bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Densitometry: Assessing the Effects of Growth Hormone Treatment in Adults
Authors: Ortolani Sergio
Published: April 2003

Dual-energy X-ray absorptiometry (DXA) is the reference method for the measurement of bone mineral mass at different skeletal sites. It has been widely used in recent years to assess the effects of growth hormone (GH) treatment on bone metabolism. In normal individuals, bone mineral content (BMC) and density (BMD), as assessed using DXA, correlate with body size. Therefore, using DXA in patients with congenital GH deficiency (GHD), who have a smaller body frame, would be expected to result in lower bone mass. Thus, comparisons with reference data derived from populations of normal body size are invalid. The evaluation of the effects of GH administration should take into account the possible effects of GH on bone size, not only in children, but also in adults. The enlargement of bone, due to stimulation of the periosteal apposition, may partially mask an increase in BMC, resulting in little or no change in BMD. The ability of GH to affect bone area therefore requires analysis of the possible changes in bone area and BMC, as well as BMD. This issue has been poorly handled in the studies published to date. Lastly, the acceleration of bone turnover induced by GH leads to an increase in bone remodelling space, which in turn is associated with a reduction in BMC and BMD, independent of the net balance between breakdown and formation in each metabolic unit. This bone loss is completely reversible when the remodelling space returns to previous levels. This phenomenon must be taken into account when analysing the effects of GH treatment on bone mass, because a net gain in bone mass may be found in long-term GH treatment or after GH discontinuation, even if bone loss was evident during the first 6 months of treatment. In conclusion, the interpretation of bone density data in patients with GHD, and after GH administration, should take into account some of the methodological aspects of bone densitometry, as well as the specific actions of GH on bone metabolism and body composition.
Bone Markers and Bone Mineral Density during Growth Hormone Treatment in Children with Growth Hormone Deficiency
Authors: Cowell Christopher T. , Woodhead Helen J. , Brody Julie
Published: April 2003

Growth hormone (GH) has a positive impact on muscle mass, growth and bone formation. It is known to interact with the bone-forming unit, with well-documented increases in markers of bone formation and bone resorption within weeks of the start of GH therapy. These changes relate significantly to short-term growth rate, but it is not evident that they predict long-term response to GH therapy. The consequences of GH deficiency (GHD) and GH replacement therapy on bone mineral density (BMD) have been difficult to interpret in children because of the dependency of areal BMD on height and weight. Some studies have tried to overcome this problem by calculating volumetric BMD, but results are conflicting. The attainment of a normal peak bone mass in an individual is considered important for the future prevention of osteoporosis. From the limited data available, it appears difficult to normalize bone mass totally in GH-deficient individuals, despite GH treatment for long periods. Studies to date examining the interaction between GH and bone have included only small numbers of individuals, making it difficult to interpret the study findings. It is hoped that these issues can be clarified in future research by the direct measurement of bone density (using quantitative computer tomography). Mineralization is only one facet of bone strength, however; other important components (e.g. bone structure and geometry) should be addressed in future paediatric studies. Future studies could also address the importance of the degree of GHD in childhood; how GH dose and insulin-like growth factor-I levels achieved during therapy relate to the final outcome; whether or not the continuation of GH therapy after the attainment of final height may further enhance bone mass; whether the timing and dose of other treatments (e.g. sex hormone replacement therapy) are critical to the outcome; and whether GHD in childhood is associated with an increased risk of fracture.
Clinical Usefulness of Bone Mineral Density and the Health Economy Consequences of Osteoporosis
Authors: Johnell Olof
Published: April 2003

Bone mineral density is one of the strongest risk factors for osteoporotic fractures and can be used, in combination with other risk factors, to identify groups at high risk of osteoporosis who could benefit from treatment to prevent fractures. Health economic studies have shown that the treatment of these high-risk patients is cost-effective.
Microalbuminuria in Nondiabetic Patients with Acute Ischemic Stroke: Prevalence, Clinical Correlates, and Prognostic Significance
Authors: Słowik Agnieszka , Turaj Wojciech , Iskra Tomasz , Strojny Jacek , Szczudlik Andrzej
Published: April 2003

Microalbuminuria is a frequent finding in several acute clinical conditions and predicts poor outcome; its role in acute ischemic stroke, however, is unknown. This study was designed to investigate the prevalence and predictive power of microalbuminuria in acute stroke patients and to establish the relationship between microalbuminuria and the patients’ clinical status. We studied 60 patients admitted within 24 h of their first ischemic stroke, 50 patients with a history of ischemic stroke, and 30 control subjects without known cerebrovascular diseases. Neurological deficit was assessed by the Scandinavian Stroke Scale (SSS) on admission and on days 1, 7, 14, and 30. Urinary albumin excretion was measured using immunonephelometric method, with 24-hour collections performed on day 2. Outcome was assessed by 30-day, 90-day and 1-year mortality. Microalbuminuria was found in 46.7% of patients with acute stroke, 16% of subjects with a history of stroke, and 16.7% of controls. On admission, acute stroke patients with microalbuminuria had more severe neurological deficit (median of SSS score on admission was 28 vs. 40, and on day 1, 22 vs. 39, both p < 0.05; Mann-Whitney U test) and more often had a decreased level of consciousness (32 vs. 10%, p < 0.05; Fisher exact test). Mortality was higher in the group of patients with microalbuminuria in acute stroke (21 vs. 3% after 30 days, 39 vs. 6% after 90 days and 50 vs. 9% after 1 year, p < 0.05 for all differences; Fisher exact test). In logistic regression analysis, microalbuminuria was found to be an independent predictor of 1-year mortality after ischemic stroke (OR = 6.0; p = 0.022; 95% CI = 1.3–27.7).
Seizure at Stroke Onset: Should It Be an Absolute Contraindication to Thrombolysis?
Authors: Selim Magdy , Kumar Sandeep , Fink John , Schlaug Gottfried , Caplan Louis R. , Linfante Italo
Published: April 2003

