bluuebunny/crossref_metadata_2025 huggingface dataset:
Brachiofacial Pure Motor Stroke
Authors: Fraix Valérie , Besson Gérard , Hommel Marc , Perret Jean
Published: April 2003

Pure motor stroke is the commonest lacunar syndrome, but it may be associated with nonlacunar mechanisms of infarction. Pure motor brachiofacial weakness has been considered as a partial syndrome depending on a lacunar mechanism. We studied the correlations between stroke type, topography of infarction and etiology in 22 patients with pure motor brachiofacial weakness who were consecutively admitted to our stroke unit during a 10-year period. Seventeen patients had a small deep infarct, 4 had a cortical infarct in the superficial MCA territory and 1 had no specific lesion. The part of the cardiovascular risk factors was about 36% for smoking, 13% for diabetes mellitus, 60% for dyslipidemia and 40% for heart disease. Hypertension was present in 75% of our cases. None of the patients had a large artery stenosis on Doppler ultrasonography. We concluded that brachiofacial pure motor stroke is not always correlated to lacunar infarcts and may be due to a cortical infarct. MRI should be performed when brain CT is normal because of the implications it may have in management and therapy.
Patient Positioning Influences Oxygen Saturation in the Acute Phase of Stroke
Authors: Rowat Anne M. , Wardlaw Joanna M. , Dennis Martin S. , Warlow Charles P.
Published: April 2003

We evaluated arterial oxygen saturation (SaO2) and heart rate in acute stroke patients to determine whether routine positioning affected these physiological parameters. Measurements were recorded at the bedside non-invasively in five different positions assigned in random order each maintained for 10 min. One hundred and twenty-nine patients examined within a median of 72 h, lying on the left side resulted in slightly lower SaO2 than lying on the right side, which was statistically significant in the patients with a right (n = 66), but not left, hemiparesis. Patients able to sit in a chair (n = 65), who mostly had less severe strokes, had a significantly higher mean SaO2 and heart rate when sitting in the chair than when placed in any other position. About 10% of patients, especially those with a severe stroke, with right hemiparesis and concomitant chest disease, experienced falls in SaO2 to 90% or less for ≧2 min in certain positions; the hypoxia was more likely when they were lying on their left side. These results may have implications for current practice and for future patient positioning strategies to improve outcome after stroke.
Randomized Controlled Trial of Rehabilitation at Home after Stroke: One-Year Follow-Up of Patient Outcome, Resource Use and Cost
Authors: von Koch Lena , de Pedro-Cuesta Jesús , Kostulas Vasilios , Almazán Javier , Widén Holmqvist Lotta
Published: April 2003

Background and Purpose: This study sought to evaluate early supported discharge and continued rehabilitation at home after stroke, at a minimum of 6 months after the intervention, in terms of patient outcome, resource use and health care cost. Methods: Eighty-three patients, moderately impaired 5–7 days after acute stroke, were included in a randomized controlled trial, 42 being allocated to the intervention and 41 to routine rehabilitation. One-year follow-up of patient outcome included mortality, motor capacity, dysphasia, activities of daily living, social activities, perceived dysfunction, and self-reported falls. Resource use over 12 months included inpatient hospital care, outpatient health care, use of health-related services, informal care, and cost of health care. Results: On univariate analysis there was no difference in patient outcome. Multivariate regression analysis showed that intervention had a significant effect on independence in activities of daily living. A significant difference in inpatient hospital care, initial and recurrent, was observed, with a mean of 18 (intervention) versus 33 days (control) (p = 0.002). Further significant differences were that the control group registered more outpatient visits to hospital occupational therapists (p = 0.02), private physical therapists (p = 0.03) and day-hospital attendance (p = <0.001), while the intervention group registered more visits to nurses in primary care (p = 0.03) and home rehabilitation (p = <0.001). Other differences in outcomes or resource utilization were nonsignificant. Conclusion: In Sweden, early supported discharge with continued rehabilitation at home proved no less beneficial as a rehabilitation service, and provided care and rehabilitation for 5 moderately disabled stroke patients over 12 months after stroke onset for the cost of 4 in routine rehabilitation.
Ventricular Fibrillation during Off-Pump Coronary Artery Bypass Grafting: Transcranial Doppler and Clinical Findings
Authors: Lund Christian , Lundblad Runar , Fosse Erik , Tønnessen Tor Inge , Sundet Kjetil , Brucher Rainer , Russell David
Published: April 2003

A 73-year-old male developed ventricular fibrillation which lasted for 2 min and 24 s, during off-pump coronary artery bypass grafting. Cerebral hemodynamics were assessed by continuous transcranial Doppler monitoring. Ventricular fibrillation resulted in an immediate fall in cerebral blood flow velocities to almost zero with only slight fluctuations. This was then followed by a pronounced reactive hyperperfusion. Cerebral magnetic resonance imaging examinations and detailed neurological and neuropsychological evaluations were performed before and at 3 and 12 months after surgery. No evidence of cerebral damage was found.
Combination Therapy Stroke Trial: Recombinant Tissue-Type Plasminogen Activator with/without Lubeluzole
Authors: Grotta James
Published: April 2003

