbison Allan E.
Published: April 2003

Gonadal steroids exert an important regulatory influence upon the biosynthetic and secretory activity of the somatostatin and growth hormone-releasing hormone (GHRH) neurons controlling the release of growth hormone. It is hypothesized that some of these effects occur in an indirect transsynaptic manner through the steroid regulation of GAGAergic inputs to these cells. Using GABAA receptor γ2 subunit knockout mice (γ2–/–), which exhibit marked deficiencies in GABAA receptor functioning, we have examined here whether signaling through the GABAA receptor has any role in maintaining normal levels of somatostatin and GHRH mRNA expression in vivo. In situ hybridization experiments using 35S-labeled oligonucleotide probes revealed that cellular levels of somatostatin mRNA in the periventricular nucleus were significantly (p < 0.01) reduced by 16% in newborn γ2–/– mice compared with wild-type litter mates (γ2+/+). Somatostatin mRNA expression in the striatum was not changed. Cellular levels of GHRH mRNA expression in the arcuate nucleus were significantly (p < 0.05) reduced by 30% in γ2–/– compared with γ2+/+ mice. These results demonstrate that deletion of the γ2 subunit of the GABAA receptor reduces somatostatin and GHRH mRNA expression within the hypothalamopituitary axis and indicate that GABA exerts a tonic stimulatory influence upon both somatostatin and GHRH biosynthesis in vivo in the neonatal mouse.
The Cytocaud: A Hair Cell Pathology in the Waltzing Guinea Pig
Authors: Kanzaki Sho , Beyer Lisa A. , Canlon Barbara , Meixner Walter M. , Raphael Yehoash
Published: April 2003

The waltzing guinea pig displays severe inner ear dysfunction that involves both an auditory and a vestibular manifestation. The aim of this study was to characterize a pathological tail-like extension of the vestibular hair cells, the cytocaud. Our data suggest that nearly all type I hair cells in the waltzing guinea pig have cytocauds, which appear as membrane-bound tails containing mitochondria and cytoplasm that proceed in a basal direction toward the basement membrane. The extensions either attach to the basement membrane or penetrate it, and further proceed into the extracellular matrix. A core made of a thick and long (30 µm) actin-rich structure supports the slender long process. The actin core has cross-links that are periodically placed along the length of the cytocaud. Our data suggest that the cytocauds in vestibular hair cells of the waltzing guinea pig are highly organized structures associated with a failure to detach from the basement membrane.
Pure Red Cell Aplasia Preceding Malignant Lymphoma in a Renal Transplant Patient
Authors: Kiykim A.A. , Arıcı M. , Altun B. , Erdem Y. , Yasavul U. , Turgan Ç. , Caglar Ş.
Published: April 2003

Malignant disorders are one of the major causes of morbidity and mortality in transplant patients. We present herein a renal transplant recipient with malignant lymphoma which preceded by pure red cell aplasia (PRCA). Acquired PRCA is a rare hematologic disorder in renal transplant recipients. It has been associated with a variety of disorders of immunologic dysfunction and neoplasms, exposure to drugs and toxins, infectious diseases, pregnancy and severe nutritional deficiency. This is the first case with PRCA preceding the malign lymphoma in a renal transplant patient. Treatment of lymphoma and lymphoma-related humoral and cellular changes or other undefined effects that may be related to therapy may be responsible of the resolving of PRCA in this patient. In this regard, renal transplant patients with acquired PRCA, must be closely followed for an underlying neoplastic disorder.
Exogenous Albumin Peptides Influence the Processing of Albumin during Renal Passage
Authors: Eppel Gabriela A. , Pratt Lynette M. , Greive Kerryn A. , Comper Wayne D.
Published: April 2003