Background: Current guidelines for the treatment of acute ischemic stroke exclude patients with seizure at stroke onset from consideration for thrombolytic therapy. It may be difficult to differentiate an ischemic stroke from postictal Todd’s paralysis by clinical examination and noncontrast CT scan. Magnetic resonance imaging (MRI) with diffusion- (DWI) and perfusion-weighted images (PWI) and angiography (MRA) can be used to confirm the diagnosis of an acute ischemic process in the presence of concurrent seizures. Methods: A case report of a patient who presented with seizures, in whom the combination of DWI/PWI MRI and MRA confirmed the diagnosis of an embolic ischemic stroke. The patient was treated with intravenous recombinant tissue plasminogen activator with clinical and radiological improvement. Conclusions: Treatment decisions with regard to thrombolysis in acute stroke patients should be based on parameters of cerebral perfusion, assessment of collateral blood flow and presence of potentially salvageable tissue. Modern neuroimaging techniques that can rapidly assess these variables, such as DWI/PWI MRI and MRA, can improve the current selection of patients who are likely to benefit from thrombolysis and extend its benefit to patients who would otherwise be excluded, such as those with seizures at stroke onset.
Change of Complexity Patterns in Human Posture during Aging
Authors: Thurner Stefan , Mittermaier Christian , Ehrenberger Klaus
Published: April 2003

Human posture is a prototypical example of a complex control system. The joint output of several physiological – most likely nonlinearly interacting – processes leads to correctional movements which enable us to stand upright. These correctional body movements reflect some features of the underlying control mechanisms. We analyze the movements of quietly standing persons by means of various types of fractal measures, which are designed to capture ‘degrees of complexity’. We observe changes of these fractal measures as a function of age and show that aging goes hand in hand with a decrease of complexity in movement patterns towards more regular movements. We try to explain these results in a stochastic resonance framework. We conjecture that the reduction of posture complexity is linked to deteriorated balance performance and argue that clinical treatment of age-related balance problems should focus on regaining this complexity therapeutically. We line out two possible starting points for actual therapy.
Now and Then, the History of Parenteral Fluid Administration
Authors: Barsoum Noha , Kleeman Charles
Published: April 2003

The use of blood and intravenous fluid therapy is now considered routine therapy. The level of sophistication that we now perceive as standard has resulted from centuries of legends, religious beliefs, pseudo-science, non-scientific supposition, experimentation and error. The purpose of this article is to review the evolution of parenteral fluid and transfusion therapy through history. Data were collected via online search through the medical literature (ovid-medline), historical journals, medical history books as well as visits to historical medical libraries. We express our appreciation and gratitude to the hundreds of scientists whose work has allowed us to practice medicine, as we know it.
MRI of Blood Volume and Cellular Uptake of Superparamagnetic Iron in an Animal Model of Choroidal Melanoma
Authors: Krause Matthias , Kwong Kenneth K. , Xiong Jing , Gragoudas Evangelos S. , Young Lucy H.Y.
Published: April 2003

Functional magnetic resonance imaging (MRI), using monocrystalline iron oxide nanoparticles (MION) as a new intravascular contrast agent, was adapted for a rabbit model of pigmented choroidal melanoma. Three-dimensionally spoiled gradient recalled sequences were used for the quantitative assessment of blood volume and cellular uptake. In all ocular tissues studied, MION reduced the T2-weighted signal intensity within 0.5 h and at 24 h (both p < 0.05) after the injection. In individual tumors, MION reduced the T2-weighted signal intensity by 46–78% within 0.5 h and by 24–48% at 24 h. In addition, MION increased the T1-weighted signal intensity in all tissues. T2 yielded a higher sensitivity than T1-weighted images. Functional MRI with MION is a noninvasive technique with regard to the eye, permitting measurement of blood volume and cellular uptake of the contrast agent. Further study is necessary to determine the feasibility of this technique for the tumor diagnosis and evaluation of tumor viability following treatments.
Hyaluronate Accumulation and Decreased CD44 Expression in Perifollicular Solitary Cutaneous Myxoma
Authors: Calikoglu Emel , Augsburger Eric , Masouyé Isabelle , Chavaz Pierre , Saurat Jean-Hilaire , Kaya Gürkan
Published: April 2003

Background: Myxomas are rare cutaneous tumors which may be solitary or associated with Carney’s complex, NAME or LAMB syndromes. The mucinous material which constitutes the stroma of cutaneous myxomas is predominantly composed of hyaluronate (HA), the major component of the extracellular matrix. CD44 is a polymorphic integral membrane glycoprotein which serves as the principal cell surface receptor for HA. Objective and Methods: Here we present 2 cases of solitary cutaneous myxomas displaying microscopically a perifollicular localization, in which we explored the nature of the accumulated mucinous material by colloidal iron and HA-binding protein stainings, as well as the epidermal expression of CD44 protein by immunohistochemistry. Results: We show that HA is accumulated in the stroma of the cutaneous myxoma lesions and that the protein expression of CD44 in the keratinocytes of the trichofolliculoma-like epithelial buds projecting from the hair follicle centering these lesions is significantly decreased. Conclusions: Our results suggest that a decrease in CD44 expression in follicular epithelial proliferations may be correlated with an abnormal HA accumulation in cutaneous myxoma.
Meyerson Phenomenon within a Nevus flammeus
Authors: Hofer Thomas
Published: April 2003