Background: A neuroprotective drug may be safe and effective if given very early and in combination with recombinant tissue-type plasminogen activator (rt-PA) to acute stroke patients. No clinical trial has yet tested this hypothesis. Objective: To assess the feasibility, safety and efficacy of simultaneously combining the neuroprotective drug lubeluzole with rt-PA. Method: Patients who qualified for and received rt-PA within 3 h of symptom onset were randomly allocated 1:1 to lubeluzole (7.5 mg i.v. over 1 h, then continuous 5-day infusion of 10 mg/day) or placebo. Infusion of the study medication was started before the end of the 1-hour rt-PA infusion. Inclusion criteria were the same as those of the FDA-approved guidelines for rt-PA, plus National Institutes of Health Stroke Scale (NIHSS) >5 and absence of serious ventricular arrhythmia, atrioventricular block or Q–T >450 ms. EKG was continuously monitored until 48 h after treatment. The primary outcomes were adverse events, especially hemorrhage and severe arrhythmia, and functionality as determined by the Barthel Index divided into >70,0–70 and dead. Results: 89 patients were randomized at 34 centers over 8 months. The study was terminated by the sponsor before the planned enrollment of 200 patients when a concurrent phase 3 trial of lubeluzole versus placebo given up to 8 h after stroke was negative. In our study, the mean NIHSS was 14.5, and the mean time from symptom onset to rt-PA was 2.5 h and to randomization to lubeluzole or placebo 3.2 h. Mortality was 26%, intracerebral hemorrhage occurred in 10% and serious adverse events in 51%. There were no differences between the two treatment groups in any of these variables, outcomes or in the Barthel Index or other measures of functionality. Conclusion: Combining neuroprotective drugs such as lubeluzole simultaneously with rt-PA is feasible and safe. The efficacy of this strategy, using a potentially more effective neuroprotective agent, should be evaluated in an adequately powered clinical trial.
Aneurysm of the Posterior Inferior Cerebellar Arteries/Communicating Artery
Authors: Okuno Shuzo , Ohnishi Hideyuki
Published: April 2003

Only 3 cases of aneurysm associated with the communicating artery between both distal posterior inferior cerebellar arteries (PICAs) have been reported in the literature. We present the 4th case of such an aneurysm arising from the communicating artery itself, which is unrelated to the arterial branches. A hypertensive 68-year-old man presented with a Hunt and Hess grade 4 subarachnoid hemorrhage. Angiographic studies revealed that the ruptured aneurysm arose from the fine communicating artery itself interconnecting both distal PICA vermian branches. The right PICA was absent and its vermian territory was supplied by the left PICA through this communicating artery. At surgery, a saccular aneurysm was noted which developed at the top of the arterial loop under the nodulus of the cerebellar vermis and was trapped. The actual prevalence and clinical significance of aneurism associated with the communicating artery interconnecting both PICAs are unknown, but defective embryonal development may lead to congenital vulnerability of the vascular wall, resulting in aneurysm formation.
Epileptic Seizures following Subcortical Infarcts
Authors: Bentes Carla , Pimentel José , Ferro José M.
Published: April 2003

Stroke is one of the most frequent causes of seizures in adulthood. Subcortical infarcts have been associated with post-stroke epileptic seizures, although less frequently than cortical ischaemia. We studied 113 patients from a hospital stroke registry. The patients had subcortical non-lacunar infarcts (64 striatocapsular infarcts, 13 thalamic, 8 choroidal artery territory, 28 internal border zone and white matter medullary infarcts) and at least 1 year of follow-up. Only 4 patients (3.5%) with striatocapsular infarcts suffered an epileptic seizure. Two seizures occurred within the first 24 h, 1 within the first month and 1 within the first year of stroke onset. Emboligenic cardiac conditions were significantly more common in patients with seizures (difference 37%; 95% confidence intervals 2–72%). Subsequently to subcortical infarct, epileptic seizures are infrequent, tend to occur early after stroke and have a very low 1-year recurrence risk.
Cerebral Autoregulation in Middle Cerebral Artery Territory Precedes That of Posterior Cerebral Artery in Human Cortex
Authors: Rosengarten B. , Kaps M.
Published: April 2003

Objective: Cerebral autoregulation tends to compensate changes in arterial blood pressure. This mechanism of cerebral blood flow regulation appears to be insufficient in orthostatic dysregulation in which mainly vertebrobasilar symptoms occur. To investigate this hypothesis, we compared cerebral autoregulation in the vascular territory of the carotic and vertebrobasilar vessel system using a leg cuff test to induce a drop in cerebral perfusion pressure. Methods: We measured blood flow velocity in 10 healthy young volunteers (aged 26.7 ± 0.3 years, 7 male) simultaneously in the middle and posterior cerebral artery with transcranial Doppler sonography. A leg cuff test was used to induce a sudden decrease in arterial blood pressure. Arterial blood pressure was measured with a non-invasive photoplethysmographic method. The averaged relative blood flow velocity changes due to the pressure step were compared between both vessel territories. Results: After cuff release systolic (diastolic) blood flow velocity increased with a latency of 1.1 ± 0.3 s (1.8 ± 0.4 s). Due to a smaller decrease and identical time courses cerebral blood flow velocity recovery in the posterior cerebral artery precedes blood flow recovery in the middle cerebral artery by 0.9 ± 0.3 s. Discussion: Cerebral autoregulation in the carotid and vertebrobasilar system does not differ in the time course of the blood flow velocity recovery. Due to a smaller decrease in blood flow velocity recovery in the posterior cerebral artery precedes recovery in the middle cerebral artery by nearly 1 s.
Increased Serum Levels of Endogenous Protectant Secretory Leukocyte Protease Inhibitor in Acute Ischemic Stroke Patients
Authors: Iłżecka Joanna , Stelmasiak Zbigniew
Published: April 2003