Exogenous albumin peptides influence the processing of albumin during renal passage. Background/Aims: This study investigates the hypothesis that there will be peptide regions in albumin that will effectively compete for the receptors associated with the renal processing of albumin. Methods: We employ albumin peptides prepared from albumin by trypsin digestion. The presentation of the exogenous peptides along with intact [3H]albumin to the kidney was made by intravenous injection into rats. The excretion rate and integrity of urinary [3H]albumin was measured. Similar experiments were performed with the use of gelatin peptides produced by trypsin digestion as controls. The formation of [3H]albumin derived fragments by extrarenal sources was also examined in rats with nonfiltering kidneys. Results: In the presence of exogenous albumin-derived peptides there was a significant increase in the proportion of larger [3H]albumin fragments in the urine. This is a reversible effect. There was no significant change when gelatin peptides were used. The albumin peptides also increase the fractional clearance of [3H]albumin. There were no [3H]albumin-derived fragments produced in plasma over a 4-hour circulation period in rats with nonfiltering kidneys. Conclusions: This study demonstrates that albumin fragments, which are produced by the kidney and not by extrarenal sources, are exclusively excreted in the urine. Exogenous albumin peptides were able to specifically exert a competitive effect on the renal enzyme cleavage of intact albumin.
The Negative Ca2+ Balance Is Involved in the Stimulation of PTH Secretion
Authors: Yokoyama Keitaro , Kagami Shino , Ohkido Ichiro , Kato Naohiko , Yamamoto Hiroyasu , Shigematsu Takashi , Nakayama Masaaki , Fukagawa Masafumi , Kawaguchi Yoshindo , Hosoya Tatsuo
Published: April 2003

The low calcium (Ca2+) dialysate have been developed to diminish the risk of hypercalcemia with the administration of active vitamin D and Ca2+ carbonate as phosphate binder. Today, increasing numbers of hemodialysis (HD) patients have been on the low Ca2+ dialysate (Ca2+ = 2.5 mEq/l). However, the clinical consequences of a negative calcium net-balance which may be induced by the use of low Ca dialysate are not well evaluated. In the present study, we explored the effects of low Ca2+ dialysate on the calcium balance and the PTH secretion. Eighty one chronic HD patients (male/female: 47/34; mean age: 60.2 ± 1.5 years; mean HD periods: 11.1 ± 0.8 years) who had been dialyzed with 3.0 mEq/l Ca2+ dialysate were studied. All patients were transferred to the low Ca dialysate, which actually brought about a negative net-balance in Ca (mean: –94.5 mg) and an increase in serum intact PTH levels (mean: +23.7%: p = 0.03) during a single HD session. However, no changes in serum ionized Ca2+ were found in spite of negative Ca2+ balance. One month after change to the low Ca2+ dialysate (total 12 sessions in each case), serum intact PTH levels increased significantly (186.7 ± 19.5 vs. 216.2 ± 21.9 pg/ml: p = 0.01) in spite of the fact that no changes were found in serum ionized Ca2+, Pi and Mg. This result indicates that the negative Ca2+ balance during low-Ca2+ hemodialysis-stimulated PTH secretion, which offset the decrease of serum Ca2+; a trade-off phenomenon between negative Ca balance and PTH. This suggests that low Ca2+ dialysate may exaggerate the progression of secondary hyperparathyroidism.
Antioxidants and the Response of Skin to Oxidative Stress: Vitamin E as a Key Indicator
Authors: Packer Lester , Valacchi Giuseppe
Published: April 2003

As the outermost barrier of the body, the skin is directly and frequently exposed to a prooxidative environment, including solar UVA and UVB radiation, and air pollution. The skin is equipped with an elaborate system of antioxidant substances and enzymes that includes a network of redox active antioxidants. Among these, vitamin E has been identified as the predominant antioxidant both in murine and human skin and shows a characteristic gradient with lower levels towards the outer stratum corneum layers. Skin exposure to UV and ozon alone and in combination resulted in a significant potentiation of the UV-induced vitamin E depletion. Oxidants and antioxidants play an important role in maintaining a balance between free radicals produced by metabolism or derived from environmental sources. Cellular antioxidants may change their redox state, be targeted for destruction, regulate oxidative process involved in signal transduction, affect gene expression and pathways of cell proliferation and death. Here we provide an overview of the antioxidant system with a special relevance to skin.
Electron Spin Resonance Detection of UVA-Induced Free Radicals
Authors: Herrling T. , Zastrow L. , Fuchs J. , Groth N.
Published: April 2003

