bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment and Characterization of Two New Rectal Neuroendocrine Cell Carcinoma Cell Lines
Authors: Takahashi Yoshiyuki , Onda Masahiko , Tanaka Noritake , Seya Tomoko
Published: April 2003

Background: Human colorectal neuroendocrine cell carcinoma (NEC) is a rare disease with a poor prognosis. The biological behavior of NEC remains poorly understood. Materials and Methods: We established two new NEC cell lines from a patient with rectal neuroendocrine carcinoma, NECS-P and NECS-L from the primary tumor and a liver metastasis, respectively. We investigated the biological differences between the two cell lines to study the mechanisms involved in liver metastasis. Results: There was no difference between NECS-P and NECS-L in the morphological, ultrastructural and immunohistochemical studies. After addition of TGF-β1, the doubling times of NECS-P were increased in a dose-dependent manner relative to untreated cells, whereas TGF-β1 had no effect on NECS-L. The attachment and chemotactic response of the two cell lines were not enhanced by TGF-β1. The invasive capacity and the production of matrix metalloproteinase-2 (MMP-2) were significantly increased only in NECS-L following the addition of TGF-β1. When anti-MMP-2 antibody was added to the medium with TGF-β1, NECS-L invasion was inhibited. Conclusion: It is considered that these differences are important to understand the mechanisms of liver metastasis of NEC.
Cytomegalovirus-Induced Transient Protein-Losing Hypertrophic Gastropathy in an Immunocompetent Adult
Authors: Suter Walter R. , Neuweiler Jörg , Borovicka Jan , Binek Janek , Fantin Amedeo C. , Meyenberger Christa
Published: April 2003

Transient protein-losing hypertrophic gastropathy with similarity to Ménétrier’s disease is described. Acute infection with cytomegalovirus (CMV) could be shown to play a causative role. Immunodeficiency was ruled out. The 34-year-old patient had complete resolution of the disease without antiviral treatment. To our knowledge the present report is the first case of CMV-associated protein-losing hypertrophic gastropathy in an immunocompetent adult. To date, a similar disorder has only been described in children. CMV infection should be considered in patients with acute and symptomatic protein loss of gastrointestinal origin.
Mononeuropathy multiplex in Hemophilia: An Electrophysiologic Assessment
Authors: Chang Chein-Wei , Shen Ming-Chin
Published: April 2003

Single nerve lesion or mononeuropathy caused by extrinsic compression of hematoma or hemarthrosis is consistently reported for hemophilic patients. To study the manifestation of peripheral nerve lesions, an extensive nerve conduction study of peripheral nerves and specific nerves in correlation with clinical involvement was carried out on 126 hemophilic patients. We found 24 patients with 34 peripheral nerve lesions. The frequency of nerve lesion positively correlated with the severity of hemophilia (p < 0.01) and increasing age (p < 0.05). Nerve lesions occurred more commonly in lower extremities than in upper extremities. The femoral nerve was most commonly involved. Seven patients were identified to have mononeuropathy multiplex with 2 or more nerve lesions involving more than one extremity. All of these patients had chronic condition. Our findings suggest that mononeuropathy multiplex may occur in hemophilic patients.
Effects of Gabapentin on the Different Components of Peripheral and Central Neuropathic Pain Syndromes: A Pilot Study
Authors: Attal Nadine , Brasseur Louis , Parker Fabrice , Chauvin Marcel , Bouhassira Didier
Published: April 2003