Background: Activated leukocytes and their mediators may participate in ischemic brain injury. Secretory leukocyte protease inhibitor (SLPI) plays an important role in regulating the activity of the proteases, and may limit tissue damage. The aim of this study was to evaluate the changes in SLPI level in ischemic stroke patients. Methods: The study comprised 20 patients with ischemic stroke and 20 controls. SLPI levels were measured in serum using enzyme-linked immunosorbent assay on the 1st, 5th and 12th day after stroke onset. Results: SLPI was increased in the whole group of ischemic stroke patients compared with controls. It was also significantly increased on the 1st, 5th and 12th day after stroke in patients with larger brain tissue damage involving one or more lobe of the brain and in patients with more severe clinical status compared to controls (p < 0.05). A significant correlation between SLPI and the extent of brain tissue damage was observed on the 12th day after ischemic stroke onset (p < 0.05). Conclusions: Our results suggest that SLPI takes part in the anti-inflammatory reaction after ischemic stroke. Endogenous SLPI may have a neuroprotective effect, and could be a prototype therapeutic approach for ischemic stroke.
Hyperglycemia in Patients with Focal Cerebral Ischemia after Intravenous Thrombolysis: Influence on Clinical Outcome and Infarct Size
Authors: Els T. , Klisch J. , Orszagh M. , Hetzel A. , Schulte-Mönting J. , Schumacher M. , Lücking C.H.
Published: April 2003

The aim of the present prospective study was to investigate whether hyperglycemia influences the clinical outcome or the infarct size after intravenous thrombolysis of focal cerebral ischemia. A consecutive series of hyperglycemic (n = 14) and normoglycemic patients (n = 17) with acute focal cerebral ischemia (<3 h) in the middle cerebral artery (MCA) territory received rtPA (0.9 mg/kg body weight) intravenously. Clinical outcome was measured using the NIH Stroke Score on admission and was followed up until day 28. Infarct volume was measured by diffusion-weighted MR imaging on admission, on days 3 and 7. There was a significantly better neurological outcome on day 28 in the normoglycemic patients than in the hyperglycemic group (NIH SS 4.0 versus 7.4; p < 0.05). The infarction volume increased significantly in the hyperglycemic patients Δ = 39.9 ± 17.4% compared to normoglycemic patients Δ = 27.1 ± 14.1% (p < 0.05). The present study suggests that hyperglycemia in patients with a focal MCA ischemia can cause a worse clinical outcome despite recanalization of the occluded vessel by thrombolysis therapy. This correlates with a markedly larger increase of the infarction volume in the hyperglycemic group. These results may be explained by an accentuated lactate accumulation and pH decrease by elevated energy levels which cannot be compensated by restoration of blood flow alone.
Effect of Acute Glycaemic Index on Clinical Outcome after Acute Stroke
Authors: Bhalla Ajay , Sankaralingam Suki , Tilling Kate , Swaminathan R. , Wolfe Charles , Rudd Anthony
Published: April 2003

Studies have shown that hyperglycaemia acutely after stroke independently predicts poorer survival and independence. Whether the change in glycaemic index in the acute phase of stroke has any effect on stroke outcome is unclear. Glycated serum proteins (GSP) reflect blood glucose concentration during the preceding 2 weeks. The aim of this study is to measure the association between the change in GSP % in the first 2 weeks after stroke and outcome. 167 patients were included. 117 (70%) patients were alive at 3 months. Admission glucose was higher in dead patients (7.8 mmol/l) compared to survivors (6.6 mmol/l) (p < 0.01). GSP at day 14 was higher in non survivors (21.8%) compared with survivors (19.1%) (p < 0.0001) as was the change in GSP (2.0 %) in non survivors compared with survivors (0.1%) (p < 0.0001). After adjusting for case mix, the change in GSP % was significantly associated with stroke mortality (p = 0.04). The odds ratio for death at 3 months after stroke associated with every 1% increase in change between GSP day 14 and GSP day 0, was 1.28 (95% CI: 1.1–1.62). Increases in glycaemic index as determined by GSP % are associated with excess in stroke mortality after adjusting for case mix. Intervention trials are required to test the hypothesis that improving glycaemic index after acute stroke improves outcome.
Stroke in Hospitalized Patients: Are There Special Risk Factors?
Authors: Nadav L. , Gur A.Y. , Korczyn A.D. , Bornstein N.M.
Published: April 2003