Free radicals generated during UV irradiation of human skin biopsies were measured with electron spin resonance spectroscopy by using spin traps. The generation of hydroxyl and lipid radicals in skin is mainly caused by the UVA part of the solar spectrum.
Influence of a Human Protease Inhibitor on Surgical Stress Induced Immunosuppression
Authors: Sato Nobuhiro , Endo Shigeatsu , Kimura Yusuke , Ikeda Kenichirou , Aoki Kiichi , Iwaya Takeshi , Akiyama Yuji , Noda Yoshinori , Saito Kazuyoshi
Published: April 2003

Background/Aim: Postoperative tissue injury and immunosuppression can occur after major surgery. In this study, we explore the potential benefits of administering a protease inhibitor to treat immunosuppression caused by surgical stress. Methods: Sixteen patients with esophageal cancer were preoperatively allocated at random into two equal groups. A urinary trypsin inhibitor, ulinastatin (UTI), was intravenously administered to the treatment (UTI) group at a dose of 150,000 U every 12 h from the start of surgery until postoperative day 5, whereas the control group received a placebo. One unit of UTI was defined as the amount of UTI necessary to inhibit the activity of 2 µg of bovine pancreatic trypsin by 50%. We measured the plasma levels of polymorphonuclear neutrophil elastase, interleukin 8, circulating T lymphocyte subsets, and mitogenic activity and in vitro production of tumor necrosis factor alpha in lipopolysaccharide-stimulated whole blood. Results: The postoperative serum value of polymorphonuclear neutrophil elastase was significantly lower in the UTI group, but the interleukin 8 concentrations did not significantly vary between the two groups. On the other hand, the severity of the postoperative immunosuppression was reduced in the UTI group, and immune functions, such as the numbers of T lymphocytes, the mitogenic activity of lymphocytes, and the level of tumor necrosis factor alpha production in whole blood, recovered significantly earlier in the UTI group. Conclusion: These data suggest that a protease-modulating therapy may be a new strategy for the treatment of surgical stress induced immune dysfunction.
Results of Surgical Therapy of Adenocarcinomas of the Esophagogastric Junction According to a Standardized Surgical Resection Technique
Authors: Meyer W. , Popp M. , Klinger L. , Awad-Allah A. , Gebhardt C.
Published: April 2003

Aim: The aim of this retrospective analysis was to exclusively present the surgical results of patients with type-I–III adenocarcinomas of the esophagogastric junction thereby providing a basis for comparison with other approaches. Methods: 56 patients with Barrett’s carcinomas and 74 patients with cardial and subcardial tumors were operated on and evaluated. The surgical procedure for type-II/III carcinomas was identical: total gastrectomy, omentectomy and splenectomy with lymph node dissection after a combined left thoraco-abdominal incision. Both tumor entities were summarized into 1 group and compared with the results of surgery for Barrett’s carcinomas: subtotal esophagectomy and proximal stomach resection with lymph node dissection after right thoracotomy and an additional abdominal incision. Results: In 93% of all patients an R0 resection was possible. In patients with Barrett’s carcinomas pulmonal complications (41%) were the predominant postoperative problems. The 30-day lethality (5.3%) was higher in the group of patients with type-I carcinomas compared to those with type-II/III carcinomas (1.4%). Tumor infiltration and nodal involvement determined the prognosis after R0 resection. The presence of Barrett’s mucosa in type-I adenocarcinomas and the histological assessment according to Lauren’s classification into type-II/III carcinomas also influenced the long-term prognosis. Conclusion: After R0 resection it is not the tumor location but tumor infiltration, lymph node status and a differentiated histological assessment that determine the prognosis of patients with adenocarcinomas of the esophagogastric junction.
Clinicopathologic Features of Mucinous Gastric Carcinoma
Authors: Woo L.S. , Kim D.Y. , Kim Y.J. , Kim S.K.
Published: April 2003