Only few reports about eczematous reactions overlying nevi flammei exist. All of them were observed in children. The description of an eczematous reaction within a congenital nevus flammeus on the left lower leg of a male adult gives reason to discuss this rare phenomenon. Eczema or inflammatory changes within a port-wine stain may mostly be a collision dermatosis with an atopic dermatitis, especially when they arise in children and are localized to the neck and face. When they are observed within a grossly visible vascular malformation, as for example in the Klippel-Trenaunay syndrome, they may have a pathogenesis similar to stasis dermatitis. In rare cases, an eczematous reaction within a nevus flammeus may be the result of genetic mosaicism and is interpreted as a variant of the so-called Meyerson phenomenon.
Topical 5% Imiquimod Long-Term Treatment of Cutaneous Warts Resistant to Standard Therapy Modalities
Authors: Grussendorf-Conen E.-I. , Jacobs S. , Rübben A. , Dethlefsen U.
Published: April 2003

Background: Long-lasting cutaneous warts may represent an unbearable stigma to patients and therefore pose a singular challenge for the physician. Generally, these warts are induced by human papillomavirus (HPV) 2, HPV-27 or HPV-57. Objectives: The present study was conducted to evaluate the efficacy and safety of long-term treatment with imiquimod 5% cream applied to long-lasting (mean duration 6.3 years) common warts, which had been resistant to previous therapeutic interventions. Patients and Methods: Imiquimod cream was self-applied by the patients twice daily. Assessment of response and occurrence of side-effects was performed every 4 weeks until clinical cure or up to a maximum of 24 weeks. A total of 37 patients were recruited. Results: 31 out of 37 patients completed the treatment. 10 out of 37 patients experienced a total clearance of their warts (27%). The mean duration to clearance was 19.2 weeks. 18 patients (49%) showed a reduction of more than 50% and 5 patients (14%) a reduction of less than 50%. Conclusions: Our data demonstrate that the long-term topical application of imiquimod 5% cream is an effective treatment for otherwise therapy-resistant cutaneous warts without causing any meaningful side-effects.
Multiple Hyperkeratotic Spicules and Myeloma
Authors: Braun R.P. , Skaria A.M. , Saurat J.-H. , Borradori L.
Published: April 2003

We report the case of a 58-year-old patient with multiple myeloma with a monoclonal gammopathy of the IgG type, who developed a striking eruption characterized by multiple hyperkeratotic spicules of the face, nose and scalp. Light-microscopic studies revealed a follicular orthohyperkeratosis, while direct immunofluorescence microscopy remained negative. Hence, our patient presented features characteristic of a rare distinctive disorder associated with an underlying paraprotein or multiple myeloma, paraneoplastic hyperkeratotic spicules.
Generalised Pustular Psoriasis Induced by Cyclosporin A Withdrawal Responding to the Tumour Necrosis Factor Alpha Inhibitor Etanercept
Authors: Kamarashev J. , Lor P. , Forster A. , Heinzerling L. , Burg G. , Nestle F.O.
Published: April 2003

We report a 50-year-old male patient with a 15-year history of psoriasis including mutilating psoriatic arthritis, in whom the withdrawal of cyclosporin A induced a generalised pustular exacerbation and a aggravation of the joint condition. Two weekly injections of 25 mg of the tumour necrosis factor α inhibitor etanercept led to a rapid improvement of his psoriatic arthritis, as well as regression of the pustular eruption, while residual erythema was still present. The clinical response was reflected by an increase in circulating interleukin (IL) 10 and a decrease in IL-6 and IL-8 serum levels during treatment. We conclude that etanercept may be a safe and effective therapy not only in severe psoriatic arthritis, but also in cases of pustular rebound after withdrawal of immunosuppressive agents.
Remineralization of Advanced Root Dentin Lesions in vitro
Authors: Mukai Y. , ten Cate J.M.
Published: April 2003

The possibility for remineralization of advanced root dentin lesions was investigated in vitro. Lesions were produced in acidic buffer solution with 0.1 and 0.5 ppm fluoride, for 3 and 5 weeks, respectively, using a single-section model. Next, the sections were immersed in a remineralization solution containing 0.1 ppm F (as NaF) for 20 weeks. Microradiographs were made after each 4-week-period. The lesions were around 500 µm deep, with mineral loss values between 11,000 and 18,000 vol%·µm. After 20 weeks of remineralization, the absolute amounts of deposited mineral ranged from 7,500 to 10,000 vol%·µm, corresponding to a repair between 50 and 85%. Lesion depth was, on average, reduced by 199 µm. This was not significantly different (at p < 0.05) between the four experimental groups. This study showed that remineralization of advanced dentinal lesions is possible in spite of the virtual absence of mineral in the lesion body after demineralization. The surface layer of the lesion was the preferred site for mineral deposition until mineral content values reached those of sound dentine. The mineral content in the lesion body increased with time, at a rate reflecting the initial severity of the lesion. We conclude that a remineralized surface layer does not inhibit transport of mineral ions to the body and that the remineralization in the lesion body reflected the number of sites for crystal growth.
Remineralisation of Enamel Lesions with Daily Applications of a High-Concentration Fluoride Gel and a Fluoridated Toothpaste: An in situ Study
Authors: Lagerweij M.D. , ten Cate J.M.
Published: April 2003