Background and Purpose: The occurrence of stroke in patients hospitalized for various illnesses remains a particular challenge for neurologists. Determining the potential causes for these particular cerebrovascular events may help to define the population at risk and to take measures in order to prevent stroke during hospitalization. The aim of our study was to evaluate the potential risk factors associated with stroke, which occurred in patients hospitalized for other illnesses. Methods: This retrospective case-control study based on data of patients who underwent an ischemic stroke while being hospitalized not because of stroke and a control group of patients admitted during the same period who were matched for age and sex to the study patients. Common vascular risk factors, e.g. fever, leukocytosis, blood pressure, hemoglobin, cardiac arrhythmia and dehydration, were compared between the study and control groups. Results: Of 2,247 consecutive patients with ischemic stroke, the stroke had occurred during hospitalization not related to any surgical procedure in 80 (3.5%). Six parameters were found as being significant independent risk factors for in-hospital stroke: fever and leukocytosis during hospitalization, elevated diastolic and unstable blood pressure, dehydration and past history of myocardial infarction. Conclusion: Careful monitoring of temperature, blood count, blood pressure, and clinical and laboratory signs of dehydration is needed to prevent in-hospital stroke.
Socioeconomic Aspects of Postacute Care for Patients with Brain Infarction in France
Authors: Spieler Jean-François , Lanoe Jean-Louis , Amarenco Pierre
Published: April 2003

Background: In France, the socioeconomic aspects of stroke have never been addressed. Such analyses are essential for health authorities to justify the establishment of new stroke units when resources are low, provided it can be shown that stroke units are effective in reducing both the morbidity and mortality of stroke. Only 6 dedicated stroke services exist for 60 million inhabitants in France. Our aim was to study acute and postacute pathways and to determine the factors that influence destination after discharge, handicap evolution and costs. Methods: In a cohort of 494 consecutive patients with brain infarction, we collected information on medical and socioeconomic variables, handicap and its evolution using the modified Rankin scale and Mini-Mental Status score at the 10th day, 6th month and 18th–40th month. These data were recorded during the initial hospital stay, at the follow-up clinic visit and in a home interview done 18–40 months after discharge by research nurses. We used multiple logistic regression for analyses. Results: The most important factor for not returning home was having a Rankin score greater than 3 with an odds ratio of 41.7 (95% confidence interval 19.2–90.0; p = 0.001). Multivariate analysis showed that when the Rankin score was 0, 1 or 2, the main factors for not returning home were socioeconomic variables and serious medical disorders. When the Rankin score was 4 or 5, the main reason for not being sent for rehabilitation was medical status. After adjustment for the Rankin score, patients who returned home or were transferred to rehabilitation were quite similar regarding socioeconomic and medical variables. Other patients transferred to a geriatric ward, nursing home or new housing were more frequently living alone, 60 years of age or older, had less than 2 children, low level of education, dementia or cancer. Overall, the mean cost was 19,513 Euros over an 18-month period and was mainly driven by the level of the Rankin score (e.g. 10,530 vs. 34,809 Euros for Rankin scores of 0–1 and 4–5, respectively). Conclusion: These data showed that not only handicap level but also socioeconomic variables are important in determining the destination of stroke patients after discharge. They may help health authorities to make decisions to establish new approaches to treat stroke. This study can also serve as a basis for future cost-effectiveness studies of new drugs being evaluated in therapeutic trials or of new management strategies of stroke patients.
From CURE to MATCH: ADP Receptor Antagonists as the Treatment of Choice for High-Risk Atherothrombotic Patients
Authors: Hacke Werner
Published: April 2003

Patients with a clinical manifestation of atherothrombosis such as a recent ischaemic cerebrovascular event are at high risk of subsequent events. Atherothrombosis often reflects disseminated disease; thus, further events may occur not only in the same arterial distribution but also in other vascular beds. To achieve adequate secondary prevention in these patients, long-term antiplatelet therapy with consistent benefit across the atherothrombosis spectrum is required. In the CAPRIE (Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events) Trial, clopidogrel (clopidogrel bisulphate) was superior to acetylsalicylic acid (ASA) in reducing the combined risk of ischaemic stroke (IS), myocardial infarction (MI) or vascular death in patients with symptomatic atherosclerosis. Post hoc analyses demonstrated that the benefit of clopidogrel was amplified in high-risk patients, including patients with a history of previous ischaemic events, diabetic patients and patients with hypercholesterolaemia. The synergistic antiplatelet effect produced by using clopidogrel on top of ASA may be beneficial in high-risk patients. The benefit of dual antiplatelet therapy was recently examined in the CURE (Clopidogrel in Unstable Angina to Prevent Recurrent Events) Study, which demonstrated that long-term treatment with clopidogrel on top of standard therapy including ASA was superior to standard therapy alone in the prevention of major vascular ischaemic events in patients with unstable angina or non-Q-wave MI. The ongoing MATCH (Management of Atherothrombosis with Clopidogrel in High-risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke) trial will evaluate the efficacy and safety of clopidogrel plus ASA versus clopidogrel alone in patients with recent transient ischaemic attack (TIA) or IS and with at least one additional risk factor. Approximately 7,600 patients will be enroled, with treatment and follow-up for each patient lasting 18 months. The primary combined efficacy endpoint will be the first occurrence of an event in the composite of IS, MI, vascular death or rehospitalization for an acute ischaemic event during the follow-up period. MATCH will explore the potential benefit of clopidogrel in high-risk stroke/TIA patients and together with CAPRIE and CURE could provide further evidence of the long-term benefit of clopidogrel in patients with major atherothrombotic manifestations.
Hepatocytes Entrapped in Alginate Gel Beads and Cultured in Bioreactor: Rapid Repolarization and Reconstitution of Adhesion Areas
Authors: Falasca Laura , Miccheli Alfredo , Sartori Elisabetta , Tomassini Alberta , Conti Devirgiliis Laura
Published: April 2003