Background/Aims: Mucinous gastric carcinoma (MGC) is a histopathologic subtype of gastric carcinoma with a poor prognosis. The purpose of this study was to compare the disease course of MGC with non-mucinous gastric carcinoma (NMGC) and study the clinicopathologic features that influence the prognosis of MGC patients. Methods: We reviewed the records of 2,383 patients with a confirmed histologic diagnosis of gastric carcinoma. There were 157 patients with MGC compared to 2,226 with NMGC. Results: A depth of invasion greater than T3 was more frequently found in MGC than in NMGC. The mean number of lymph nodes with metastases was 2.78 in MGC and 2.28 in NMGC (p < 0.001). There were more MGC patients with TNM stages II through IV (UICC classification). The overall survival rate was lower for the MGC group (46.5%) than for the NMGC group (64.0%; p < 0.05). Depth of invasion, lymph node metastases, and stage at diagnosis were significant factors affecting the outcome. Conclusion: The factors influencing the poorer prognosis (lower 5-year survival rate) of MGC are the advanced stage at the time of diagnosis, lymph node metastases, and a higher TNM status. Mucinous histologic type itself was not an independent predictive factor in survival.
The Neuron Theory
Authors: Fodstad Harald
Published: April 2003

In 1740 the Swedish scientist and philosopher Emmanuel Swedenborg described what is the first known anticipation of the neuron (a nerve cell with its processes). One hundred years later Ehrenberg, Remak and Purkinje recognized the nerve cell as the important element of the nervous system and provided its first accurate description. Vilhelm von Waldeyer in 1891 proposed to call the unit ‘neuron’ from the Greek word for ‘sinew’. The ‘neuron theory’ or ‘neuron doctrine’, which emerged at the end of the 19th century, asserts that nerve tissue is composed of individual cells, which are genetic, anatomic, functional and trophic units. The pioneers of the neuron doctrine included neuroscientists, physicians, a polar explorer and three Nobel Laureates. The classic neuron doctrine has served well as the theoretical basis for the great advances in our current understanding of the cellular basis of nervous system functions.
A Rare, In-Frame BCR-ABL Fusion (e13a3) in a Patient with an Aggressive Chronic Myeloid Leukaemia
Authors: Otazú Ivone B. , Belén Rivero María , Olício Renata , Pinto Augusto , Zalcberg Ilana , Seuánez Héctor N.
Published: April 2003

We have identified a rare BCR-ABL chimaeric gene with multiplex and nested RT-PCR in a patient with an unusually aggressive chronic myeloid leukaemia. cDNA sequencing showed an in-frame rearrangement with a breakpoint in BCR exon e13 (b2) and fusion with ABL exon 3 following skipping of the entire ABL exon a2. These data confirm the heterogeneity of breakpoints in BCR-ABL rearrangements.
Electrocardiographic Changes in Patients with Acute Stroke: A Systematic Review
Authors: Khechinashvili George , Asplund Kjell
Published: April 2003

Repolarization and ischemic-like electrocardiographic (ECG) changes observed during acute phase of stroke may cause diagnostic and management dilemmas for the clinician. In this systematic review, we have compiled all information available in the literature on the prevalence of these ECG changes and QT prolongation during the acute phase of stroke and their coexistence with other abnormal cardiac findings. Abnormalities, such as ischemic-like ECG changes and/or QT prolongation, were found in 76% (95% CI 73–90) of patients with subarachnoid hemorrhage, irrespective of whether they had preexisting heart disease or not. Such ECG changes were present in more than 90% of unselected patients with ischemic stroke and intracerebral hemorrhage, but the prevalence was much lower after exclusion of patients with preexisting heart disease. Compared with other abnormal cardiac findings (cardiac wall motion abnormality detected by echocardiography, elevated levels of biochemical markers of myocardial injury, autopsy findings, thallium scintigraphy), these ECG changes were characterized by a high sensitivity but a very low specificity. Thus, in patients with subarachnoid hemorrhage, repolarization and ischemic-like ECG changes are mainly direct consequences of the cerebral condition and their absence essentially rules out cardiac abnormalities. In patients with ischemic stroke and intracerebral hemorrhage, these ECG abnormalities (and QT prolongation) most often represent preexisting coronary artery disease. The specificity of ECG changes to diagnose acute myocardial infarction is low in the acute phase of stroke.
Symptom Spread to Contiguous Body Parts as a Presentation of Cerebral Ischemia
Authors: Cohen Stanley N. , Muthukumaran Abirami , Gasser Hathout , El-Saden Suzie
Published: April 2003