The inhibition of enamel demineralisation and the enhancement of remineralisation are positively but not linearly related to the concentration of fluoride, especially when high fluoride concentrations are used. The aim of this in situ experiment was to determine the maximum amount of enamel remineralisation that can be achieved with daily applications of very high concentrations of fluoride. For this purpose we compared the efficacy of a daily application of fluoridated topical gel (12,500 ppm F, partly as NaF, Olafluor and Dectafluor, pH 4.5) in combination with a fluoridated toothpaste (1,450 ppm F as NaF), with fluoridated toothpaste alone. Participants (n = 26, with partial dentures) were fitted with a demineralised enamel specimen (mean mineral loss of 1,674 vol%·µm) and were instructed to use one of the two fluoride treatments. After 4 weeks of treatment, the specimens were retrieved, a section was cut and analysed with microradiography. The remainder of each of the specimens was used for analysis of the ‘loosely bound’ and ‘bound’ fluoride. Fluoride was measured with gas-liquid chromatography. After 4 weeks in the mouth, the original lesion was reduced in size by 54% in the toothpaste + gel group (n = 14) and by 44% in the toothpaste-only group (n = 12), but the difference between the groups was not statistically significant. The mineral content profiles showed remineralisation of the lesions throughout the depth of the lesion. The enhancement of remineralisation by the high amounts of fluoride was most pronounced in the surface layer. For both the ‘loosely bound’ and ‘bound’ fluoride, a statistically significant increase in fluoride concentration could be found in the toothpaste + gel group. In the 4-week in situ period the use of high amounts of fluoride resulted in a maximum remineralisation rate. This is illustrated by an increase in remineralisation and higher fluoride concentrations in the toothpaste + gel group compared to the toothpaste-only group.
Increased Intestinal Permeability Correlates with Gastrointestinal Toxicity among Formulations of the Fluorouracil Analogue Tegafur in Rats
Authors: Korenaga D. , Honda M. , Yasuda M. , Inutsuka S. , Nozoe T. , Tashiro H.
Published: April 2003

Background: S-1 is a new antitumor agent which was developed based on biochemical modulation of fluorouracil. S-1 consists of tegafur (FT), 5-chloro-2,4-dihydroxypyridine (CDHP), and potassium oxonate (Oxo) in a molar ratio of 1:0.4:1. S-1 has been reported to enhance therapeutic effects and to reduce the gastrointestinal toxicity as compared with 5-fluorouracil. In this study performed in rats, S-1 was used to assess the relationship between gastrointestinal mucosal toxicity and changes in intestinal barrier function. Methods: Fifteen rats were equally divided into three groups: group A (untreated controls), group B (FT and CDHP mixture), and group C (FT and CDHP in combination with Oxo). The animals in groups B and C received equitoxic doses of the drugs in their food for 14 consecutive days. The intestinal permeability was determined on the basis of the urinary recovery of orally administered lactulose and mannitol (L/M). Injury to the small intestines was evaluated by light microscopy. The cell surface expression of CD44 was evaluated immunohistochemically. Results: Recovery of L/M in urine (expressed as a fraction of the dose administered) was 0.15 ± (SE) 0.08, 0.23 ± 0.13, and 0.09 ± 0.04 in groups A, B, and C, respectively. The intestinal permeability in group B was significantly higher than that in group C (p < 0.05). Treatment with FT and CDHP (groups B and C) induced injury to the small intestine and decreased expression of CD44 within the intestinal mucosa, but the extent of damage was reduced by coadministration of Oxo (group C). Conclusion: This experimental study suggested that the gastrointestinal toxicity resulting from administration of anticancer drugs is accompanied by an impaired gut barrier function measurable as an increase in intestinal permeability to L/M.
Establishment of the genomic structure and identification of thirteen single-nucleotide polymorphisms in the human RECK gene
Authors: Eisenberg I. , Hochner H. , Sadeh M. , Argov Z. , Mitrani-Rosenbaum S.
Published: April 2003

The human RECK gene, mapped at 9p13→p12, is known as a tumor suppressor gene and as a key regulator of extracellular matrix integrity and angiogenesis. We have established the entire genomic structure of this gene, which spans more than 87 kb and consists of 21 exons and 20 introns, and identified thirteen single nucleotide polymorphisms (SNPs). Four SNPs were identified in the coding region of the gene (exons 1, 9, 13 and 15), and the remaining nine in introns 5, 8, 10, 12, 15 and 17. The availability of the genomic organization of the RECK gene and the identification of polymorphisms throughout its entire genome will facilitate the evaluation of its role in several disorders and also contribute to the assignment of genes to the several diseases mapped to this chromosomal region.
Frequency of hyperdiploid chromosome complements in endometrioid tumors of the endometrium whereas similar tumors in the ovary tend to show hypodiploidy: a significant difference that may not be distinguishable by flow cytometry of DNA content
Authors: Atkin N.B.
Published: April 2003