The maintenance of the differentiated hepatocyte phenotype and its specific physiological properties is known to depend on several factors, such as chemical signals, cell-cell and extracellular matrix molecular interactions, as well as the use of three-dimensional matrices. The entrapment of hepatocytes within Ca-alginate at high cell density and the culture under continuous flow favour the development of three-dimensional organization and promote expression of the differentiated hepatic phenotype. This system could represent an improvement in hepatocyte cultivation for basic studies of liver physiology and metabolism; it could also be applicable in toxicology, hepatocyte transplantation or development of bioartificial organs. This report describes the effect of alginate entrapment and culture in a bioreactor on hepatocyte aggregate formation, with particular attention to the re-establishment of cell polarity, cell junctions and three-dimensional re-organization of the cytoskeleton. Oxygen supply and cell oxygen consumption rate were monitored in order to evaluate possible changes in hepatocyte energy requirement. Our data show that after only 6 h of perfusion in the bioreactor, actin and cytokeratin localize along the adhesion areas of the plasma membrane, in which reconstituted bile canaliculi were also observed. Moreover, the presence of connexin at the level of joined membranes of neighbouring cells suggests the establishment of gap junctions between hepatocytes. After the first 30 min of perfusion the oxygen consumption rate remained constant throughout the experimental period.
Cytological and Lectin Histochemical Characterization of Secretion Production and Secretion Composition in the Tubular Glands of the Canine Anal Sacs
Authors: Meyer Wilfried , Tsukise Azuma , Neurand Klaus , Hirabayashi Yoshifumi
Published: April 2003

The study reports on secretion production and composition in the tubular glands of the canine anal sacs. For this purpose, light and electron microscopical (TEM, SEM) as well as several histochemical methods for the demonstration of lysosomal acidity, lipofuscin, and complex carbohydrates were used. The glandular tubules exhibited a pseudostratified epithelium with secretory cells of a different shape as related to secretion production activity, and regionally varying amounts of basal cells. Flat, cuboidal or columnar cells with or without apocrine-like protrusions were assembled in one glandular endpiece, although grouping of these cell types often occurred. Active secretory cells were columnar with many cytoplasmic vesicles and a typically merocrine and/or micro-apocrine exocytosis of vesicle contents. Additionally, many lysosomes of different sizes could be found, whereby in aged cells giant secondary lysosomes (autophagolysosomes, about 7 µm in diameter) occupied the major cell part. These giant lysosomes were shed by an apocrine-like process forming a final bottleneck stage of the upper cell part, and consisted of ceroid-type lipofuscin. The general carbohydrate histochemical and the lectin histochemical methods revealed that the secretion produced was composed of strongly concentrated neutral glycoproteins with the following saccharide residues: α-D-mannose, β-D-galactose, β-N-acetyl-D-glucosamine, α-L-fucose and N-acetyl-neuraminic acid (sialic acid); the luminal secretion contained only β-D-galactose and, especially, N-acetyl-neuraminic acid. This luminal secretion showed a spatially orientated maturation beginning in terminal tubular regions and finishing near the excretory duct, independent of the different secretory cell types. The results obtained demonstrated highly active secretion production, with a regional variation in the glandular tubule, and at least three different modes of secretion by the secretory cells, whereby the shedding of giant lipofuscin granules seems to be very specific. The high amounts of sialic acids in the glycoproteins found may influence the rheological properties of the secretion by their water-binding capacities.
Motoneurons of the Lateral and Medial Rectus Extraocular Muscles in Squirrel Monkey and Cat
Authors: McClung J. Ross , Shall Mary S. , Goldberg Stephen J.
Published: April 2003

The goal of this study was to examine and compare the number and size of motoneurons in the cat and squirrel monkey abducens nucleus. We also examined medial rectus muscle motoneuron compartmentalization in the squirrel monkey oculomotor nucleus and compared those cells to abducens nucleus motoneurons. Retrograde labeling of the motoneurons, using cholera toxin conjugate of horseradish peroxidase (CTHRP) injected into cat and monkey lateral or medial rectus muscles, was observed after 24 h. The CTHRP was histochemically localized with tetramethylbenzidine. The slide-mounted sections were analyzed using a computerized imaging system. Cat abducens nucleus motoneurons showed a wide range of cell sizes (26.0–66.0 µm, mean = 37.2 ± 6.2 µm), four or more dendrites per cell and an average of 1,418 cells within a relatively loosely packed nucleus. Squirrel monkey abducens nucleus motoneurons were significantly smaller than those in the cat with a narrower range of cell sizes (20.0–44.0 µm, mean = 31.7 ± 3.8 µm), four or more dendrites per cell and an average of 2,473 cells densely packed within the nucleus. Squirrel monkey medial rectus muscle motoneurons were organized into MRa, MRb and MRc subgroups. MRa motoneurons comprise the primary innervation for the medial rectus muscle and were similar in size to abducens nucleus motoneurons while the MRc subgroup cells were significantly smaller in size. Similar relationships among medial rectus motoneurons have been seen in rhesus monkeys. The relationship of these anatomical findings to previous physiological results regarding the generation of extraocular muscle force in the squirrel monkey is discussed.
Effect of Undernutrition on Cranial Components and Somatotroph-Lactotroph Pituitary Populations in the Squirrel Monkey (Saimiri sciureus boliviensis)
Authors: Cónsole G.M. , Oyhenart E.E. , Jurado S.B. , Riccillo F.L. , Pucciarelli H.M. , Gómez Dumm C.L.A.
Published: April 2003