Background: Ischemic stroke commonly presents with sudden onset of focal deficit that is maximal at onset. Symptom onset marked by the spread of symptoms to contiguous body parts may suggest migraine, seizure or cerebral amyloid angiopathy (CAA) that is mimicking ischemic symptoms. Objective: To assess (1) if the spread of symptoms to contiguous body parts is an uncommon presentation of ischemic stroke and transient ischemic attack (TIA) and (2) if patients presenting with this symptom complex frequently have migraine, seizure or CAA mimicking stroke or TIA. Methods: 110 consecutive patients presenting with stroke-like symptoms were prospectively evaluated for symptoms at onset, abnormalities on cerebral imaging, risk factors for stroke, discharge diagnosis, and development of subsequent TIA/stroke, migraine, seizure, or cerebral hemorrhage during follow-up. Results: Of patients able to give a history of symptoms at onset, 23% described symptoms spreading to contiguous body parts. None had a history of migraine or seizure. None had clinical course or imaging features typical of CAA. During follow-up, 1 was diagnosed with migrainous stroke and none had suffered seizure or intracranial hemorrhage. Conclusions: The spread of symptoms to contiguous body parts is not uncommon at the onset of ischemic TIA/stroke. In our series, migrainous stroke was much less common and none had evidence of seizure or CAA.
Noninvasive Monitoring of Hypertensive Breakthrough of Cerebral Autoregulation in a Patient with Acute Ischemic Stroke
Authors: Georgiadis D. , Schwarz S. , Cencetti S. , Schwab S.
Published: April 2003

Background and Purpose: We describe the first documentation of hypertensive breakthrough of cerebral autoregulation in a patient with acute stroke with transcranial Doppler sonography. Case Description: A 55-year-old patient with acute left hemispheric stroke was treated with moderate hypothermia. He died of transtentorial herniation 4 days after admission. Static cerebral autoregulation (sCA) of the unaffected hemisphere was evaluated 6 times during this period and always found to be intact. A bolus application of epinephrine resulted in a hypertensive episode (mean arterial pressure (MAP) 135 mm Hg); hypertensive breakthrough of cerebral autoregulation was evident when MAP exceeded approximately 110 mm Hg. Interestingly, no such breakthrough was evident during testing of sCA, even when MAP reached 120 mm Hg. Conclusions: Our observation suggests that (1) the pace of the MAP increase is crucial for the occurrence of a hypertensive breakthrough of the cerebral autoregulation and (2) the disturbance of cerebral autoregulation is potentially longer as previously assumed.
Burden of Acute Stroke and Hospital Resources in the Campania Region of Italy
Authors: de Falco Fabrizio A. , Santangelo Roberto , Majello Luigi , Marasco Giuseppe
Published: April 2003

We examined all the official hospital records referring to admissions for acute stroke (AS) (DRG 14) from January 1 to December 31, 1996 in Campania (Italy), a large region with 10% of the Italian population. Related healthcare burden and available resources were evaluated. During the study period, a total of 9,003 discharges were reported. We counted 11 neurological care units (NCU) committed to emergency in the region, with 230 hospital beds. The 4,890 admissions in NCU represented 54.3% of the total AS hospitalizations per year. A large number of strokes (45.7%) had no access to specialist assistance and were hospitalized mainly in general wards with a mean hospital stay of 12.7 days, compared with 9.5 days in NCU (p < 0.01). In our region, the number of hospital beds available for neurological emergencies do not meet the demand.
Growth and Puberty and Its Management in Thalassaemia
Authors: De Sanctis Vincenzo
Published: April 2003