Recent interest has focused on endometrioid carcinomas of the endometrium in view of the frequent occurrence of microsatellite stability, accompanied by a favorable prognosis, and by near-diploidy when studied by flow cytometry. The latter feature fails to address the question whether (and to what extent) the karyotypes of the tumor cells may or may not be truly diploid, an important feature on which there is virtually no information. A reconsideration of earlier published and unpublished work in this laboratory on near-diploid carcinomas of the endometrium, and comparable studies on near-diploid ovarian carcinomas (a site where endometrioid carcinomas are also commonly found) has therefore been undertaken. In the endometrium, these studies have clearly shown that carcinomas with near-diploid chromosomes are in fact commonly hyperdiploid, often of endometrioid histology, and in many instances show a single additional chromosome, differing in different tumors, as the apparently sole chromosome change. By contrast, similar studies on the ovary (which also included several endometrioid carcinomas) revealed a tendency towards hypodiploidy, with loss of a few chromosomes, as well as the presence of structural chromosome changes and a generally poor prognosis.
Mouse pelota gene (Pelo): cDNA cloning, genomic structure, and chromosomal localization
Authors: Shamsadin R. , Adham I.M. , Engel W.
Published: April 2003

The pelota gene of Drosophila melanogaster encodes a protein which is included in cell cycle regulation. Mutations were found to result in spermatogenic arrest, female sterility and disturbances in the patterning of the eye. We have recently isolated and characterized cDNA clones coding for the human pelota gene (PELO). Here we describe the cloning of the murine pelota cDNA and gene (Pelo) that encodes a 385-amino-acid protein. The exon-intron structure of the gene, which contains three exons, was determined. Comparison of the mouse amino acid sequences with the human and Drosophila sequences revealed an overall high identity (96% and 70%, respectively). Northern blot analysis detected a 1.7-kb transcript in all tissues studied. Southern blot analyses revealed that the pelota gene is present as a single copy in the mouse genome. The mouse pelota gene (Pelo) was mapped to the distal end of chromosome 13, in a region that is homologous with a segment of human chromosome 5q11 containing the orthologous human gene. Cloning of the mouse gene is an important step to study the function of the pelota gene in mammals and to create a mouse model for this evolutionarily conserved gene.
Validation of Simple Indices to Assess Insulin Sensitivity and Pancreatic Beta-Cell Function in Patients with Renal Dysfunction
Authors: Kanauchi Masao , Akai Yasuhiro , Hashimoto Toshio
Published: April 2003

Background/Aims: Insulin resistance and hyperinsulinemia has been reported in patients with chronic renal failure. However, usefulness and validation of new indices for assessment to insulin sensitivity and pancreatic beta-cell function were unknown. Methods: We evaluated insulin sensitivity and pancreatic beta-cell function in 61 normal glucose tolerant (NGT) and 60 diabetic (DM) subjects; both groups were subdivided as normal renal function (NRF; Ccr ≥ 70 ml/min) and impaired renal function (IRF; Ccr <70 ml/min). Insulin sensitivity were assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and plasma glucose and insulin concentrations obtained at fasting or during a 75-gram oral glucose tolerance test (insulin sensitivity index), and pancreatic beta-cell function were assessed by insulinogenic index, first-phase insulin secretion index, and area under the response curve for plasma insulin (insulin-AUC0–180). Results: There was no evidence of insulin resistance in NGT-IRF group. No differences in both insulinogenic index and first-phase insulin secretion index between NGT-NRF and NGT-IRF, but these were significantly decreased in DM-NRF and DM-IRF. There were inverse linear correlations between the insulin sensitivity index and insulin-AUC0–180 in patients with NGT and DM, respectively. These correlations were similarly robust in NRF subjects and IRF subjects. Conclusions: New indices for assessment of insulin sensitivity and pancreatic beta-cell function calculated from plasma glucose and plasma insulin concentrations after OGTT are applicable for clinical use even in patients with renal dysfunction.
Renal Amyloidosis Secondary to Tuberculosis of Cecum
Authors: El-Hennawy A.S. , Goldstein M. , Nicastri A.
Published: April 2003

Renal amyloidosis can occur as a primary or secondary, systemic or localized disorder. It is defined as a chronic infiltrative disorder characterized by impaired organ function caused by extracellular insoluble protein fibrils. Although colonic tuberculosis is not uncommon, the occurrence of reactive renal amyloidosis in such patients is not as prevalent. We report a single case of renal amyloidosis in a patient with tuberculosis of the cecum who presented with nephrotic syndrome.
In vitro Effects of Habu Snake Venom on Cultured Mesangial Cells
Authors: Kubo Atsushi , Iwano Masayuki , Kobayashi Yoshiyuki , Kyoda Yusuke , Isumi Yoshitaka , Maruyama Naoki , Samejima Kenichi , Dohi Yoshiko , Minamino Naoto , Yonemasu Kunio
Published: April 2003

Background: Habu snake venom (HSV)-induced glomerulonephritis is a unique model showing a progressive course of mesangial proliferation. To elucidate the in vitro effects of HSV, we examined whether HSV itself could have direct effects on the cultured mesangial cells, such as cell proliferation and activation of chemokine gene expression. Methods: The incorporation of 5-[125I]iodo-2’-deoxyuridine was measured with a γ-counter, and gene expressions of growth factors, chemokines and cytokines were evaluated by a real time quantitative PCR. Results: We demonstrated that excessive or continuous HSV stimulation decreased a mesangial cell viability. However, adequate and temporary HSV stimulation induced proliferation of mesangial cells in vitro along with a significant elevation of monocyte chemoattractant protein-1 (MCP-1) mRNA levels. In addition to these in vitro results, we showed that MCP-1 mRNA levels increased in renal cortices of glomerulonephritis induced by HSV. Immunohistochemistry also showed a positive staining for MCP-1 in the marginal area of glomerulus with mesangiolysis. Conclusions: These data suggest that HSV itself may elicit direct biological effects on mesangial cells which may participate in pathophysiology of glomerulonephritis induced by HSV.
Efferent Connections of the Cerebellum of the Goldfish, Carassius auratus
Authors: Ikenaga Takanori , Yoshida Masayuki , Uematsu Kazumasa
Published: April 2003