The aim of the present study was to investigate in monkeys the effects of undernutrition on neurocranial and facial components, correlated with a histometric and ultrastructural analysis of somatotroph (growth hormone, GH) and lactotroph (prolactin, PRL) pituitary populations. Twenty Saimiri sciureus boliviensis (Cebidae) of both sexes were employed. The monkeys were born in captivity and when they reached 1 year of age, they were separated into two groups: control and undernourished animals. They were fed ad libitum a 20% and 10% protein diet, respectively. The monkeys were radiographed when they were 3 years old in order to measure the length, width and height of the anterior, middle and posterior components of the neurocranium, as well as those of the masticatory, respiratory and optic components of the face. The volumetric and morphometric indices were then calculated. After the sacrifice, pituitary glands were processed for light and electron microscopy. The quantitative immunohistochemistry revealed a decrease in the volume density and cell density of both GH and PRL cells from malnourished animals when compared to control ones. The ultrastructural study showed changes suggestive of cellular hyperfunction for both types of cells in the former experimental group. Under nutrition also affected the size of the cranial components, with males being more affected than females; brain weight was, however, nonmodified by stress, with the brain/body ratio difference being the same for both sexes. We conclude that in monkeys, experimental undernutrition produces a decrease in the pituitary GH and PRL cell populations, in some way related to changes in the cranio-facial morphometric patterns.
Hair Growth Pattern in Nude Mice
Authors: Militzer Klaus
Published: April 2003

Nude mice are not bald but instead show an ‘abortive’ reduced hair growth on different sites of the integument. An albino (NMRI-nu) and a pigmented (C57BL/6-nu) strain of nude mice were examined as to whether the regional distribution pattern of this anagen hair proliferation is subject to the same ontogenetic development as in hairy mice. Hairy mice of both strains served as a comparison. Hair distribution was documented macroscopically by drawing and photography in a total of 415 mice of both sexes up to 421 days of age. Because of the pigmentation of the growing anagen hair follicles, the growth areas in the pigmented nude mice were distinctly visible whereas in the albino mice they were roughly recognisable from the boundaries of hair covering. The regional distribution of the ‘abortive’ anagen hair pattern in both nude strains corresponded to the wave-like course of the adult hair generations of hairy mice. As in older hairy mice, the hair cycle duration in nude mice was prolonged from an age of 121–180 days, the hair growth areas appeared reduced and less symmetrically orientated. Differences of up to 33% in body mass between the lighter nude and +/nu mice made ontogenetic comparison impossible so that all information is based on direct pattern or age comparison. The significance of experiments on the skin and hair follicles of nude mice is further increased if litters are examined comparatively and the temporal and spatial dimension of the follicle proliferation is considered more carefully than has been the case until now.
The Pars tuberalis of the Monkey (Macaca fascicularis) Hypophysis: Cell Types and Hormone Expression
Authors: Bock N. , Böckers T.M. , Bockmann J. , Nowak P. , Buse E. , Wittkowski W.
Published: April 2003

The pars tuberalis (Pt) of most mammalian species contains specific cells which are structurally and functionally different from the pars distalis (Pd) cells. Pt-specific cells possess melatonin receptors and reveal morphological changes dependent on the duration of the photoperiod. Furthermore, in hamsters the transmission of photoperiodic stimuli to the endocrine system is influenced by melatonin, an effect which is likely to be mediated by Pt-specific cells. In monkeys, however, only little is known about this cell type. Therefore, we studied the ultrastructural differentiation of Pt-specific cells and describe the expression of different hormones and their mRNA by immunohistochemistry and in situ hybridization. Apparently the Pt consists of (1) cells similar to gonadotropic cells of the Pd, (2) folliculostellate cells and (3) a cell population which is morphologically and functionally clearly distinct from all other cell types found in the Pd. Morphologically they resemble the Pt-specific cells found in other species. Regarding the expression of secretory products there is evidence that they transcribe and translate the β-TSH subunit. Although there is a strong signal for the mRNA of the common α-chain, protein staining is much weaker. POMC mRNA is expressed in the Pt while there is no evidence for PRL mRNA. The present results lead to the conclusion that the Pt of the monkey contains Pt-specific cells which express different hormonal subunits as was already shown for other species. In context with previous findings of melatonin receptors in the monkey Pt further investigations are necessary to establish the possible role of Pt-specific cells in the photoperiod-dependent generation of endocrine rhythms.
Loading of the Temporomandibular Joint: Anatomical and in vivo Evidence from the Bones
Authors: Herring Susan W. , Liu Zi Jun
Published: April 2003