Anticonvulsants are widely used in the treatment of neuropathic pain, and are assumed to act preferentially on lancinating, shooting pain. In the present study, the effects of gabapentin, a novel anticonvulsant, were evaluated systematically on both spontaneous and evoked pain in 18 patients with peripheral nerve injuries or central lesions. Gabapentin was administered orally in gradually increasing doses up to a maximum of 2,400 mg/day. Evaluations of spontaneous ongoing and paroxysmal pain, allodynia and hyperalgesia were performed at the beginning of the study (‘baseline’) and 6 weeks after the steady-state dose had been reached. Quantitative sensory tests were used to measure detection and pain thresholds to mechanical and thermal stimuli and the responses to suprathreshold stimuli. Gabapentin induced a moderate and statistically significant relief of ongoing spontaneous pain and was particularly effective in reducing paroxysmal pain. A striking finding was the significant effect on brush-induced and cold allodynia. In contrast, no effects were observed on detection and pain thresholds to static mechanical and hot stimuli. Side effects were generally minor and did not interfere with everyday activities. The present study suggests that gabapentin has preferential antihyperalgesic and/or antiallodynic effects, and is equally effective in pain due to peripheral nerve injuries and central lesions.
The ACE Deletion Polymorphism Is Not Associated with Parkinson’s Disease
Authors: Mellick G.D. , Buchanan D.D. , McCann S.J. , Davis D.R. , Le Couteur D.G. , Chan D. , Johnson A.G.
Published: April 2003

The deletion allele (D allele) polymorphism in the angiotensin converting enzyme (ACE) gene is associated with increased levels of the neuropeptide substance P in the basal ganglia and substantia nigra. A reduction of substance P levels in the brain occurs in Parkinson’s disease (PD) and has been implicated in the pathogenesis of the disease. We investigated the hypothesis that the D allele may be protective towards PD by examining the frequency of the ACE (I/D) polymorphism in 178 PD cases (male:female ratio = 1.4) and 192 controls (male:female ratio = 1.5). ACE (I/D) genotype was determined using polymerase chain reaction and 3% agarose gel electrophoresis. Unadjusted chi-square analysis revealed no significant difference between genotype frequencies (χ2 = 3.30, p > 0.10) or allele frequencies (χ2 = 2.52, p > 0.10) between patient and control groups, although PD patients were less likely to be homozygous (OR = 0.80, 95% CI = 0.49–1.29) or heterozygous (OR = 0.80, 95% CI = 0.59–1.06) for the D allele. A stepwise logistic regression analysis of the ACE deletion and risk factor data confirmed that there was no significant association between the ACE deletion (D allele) polymorphism and PD (OR = 0.62, 95% CI = 0.35–1.10, p = 0.10). This study does not support the hypothesis that the D allele of the ACE gene confers a protective effect with respect to PD.
Near Infrared Spectroscopy and Transcranial Doppler in Monohemispheric Stroke
Authors: Vernieri Fabrizio , Rosato Nicola , Pauri Flavia , Tibuzzi Francesco , Passarelli Francesco , Rossini PaoloMaria
Published: April 2003

We simultaneously performed near infrared spectroscopy (NIRS) and transcranial Doppler (TCD) to evaluate the effects of hypercapnia as well as of scalp ischemia on the blood flow at two different depth levels within the brain and of the scalp vessels. A decrease in the backscattered light intensity, meaning an increment of blood volume, was detected at the end of hypercapnia in all healthy subjects. This decrement was partly masked by ischemia in the cutaneous vessels. In 2 patients with a monohemispheric lesion in the middle cerebral artery (MCA) territory, an increase in NIRS response was found in the healthy hemisphere, while in the stroke side the CO2-induced changes were negligible. TCD data showed a similar increment of blood flow velocity to the hypercapnia in both hemispheres, with no differences between the affected and normal side in 1 patient, whereas in the second one, no increment was observed on the affected side, probably due to internal carotid artery stenosis. The two methods nicely integrate: TCD mainly tests subcortical changes in the MCA flow, while NIRS is exquisitely sensitive to cortical arterioles and capillary blood flow modifications.
Classification of the Epilepsies: Time for a Change?
Authors: Everitt Alex D. , Sander J.W.A.S.
Published: April 2003