Efferent fiber connections of the corpus and valvula cerebelli in the goldfish, Carassius auratus, were studied using an anterograde neural fiber tracing technique. Efferent targets of the corpus cerebelli are the posterior parvocellular preoptic nucleus, the ventromedial and ventrolateral thalamic nucleus, dorsal posterior thalamic nucleus, periventricular nucleus of posterior tuberculum, dorsal periventricular pretectal nucleus, inferior lobe, optic tectum, torus semicircularis, nucleus of the medial longitudinal fascicle, nucleus ruber, dorsal tegmental nucleus, nucleus lateralis valvulae, reticular formation, torus longitudinalis, and the medial and lateral lobe of the valvula cerebelli. Projections to the posterior parvocellular preoptic nucleus and the periventricular nucleus of posterior tuberculum are not reported in previous studies. Efferent targets of the medial lobe of the valvula cerebelli are similar to that of the corpus cerebelli except for lacking a projection to the inferior lobe and torus longitudinalis, but showing one to the corpus cerebelli. On the other hand, the lateral lobe of the valvula cerebelli projects only to the dorsal zone of the periventricular hypothalamus, the diffuse nucleus of the inferior lobe, corpus mamillare, vagal lobe and the corpus cerebelli. There are topographical projections from the lateral valvula to the inferior lobe. These results suggest that the function of the corpus and medial lobe of the valvula cerebelli include not only motor control but also functions similar to the mammalian higher cerebellum. This study also suggests that there are obvious functional divisions between the medial and lateral lobes of the valvula cerebelli.
Interleukin 8 in the Human Colostrum
Authors: Hashira Shintaro , Okitsu-Negishi Shoko , Yoshino Kazuya
Published: April 2003

We investigated the postpartum changes in colostral interleukin (IL) 8 concentrations during the first 3 postpartum days and examined the IL-8 production of colostral cells at the levels of both protein and mRNA. Colostrum samples were obtained from healthy mothers after full-term delivery. Colostrum, supernatants, and cell lysates of cultured colostral cells were assayed for IL-8 by enzyme-linked immunosorbent assay. Reverse-transcription polymerase chain reaction was used to test uncultured colostral cells for the production of IL-8 mRNA. The colostral IL-8 concentrations, especially high on day 1 postpartum, declined abruptly during the first 3 postpartum days (mean 19.7, 10.0, and 3.0 ng/ml on days 1, 2 and 3 postpartum, respectively). Colostral cells apparently produced and secreted IL-8 in in vitro culture without stimulant, although in smaller quantities than with lipopolysaccharide stimulation. The majority of uncultured colostral cell samples expressed IL-8 mRNA, suggesting a role of colostral cells, at least in part, as a source of colostral IL-8.
Common Perinatal Insults Diminish Cord Blood RANTES
Authors: Dekel Benjamin , Rubinstein Marina , Mazkeret Ram , Lotan Danny , Paret Gideon
Published: April 2003

We demonstrate that the cord blood RANTES concentrations are reduced in full-term newborns who were born from meconium-stained amniotic fluid as compared with full-term newborns born after normal delivery. Since RANTES inhibits immunodeficiency virus (HIV) entry into macrophages, thereby bestowing increased resistance to HIV (including protection in utero), we propose that common perinatal events might precipitate higher perinatal transmission of HIV.
Preoperative Colonoscopic Derotation Is Beneficial in Acute Colonic Volvulus
Authors: Renzulli Pietro , Maurer Christoph A. , Netzer Peter , Büchler Markus W.
Published: April 2003

Aims: Analysis of preoperative and operative management of acute colonic volvulus and development of treatment guidelines in a region of low incidence. Methods: A study of 42 consecutive patients operated for acute colonic volvulus between 1970 and 2000. Results: There were 20 patients with sigmoid volvulus, 21 with cecal volvulus and 1 with volvulus of the transverse colon. All patients presented as emergencies. The correct preoperative diagnosis was possible for sigmoid volvulus in 95% (19/20) of cases and for cecal volvulus in 67% (14/21). Preoperative colonoscopic volvulus derotation was attempted in 19 patients and successfully completed in 9 patients (47%). The success rates for preoperative colonoscopic derotation were 58 (7/12) and 33% (2/6) for sigmoid and cecal volvulus, respectively. Thirty-four patients (81%) underwent colon resections, 26 times as a single-stage procedure, and 8 patients (19%) underwent non-resectional operative techniques. Overall surgical morbidity was 24%, the reoperation rate 9.5% and mortality 12% (5/42). The subgroup of 9 patients with successful non-operative volvulus derotation, however, underwent semi-elective single-stage colonic resection without surgical morbidity or mortality. There were no recurrences during a median follow-up period of 9.5 years. Conclusion: In the absence of clinical, laboratory or radiological signs of bowel necrosis or perforation, colonoscopic volvulus derotation is recommended in all cases of acute colonic volvulus, followed by semi-elective single-stage colonic resection.
Risk Factor Analysis for Long-Term Tunneled Dialysis Catheter-Related Bacteremias
Authors: Jean G. , Charra B. , Chazot C. , Vanel T. , Terrat J.C. , Hurot J.M. , Laurent G.
Published: April 2003