‘Loading of the TMJ’ is usually understood to mean a compressive force applied to the articular surfaces of the jaw joint. Theoretical models of jaw mechanics can be manipulated to support either the presence or the absence of loading, depending on the assumed contraction patterns of the muscles and the assumed occlusion. This paper synthesizes a series of studies on jaw joint function using pigs as substitutes for humans. Bone strain (deformation) was directly measured on the lateral surfaces of the condylar neck and the squamosal (equivalent to the human temporal) bone. Chewing strains indicate that loading does occur and is not light. The peak strains on the condyle are indeed primarily compressive, but the situation is dynamic. Small tensile strains can occur during chewing, and protrusive splints may decrease the strain resulting from muscle stimulation. The squamosal bone is even more surprising, in that the major strain is tensile. The most likely explanation for this finding is that the squamosal bone is bent under the load. Thus, the two elements of the TMJ are deformed in different ways by the same movements and muscle activities. Internal bony architecture reflects these differences. The condyle is filled with fine, vertically oriented bony trabeculae. The articular eminence has thick cortices and trabeculae oriented approximately transversely. In conclusion, the TMJ is loaded, but the situation is complex. The largest forces seen by the condyle are compressive, and they arise from muscle contraction. These same forces serve to bend the squamosal bone.
Cryopreservation of Artificial Cartilage: Viability and Functional Examination after Thawing
Authors: Lübke C. , Sittinger M. , Burmester G.-R. , Paulitschke M.
Published: April 2003

In biomedical research and in reconstructive surgery, preservation of intact tissue has been an unsolved problem. In this study, we investigated the viability of cryopreserved artificial cartilage and its synthetic activity of cartilage-specific matrix proteins after thawing for in vitro use. A polymer fleece cylinder (diameter = 3 mm; height = 3 mm) was loaded with a suspension of bovine chondrocytes (25 × 106/ml) and encapsulated with fibrin glue. After a culture period of 1 week, the artificial cartilage units were frozen in a cryoprotection solution containing 10% basal medium (RPMI 1640), 10% DMSO and 80% FCS. The freezing procedure consisted of three steps: a 30-min period at +4°C followed by a 24-hour storage at –80°C. After that, the tissue units were transferred into liquid nitrogen (–196°C) for final storage. Using histochemical staining techniques of cryogenic slices, we investigated the ability of cryopreserved artificial cartilage to produce its specific matrix after thawing. A modified MTT assay was used to determine the viability of frozen tissue units in comparison with unpreserved samples at different moments after thawing. Depending on the chondrocytes used for the formation of artificial cartilage, the viability of cryopreserved tissue varied between 65 and 85%. Both the intensity of alcian blue staining for proteoglycans and the azan staining for collagens increased proportionally with incubation time after thawing. These findings indicate that cryopreservation of small artificial cartilage units is possible with a minor loss of cell viability. Secondly, its synthetic activity of cartilage-specific matrix did not decline after the freezing process.
Morphology of the External Nose in Hipposideros diadema and Lavia frons with Comments on Its Diversity and Evolution among Leaf-Nosed Microchiroptera
Authors: Göbbel Luminita
Published: April 2003

In some bats, a noseleaf is thought to help focus echolocation calls emitted through the nostrils. I studied the ontogenetic mode of the rhinarial cartilages and the associated facial muscles to assess how these rhinarial infrastructures interact with the noseleaf, and the inferred function of such a rhinarial complex. This study focuses on developmental stages of Hipposideros diadema and Lavia frons. Based on new data on these two rhinolophoids and a review of former studies concerning rhinopomatids, rhinolophoids and phyllostomids, the functional and phylogenetic implications of the rhinarial complex among leaf-nosed Microchiroptera are evaluated by the current study. Nasal emitting forms evolved several times independently in the Microchiroptera and share various features, irrespective of their phylogenetic position: the nostrils lie dorsally; the noseleaf has a well-developed horseshoe-shaped plate; the cartilago cupularis bears a large processus cupularis; M(iv) is extended on the lateral plate of the processus alaris superior. The unique similarities of the ontogenetic process of the nasal ‘resonators’ support the assumption that the rhinolophids + megadermatids and rhinopomatids may represent a natural group. In some features, the rhinolophids + megadermatids differ significantly from the phyllostomids. The noseleaf has a median flap and anterior-facing pockets. The processus alaris superior is half-tube-shaped or included in the lateral wall of the cupula nasi anterior. The cartilago accessoria and the attendant musculature perform an important function for supporting and moving the noseleaf. Similar emission of the echolocation pulses but alternative constructional designs of the external nose structures suggest that a separate history of rhinolophoids and phyllostomids might account for these differences.
Beyond a Glimpse at Seasonal Dry Skin: A Review
Authors: Piérard-Franchimont Claudine , Piérard Gérald E.
Published: April 2003

On clinical grounds, the so-called dry skin corresponds in reality to a rough, sometimes flaky and scaly stratum corneum. The spectrum of xerotic disorders is quite large encompassing diverse aetiologies and physiopathological pathways. The clinical assessment of these conditions relies on close visual and tactile inspection. EEMCO guidances were proposed in this field for subject and expert evaluations. Scoring systems include analogue scales, the overall dry skin score and the SRRC score combining the grading of scaliness, roughness, redness and cracks. The dry skin extent area and severity index is defined for the dermatological evaluation of the entire body surface. The use of a video camera equipped with an internal ultraviolet light illumination unit is very informative and allows better comparative assessments.
An Outbreak of Microsporum canis in the Community Demonstrating Rapid Transmission
Authors: Chiller Katarina , Resneck Jack , Chiller Tom , Aly Raza
Published: April 2003