The Commission on Classification and Terminology of the International League against Epilepsy (ILAE) first devised a comprehensive classification for the epilepsies and epileptic syndromes nearly 30 years ago. Despite subsequent revisions, the classification remains too complicated to be of utility in clinical practice and epidemiological research. Recent developments in neuro-imaging and neurogenetics have also contributed to the limited usefulness of the current International Classification of the Epilepsies and Epileptic Syndromes (ICEES). This review examines the evolution, advantages, and notable disadvantages of the ICEES and assesses its previous application in several population-based studies of epilepsy. The important need for a new, simplified, and aetiologically orientated classification which is amenable to use outside of the tertiary epilepsy centre is discussed.
Familial Scapuloperoneal Myopathy and Mitochondrial DNA Defect
Authors: Pál Endre , Bedekovics Tibor , Gáti István
Published: April 2003

The authors present 13 members of 4 generations in a family with scapuloperoneal myopathy. The disease showed autosomal dominant inheritance. In all 6 patients examined, the disease began in the third decade (18–31 years). Initially the shoulder girdle was involved, and the process slowly spread to the distal part of the lower extremities in several years or decades. The facial and pelvic muscles were only moderately involved; ocular muscle involvement was absent. Myopathy was proved by electromyography and muscle biopsy. In 1 case, electrophysiological evidence of peripheral neuropathy was found, and in 3 other patients central nervous system involvement (dementia, epilepsy) and optic atrophy complicated the syndrome. In the youngest patient, a mutation could be found in the ‘hot-spot region’ of the muscle mitochondrial DNA by polymerase chain reaction.
Somesthetic Disconnection Syndromes in Patients with Callosal Lesions
Authors: Ihori Nami , Kawamura Mitsuru , Fukuzawa Kazuyoshi , Kamaki Mutsuo
Published: April 2003

Somesthetic disconnection syndromes were investigated in relation to the sites of lesions in the corpus callosum in 3 patients with callosal lesions, in order to identify the callosal regions responsible for the interhemispheric transfer of somesthetic information. Cases 1 and 2 with lesions in the posterior truncus exhibited transfer deficits of discriminative sensations between the left and right hands, left-sided tactile anomia and left-sided somesthetic alexia. Case 3 with lesions in the posteroventral part of the posterior truncus showed no signs of somesthetic disconnection syndromes. The results suggest the importance of the anterior and/or dorsal part of the posterior truncus of the corpus callosum for interhemispheric transfer of the discriminative sensations and integrated somesthetic information necessary for tactile naming and somesthetic reading.
Miller Fisher Syndrome: A Hospital-Based Retrospective Study
Authors: Yuan Chih-Lun , Wang Yuh-Jen , Tsai Ching-Piao
Published: April 2003

Miller Fisher syndrome (MFS), characterized as ataxia, areflexia and ophthalmoplegia, is generally considered as a variant of Guillain-Barré syndrome (GBS). However, some investigators believed that the syndrome could be explained by a central origin. To obtain more information about MFS for comparison with GBS, we conducted a retrospective study by analyzing the clinical data of MFS patients admitted to our hospital over a period of 11 years. The calibrated male/female ratio was 1.65. A seasonal clustering in winter was noted. The percentage of MFS among GBS was especially high (18%, 11/60) in Taiwan when compared with other series. Involvement of limb muscle strength, autonomic function and cranial nerves, except ocular motor nerves, was rarely found in our patients. When MFS is accompanied by limb weakness, it might represent a transitional form between MFS and GBS. Bulbar palsy and dysautonomia might predict a relatively poor prognosis. To obtain more reliable information, lumbar puncture should be done 1 week after disease onset, and electrophysiological tests should be done serially in every MFS patient. Eighty percent (80%, 4/5) of our patients were positive for IgG anti-GQ1b antibody activity. In our study, there is more evidence indicating that MFS is a peripheral nervous system disorder; however, no definite conclusion could be made as to whether MFS is exclusively a peripheral or central nervous system disorder. We think MFS is an immune-mediated clinical entity which mainly involves the peripheral nervous system with rare involvement of other parts of the central nervous system.
Loss of Left-Sided Volitional Movements Caused by a Combined Lesion of theCorpus callosum and Right Hemisphere:‘Initiation Pseudohemiakinesia’
Authors: Yokoyama Kazumasa , Hasegawa Chihiro , Kameyama Misumi
Published: April 2003