Infection, mainly related to vascular access, is one of the main causes of morbidity and a preventable cause of death in hemodialysis patients. From January 1994 to April 1998 we conducted a prospective study to assess the incidence and risk factors of catheter-related bacteremia. One hundred and twenty-nine tunneled dual-lumen hemodialysis catheters were inserted percutaneously into the internal jugular vein in 89 patients. Bacteremia (n = 56) occurred at least once with 37 (29%) of the catheters (an incidence of 1.1/1,000 catheter-days); local infection (n = 45, 1/1,000 catheter-days) was associated with bacteremia in 18 cases. Death in 1 case was directly related to Staphylococcus aureus (SA) septic shock, and septicemia contributed to deaths in 2 additional cases. Catheters were removed in 48% of the bacteremic episodes. Treatment comprised intravenous double antimicrobial therapy for 15–20 days. Bacteriological data of bacteremia showed 55% involvement of SA. Nasal carriage of SA was observed in 35% of the patients with catheters. Bacteremic catheters were more frequently observed in patients with diabetes mellitus (p = 0.03), peripheral atherosclerosis (p = 0.001), a previous history of bacteremia (p = 0.05), nasal carriage of SA (p = 0.0001), longer catheter survival time (p = 0.001), higher total intravenous iron dose (p = 0.001), more frequent urokinase catheter infusion (p < 0.01), and local infection (p < 0.001) compared with non-bacteremic catheters. Monovariate survival analysis showed that significant initial risk factors for bacteremia were nasal carriage of SA (p = 0.00001), previous bacteremia (p = 0.0001), peripheral atherosclerosis (p = 0.005), and diabetes (p = 0.04). This study confirms the relatively high incidence of bacteremia with tunneled double-lumen silicone catheters and its potential complications. Possible preventive actions are discussed according to the risk factors.
Dysregulation of Podocyte Phenotype in Idiopathic Collapsing Glomerulopathy and HIV-Associated Nephropathy
Authors: Yang Youxin , Gubler Marie-Claire , Beaufils Hélène
Published: April 2003

Background: Idiopathic collapsing glomerulopathy (ICG) and HIV-associated nephropathy (HIV-AN) are characterized by severe nephrotic syndrome, collapse and sclerosis of the glomerular tuft with prominent podocyte alterations and extensive tubulointerstitial lesions. We previously showed phenotypic changes in podocytes from patients with diffuse mesangial sclerosis, a severe glomerulopathy sharing several morphological features with collapsing glomerulopathy. The aim of this study was to analyze the podocyte phenotype in ICG and HIV-AN. Methods: Using immunohistochemical techniques, we studied the podocyte expression of the transcription factor WT1 and its target PAX2, GLEPP1, synaptopodin and vimentin as markers of podocyte maturity and of proliferating cell nuclear antigen (PCNA) as a marker of proliferation. Apoptosis was analyzed by the TUNEL method. Results from renal biopsies of ICG and HIV-AN were compared with those obtained from normal kidney, minimal change nephrotic syndrome (MCNS), focal and segmental glomerulosclerosis (FSGS) and membranous glomerulonephritis (MGN). Results: Abnormal distribution of WT1 and PAX2 and extensive loss of podocyte markers were observed in ICG and HIV-AN; this dysregulation was associated with podocyte proliferation without detectable apoptosis. In contrast, no podocyte changes were detected in MCNS or MGN. In FSGS, phenotypic changes, without proliferation, were restricted to podocytes surrounding focal and segmental glomerular lesions. Increased PCNA expression and apoptosis were observed in ICG and HIV-AN tubular cells. Conclusion: Dysregulation of podocyte phenotype and proliferation are present in both ICG and HIV-AN. This suggests that, whatever their etiology, both types of collapsing glomerulopathy share a common pathogenic pathway. Upregulation of cell proliferation and apoptosis observed in tubular epithelial cells is probably involved in the occurrence of severe tubulointerstitial lesions in collapsing glomerulonephritis.
Effects of Oral Adsorbent AST-120 (Kremezin®) on Renal Function and Glomerular Injury in Early-Stage Renal Failure of Subtotal Nephrectomized Rats
Authors: Kobayashi Noriyoshi , Maeda Atsuko , Horikoshi Satoshi , Shirato Isao , Tomino Yasuhiko , Ise Michihito
Published: April 2003

The aim of the present study was to determine if treatment with an oral adsorbent (AST-120, Kremezin®) might decrease the urinary albumin excretion and serum indoxyl sulfate (s-IS), and prevent glomerular sclerosis in early-stage renal failure, i.e. 0.9–1.2 mg/dl of serum creatinine (s-Cr) and 60–95 mg/dl of blood urea nitrogen (BUN), in subtotal (3/4) nephrectomized rats. Levels of s-Cr and s-IS in the AST-120-treated rats were significantly lower than those in the untreated control rats. The AST-120-treated rats showed an increase of creatinine clearance. Urinary protein and indoxyl sulfate excretion in the AST-120-treated rats were also significantly lower than those in the untreated control rats. The ratio of glomerular tuft area to the area of Bowman’s capsules (GT/BC) in the AST-120-treated rats was significantly lower than that in the untreated control rats. The degree of glomerular sclerosis and tubulointerstitial fibrosis in the AST-120-treated rats was significantly lower than that in the untreated control rats. Furthermore, there was a significant relationship among the degree of GT/BC, glomerular sclerosis, tubulointerstitial fibrosis and the levels of urinary protein excretion. It appears that AST-120 might decrease the accumulation of s-Cr and s-IS, and prevent glomerular sclerosis in early stage renal failure in the subtotal nephrectomized rats.
Central Olfactory Connections in the Microsmatic Marmoset Monkey (Callithrix jacchus)
Authors: Liebetanz David , Nitsche Michael Andreas , Fromm Christoph , Reyher Christian Karl Hermann
Published: April 2003