The purpose of this review is to report the personal experience on growth and pubertal development in a large number of thalassaemic and ex-thalassaemic patients followed at the Pediatric and Adolescent Unit of Ferrara. Secondary amenorrhoea (SA), hypogonadism and short stature are the commonest endocrine and auxological complications. The anterior pituitary gland is particularly sensitive to free radical oxidative stresses and exposure to this. Magnetic resonance imaging (MRI) shows that even a modest amount of iron deposition within the anterior pituitary can interfere with its function. Other possible cause of hypogonadism in β-thalassaemia major include liver disorders, chronic hypoxia, diabetes mellitus and zinc deficiency. The treatment of pubertal disorders consists of hormone replacement therapy with sex steroids. Successful induction of spermatogenesis and ovulation has been reported after hormonal stimulation with gonadotrophins. Height above the 10th centile was achieved in 50% of males and 64% of females. Eight prepubertal thalassaemic patients, 6 males and 2 females, ranging in age from 8.6 to 11.7 years, were treated with GH. After the first 12 months of GH treatment a significant increase of growth velocity was observed in 6 patients who doubled growth velocity before basal value (4 cm or more above the basal value), 2 patients had a partial response (2–4 cm above the basal value). In the following 3 years all thalassaemic patients had a partial response to the treatment with GH. These data indicate that despite somewhat reduced sensitivity to GH, compared to GH deficiency children, there is evidence indicating that thalassaemic patients may benefit from GH treatment. Sixty-eight thalassaemic patients (30 males and 38 females) who had successfully undergone bone marrow transplantation (BMT) during childhood were studied. Following BMT growth rate decelerated when compared to Tanner and Whitehouse standards. Twenty-nine ex-thalassaemics reached final height. The patterns of growth during puberty was variable in ex-thalassaemic males, while in all but 3 ex-thalassaemic females we observed an improvement in the percentile of standing height. A gonadal dysfunction was found in 68% of ex-thalassaemic patients. Since the quality of life of these patients is an important aim, it is vital to monitor carefully the growth and pubertal development in order to detect abnormalities and to initiate appropriate and early treatment.
Acoustic Differences between Spontaneous and Induced Long Calls of Golden Lion Tamarins, Leontopithecus rosalia
Authors: Ruiz-Miranda C.R. , Archer C.A. , Kleiman D.G.
Published: April 2003

Long calls are emitted by several primate taxa and appear to have multiple functions related to spacing mechanisms and reproduction. Yet, in some species the spontaneous rate of emission of these calls is low, and playbacks are used to elicit long calls to augment the sample size of studies. The objective of this study was to compare the acoustic structure of spontaneously emitted and experimentally induced long calls of golden lion tamarins. Results from 6 adult tamarins show that spontaneously emitted long calls differ acoustically from experimentally induced long calls in several frequency measures. Several explanations for these differences are discussed. We conclude that regardless of the underlying mechanisms, playbacks elicit responses that may be different from naturally occurring calls.
Three-Dimensional CT Scan Stone Reconstruction for the Planning of Percutaneous Surgery in a Morbidly Obese Patient
Authors: Buchholz Niels-Peter
Published: April 2003

A three-dimensional spiral CT (3D CT) reconstruction of staghorn stones provides a precise picture of its extent and branching within the kidney. The author reports a case of a large renal staghorn stone in a morbidly obese woman, further complicated by malrotation and hypermobility of the kidney. Two-dimensional plain CT was unable to provide sufficient information for a safe percutaneous approach. This was achieved by means of 3D CT, which also was very helpful during the procedure. Although 3D CT should by no means be routinely employed, it is a valuable tool for pretreatment decision-making and intraoperative orientation in selected cases.