We report a right-handed patient who showed a marked loss of unilateral volitional movements of the left limbs after the onset of a cerebral infarction in the combined territories of the right anterior and middle cerebral arteries. The same limbs retained their mobility in acts requiring bilateral sides of the body. This left-sided abnormal behavior resembled motor neglect resulting from lateralized brain damage. Behavioral and neuroradiological findings presented by this patient, however, suggested that callosal disconnection was definitely involved in this symptomatology. We postulate that in this patient, the diseased right hemisphere could no longer initiate movements of the left limbs despite its potential ability to realize them, and that the injured callosum prevented the intact left hemisphere from initiating unilateral voluntary movements of the left limbs. We suggest that this so far undescribed symptomatology be called ‘initiation pseudohemiakinesia’ in order to be distinguished from other rare forms of unilateral voluntary movements like motor neglect, extinction or directional hypokinesia.
Intrahepatic Tissue pO2 during Continuous or Intermittent Vascular Inflow Occlusion in a Pig Liver Resection Model
Authors: van Wagensveld B.A. , van Gulik T.M. , Gabeler E.E.E. , van der Kleij A.J. , Obertop H. , Gouma D.J.
Published: April 2003

Background: Temporary vascular inflow occlusion of the liver (clamping of the hepatic pedicle) can prevent massive blood loss during liver resections. In this study, intrahepatic tissue pO2 was assessed as parameter of microcirculatory disturbances induced by ischemia and reperfusion (I/R) in the liver following continuous (Cnt) or intermittent (Int) clamping in a hemihepatectomy model in the pig. Methods: Pigs (20–34 kg) were divided into 2 groups: I/R without hemihepatectomy (–HH; n = 10) and I/R with hemihepatectomy (+HH; n = 8). Ischemia during 90 min was Cnt or Int (6 sequential periods of 12 min of ischemia and 3 min of reperfusion), followed by 120 min of reperfusion. Intrahepatic pO2 histograms (polarographic pO2 needle electrode) were constructed before ischemia, at the end of 90 min of ischemia and after 120 min of reperfusion, along with assessment of plasma AST, ALT and LDH. Bile production was monitored continuously. Results: Cumulative frequency distribution curves (CFDC) after 120 min of reperfusion in the Cnt–HH group were not different from preischemic CFDC (means ± SEM), whereas in the Int–HH group a left shift occurred indicating more hypo(non)perfused liver areas (pO2 < 10 mm Hg: 2.6 ± 1.2 and 41.0 ± 17.5% in Cnt–HH and Int–HH; p < 0.01). In the Cnt+HH group, a left shift in the CFDC occurred. In the Int+HH group, a left and a right shift occurred simultaneously, indicating both hypo(non)- and hyperperfused (shunting) liver areas (pO2 < 10 mm Hg: 4.0 ± 2.7 and 9.6 ± 8.5%, n.s., and pO2 > 60 mm Hg: 2.0 ± 2.0 and 17.3 ± 6.4%, p = 0.015, in Cnt+HH and Int+HH). Plasma AST, ALT and LDH levels were not increased after 120 min of reperfusion, except for AST in Cnt+HH and Int+HH (from 54.6 ± 14.0 to 270.4 ± 42.8 U/l, p < 0.01, and from 47.8 ± 9.4 to 176.5 ± 55.9 U/l, n.s.). Bile production (percentage of mean preischemic value) during 120 min of reperfusion was significantly reduced in the Int–HH group, as compared to the Cnt–HH group (57.0 and 117.0% after 120 min of reperfusion, p = 0.002). In Cnt+HH and Int+HH, bile production was significantly reduced (33.3 ± 20.0%, p = 0.05, and 38.5 ± 7.9%, p = 0.007); however it was not different between the two groups. Conclusions: (1) Intrahepatic tissue pO2 as indicator of microvascular perfusion is a parameter of early I/R injury; (2) continuous vascular inflow occlusion resulted in less microcirculatory disturbances, when compared to intermittent occlusion.
Standardization of the Lactulose-Mannitol Test in Rats: Application to Burn Injury
Authors: Pernet P. , Aussel C. , Le Boucher J. , Giboudeau J. , Cynober L. , Coudray-Lucas C.
Published: April 2003