The mammalian primary olfactory system consists of a set of different telencephalic structures, including paleo-, archi-, periarchi- and mesocortical components. We present the first characterisation of the normal and connectional anatomy of the primary olfactory cortex of the common marmoset, a microsmatic simian species increasingly used in primate research. The centrifugal and centripetal bulbar projections were determined by injections of the anterograde and retrograde tracer wheat germ agglutinin-conjugated horseradish peroxidase and fluorescent dyes into the ipsilateral main olfactory bulb. The efferent projections of the marmoset bulb are organised entirely ipsilaterally and are established via a rudimentary medial olfactory tract and the dominant lateral olfactory tract. Target areas are the anterior olfactory nucleus, the entire prepiriform cortex, ventral tenia tecta, periamygdaloid cortex and the rostral part of the entorhinal cortex. The bulbar axons predominantly terminate in the outer part of layer I. The anterior olfactory nucleus receives a weak additional input within layer II and III, which is not found in macrosmatic rodents. Further anterograde labelling was found in the endopiriform nucleus deep under the prepiriform cortex and within an anterolateral strip of the olfactory tubercle. However, control injections into the olfactory tubercle suggest that the marmoset olfactory tubercle receives a bisynaptic olfactory input only. Retrograde labelling after bulb injections revealed that, except for the olfactory tubercle, all primary olfactory cortices contributed to an ipsilateral bulbopetal feedback projection. Like in rodents, the only bulbopetal projection organised bilaterally in the marmoset is maintained by the anterior olfactory nucleus. With few exceptions, the projections of the marmoset olfactory brain are organised similarly to that of the macaque monkey or those of macrosmatic species.
Pro- and Anti-Apoptotic Effects of Nitric Oxide in Irradiated Keratinocytes: The Role of Superoxide
Authors: Weller R. , Billiar T. , Vodovotz Y.
Published: April 2003

Ultraviolet radiation (UV) induces apoptosis in keratinocytes by both p53- and death receptor-dependent pathways. It also generates free radicals in keratinocytes, including the synthesis of nitric oxide (NO) by constitutive and inducible NO synthases (NOS). NO has both pro- and anti-apoptotic effects. We wished to determine which of these was predominant in keratinocytes. Human CCD1106 keratinocytes were irradiated with UVB in the presence and absence of several NOS antagonists. Apoptosis was measured by flow cytometry with annexin V binding. NOS antagonism consistently altered UVB-induced apoptosis measured 18 h after irradiation. In 9 of 13 experiments, NOS antagonism increased apoptosis. However, in 4 of 13 experiments, NOS antagonism reduced apoptosis. We postulated that the variable effects of NO might be due to a critical balance between UVB-induced NO and superoxide production. We predicted that NO would be anti-apoptotic in the presence of low O–2, but pro-apoptotic when NO combined with O–2 to form peroxynitrite. Though superoxide dismutase reduced apoptosis after UVB, addition of peroxynitrite did not affect apoptosis. We conclude that NO released by UV irradiation is anti-apoptotic; however, the levels of O–2 may be a determinant of NO action.
The Past and Present Practices and Continuing Controversies of Preconception Care
Authors: de Weerd Sabina , Steegers Eric A.P.
Published: April 2003

Preconception care, a long-established concept for primary prevention of maternal and perinatal morbidity and mortality through detection and reduction of modifiable risks, has been widely propagated for the last decades. This article provides an overview of the various goals and practices described in the literature in different parts of the world, including issues and controversies pertaining to the provision and implementation of preconception care in different health care settings.
Preventing Congenital Anomalies in Developing Countries
Authors: Penchaszadeh Victor B.
Published: April 2003

The birth prevalence of congenital anomalies in developing countries is similar to that observed in developed countries. However, the health impact of birth defects is higher because of a lack of adequate services for the care of affected infants and a higher rate of exposures to infections and malnutrition. A number of successful measures for the prevention of congenital anomalies are being taken in a number of developing nations. Primary prevention programs are based on public education about preconceptional and prenatal risks. Prevention based on reproduction options includes teratogen information services and prenatal screening for fetal anomalies. In addition, programs for the detection of congenital malformations at birth, followed by early treatment, are contributing to secondary prevention. Prevention of congenital anomalies in the developing world requires: (a) good epidemiological data on the prevalence and types of birth defects and genetic disorders; (b) educating health professionals in the goals and methods of preventing birth defects at low cost but with high impact, and (c) expansion of family planning and improvement of antenatal care combined with educational campaigns to avoid the risks for birth defects. The basis for public health preventive measures should be the primary health care level. In a sizable proportion of developing countries, the stage is already set for these measures to be implemented. Required are education, political will, and proper organization and allocation of resources.