While Microsporum canis is an infrequent cause of tinea infections in the USA, it should remain in the differential diagnosis when a fungal infection presents in an atypical fashion. We describe an outbreak of M. canis affecting 15 people and 2 dogs with rapid transmission. Family pets may have acted as intermediate hosts in this outbreak, facilitating transmission between human contacts.
Alpha-Fetoprotein Values in Amniotic Fluid Obtained during Early Amniocentesis (11–13 Weeks)
Authors: Nwebube Nwachukwu I. , Lockitch Gillian , Halstead Cathy , Johnson Joann , Wilson R. Douglas
Published: April 2003

Objectives: To determine the normal values of α-fetoprotein (AFP) in amniotic fluid between the gestational ages of 11 and 13 weeks and compare these with previously published values. Methods: Amniotic fluid AFP was analyzed in 149 patients who had undergone amniocentesis between 11 ± 0 and 13 ± 6 weeks gestation as part of the pilot study of the Canadian Early and Mid-Trimester Amniocentesis Trial. Analysis was done using the Abbott IMX System (Abbott Laboratories Diagnostic Division, Abbott Park, Ill.). These values were then compared with previously published values. Results: There is a progressive and linear rise in the amniotic fluid AFP concentration from 11 to 13 weeks gestation. The differences between each of the three gestational ages were statistically significant at the 0.05 level. The values differed significantly from those obtained by Crandall et al. [Am J Obstet Gynecol 1989;160:1204–1206], which were also consistently higher. Conclusion: Although reference points for 11, 12 and 13 weeks have been established, there are limitations to their clinical application.
Early Transvaginal Biometry of Fetal Orbits: A Cross-Sectional Study
Authors: Guariglia Lorenzo , Rosati Paolo
Published: April 2003

Objective: To construct nomograms of orbital diameters in early pregnancy by transvaginal sonography. Design: A prospective cross-sectional study. Methods: The study was performed on 923 consecutive normal singleton pregnancies from 10 to 16 weeks of gestation, using transvaginal high-resolution ultrasound technique. The interocular distance (IOD), binocular distance (BOD), as well as the orbital diameter (OD) at each gestational age (GA, days), were recorded. The distribution of the residuals for the different orbital measurements are also described. Results: The increase in each of the ocular parameters studied could be accurately described by a linear model. The regression equation for orbital measurements as a function of GA was: for IOD, y = 0.153 GA (days) – 6.73 (r2 = 0.82); for BOD, y = 0.387 GA (days) – 16.85 (r2 = 0.80), and for OD, y = 0.132 GA (days) – 6.435 (r2 = 0.79). IOD and OD demonstrate a normal distribution of the residuals with uniform variance. Conclusion: The presented data obtained in early pregnancy by transvaginal scan offer normative measurements of the orbital diameter which may be useful in the prenatal diagnosis of congenital syndromes that include, among other manifestations, orbit maldevelopment and growth disturbances.
Gestational Age at Intrauterine Myelomeningocele Repair Does Not Influence the Risk of Prematurity
Authors: Hamdan A.H. , Walsh W. , Heddings A. , Bruner J.P. , Tulipan N.
Published: April 2003

Objective: To determine the effect of gestational age at the time of intrauterine myelomeningocele repair on the duration of pregnancy and the gestational age at the time of delivery. Methods: This study is a retrospective chart review of the maternal and neonatal medical records of all infants undergoing intrauterine myelomeningocele repair at Vanderbilt University Medical Center. Birth weight, gestational age at the time of surgery and gestational age at the time of delivery were recorded. Infants were divided into 2 groups depending on gestational age at the time of surgery, either ≧25 weeks’ gestation (group 1) or <25 weeks (group 2). Results were expressed as medians and interquartile ranges. Statistical analysis was done using the unpaired (2-sample) t test; p values ≤0.05 were considered significant. Results: Ninety-five infants were studied. Fifty-one infants were repaired after 25 weeks’ gestation (group 1) at a median gestational age of 26.3 weeks (range 25.6–27.6). Their median gestational age at delivery was 34.4 weeks (range 32.6–35.3). Forty-four infants were repaired before 25 weeks’ gestation (group 2). Surgery was done at a median gestational age of 23.6 weeks (range 22.4–24.5). The median gestational age at delivery was 34 weeks (range 31.6–35.3; p = 0.88). Conclusion: Early intrauterine myelomeningocele repair before 25 week’s gestation does not decrease the gestational age at delivery when compared with repair after 25 weeks.
Fetal Atrial Flutter Recorded Prenatally by Magnetocardiography
Authors: Hosono Takayoshi , Kanagawa Takeshi , Chiba Yoshihide , Neki Reiko , Kandori Akihiko , Tsukada Keiji
Published: April 2003

A case of fetal atrial flutter successfully recorded by magnetocardiography (MCG) is reported. Initial ultrasonography revealed frequent fetal atrial extrasystoles at 31 weeks of gestation. Fetal MCG was recorded using a multichannel MCG system at 31, 35 and 38 weeks of gestation. A series of fluctuations in the baseline of the MCG were noted at 35 and 38 weeks of gestation, which were revealed to be atrial flutter P waves. The averaged MCG showed that the fetal arrhythmia was an atrial flutter with a 3:1 atrioventricular block. The diagnosis was confirmed by neonatal electrocardiogram. Fetal MCG may be useful for the diagnosis of fetal atrial flutter.