Intestinal permeability can be assessed by measuring urinary mannitol and lactulose excretion after oral administration. This test may be useful as a tool in experimental studies to explore the effects of specific diets intended to promote the repair of the integrity of the gut barrier. In this study we standardized the lactulose-mannitol test in rats and applied it to a burned-rat model. The conditions were: oral administration of an isotonic mixture of 50 mg of mannitol and 66 mg of lactulose, followed by aseptic collection of urine over 4 h. The increase in the lactulose/mannitol ratio in burned rats was due to higher lactulose excretion. These results corroborate those obtained in burn patients and show that our model is suitable for further experiments on nutritional manipulation.
Effect of Autotransplantation of Microvessel Fragments on Experimental Random-Pattern Flaps in the Rat
Authors: Nakano M. , Nakajima Y. , Kudo S. , Tsuchida Y. , Nakamura H. , Fukuda O.
Published: April 2003

We examined whether autotransplantation of microvessel fragments (Mvf) and/or myofibroblasts (Mf) into an in vivo skin flap model might improve the survival of the ischemic flap. If so, this could improve blood perfusion, increase blood flow, and improve the survival of the flap. A skin flap was raised on the back of each rat (n = 15 in each group). In the control group, the flap was sutured to the original bed. In the other groups (1) phosphate-buffered saline; (2) autotransplanted Mvf, Mf, or Mvf plus Mf, and (3) a homogenized mixture of Mvf plus Mf was injected into the distal part of the flap. In a further group, Mvf labeled with DiI-acetylated low-density lipoprotein were autotransplanted with Mf into the distal part of the flap, and India ink was perfused through the abdominal aorta 7 days postoperatively. The transplanted Mvf plus Mf group showed better flap survival after 7 days than the other groups (p < 0.02). Labeling with DiI-acetylated low-density lipoprotein showed that transplanted Mvf sent arborizations into the nearby tissue. India ink was found in the lumina within such arborizations. Thus, autotransplanted Mvf may improve the survival of ischemic skin flaps by promoting the early formation of patent connections between Mvf and the host’s microcirculatory system. This apparently requires the presence of Mf.
An Evaluation of the Influence of Devazepide and CCK-8S on the Intact and Resected Rat Liver
Authors: Ohlsson B. , Rehfeld J.F. , Axelson J.
Published: April 2003

Background: Recently, it has been shown that infusion of the CCK-A receptor antagonist devazepide induced proliferation of hepatocytes and bile duct epithelium in the rat liver. The aim of this study was to further evaluate the influence of devazepide and sulfated cholecystokinin-8 (CCK-8S) on the intact rat liver and rat liver after resection. Methods: In the first experiment, either saline or devazepide was injected subcutaneously twice daily to rats for 18 and 36 h and 3 and 7 days. In the second experiment, a 70% liver resection was followed by infusion of either DMSO, devazepide, saline or CCK-8S for 2 or 7 days. Prior to sacrifice, all rats received 1 mCi/kg of tritiated thymidine intraperitoneally. The liver was excised and the contents of protein, DNA and water and incorporation of tritiated thymidine were measured. Results: Intermittent injections of devazepide increased the liver protein content after 36 h, followed by a decrease after 7 days. The weight, DNA content or cell proliferation was not affected. Two days after liver resection hyperCCKemia was evoked, which was less prominent after 7 days. Devazepide lowered the plasma concentration of CCK, while the infusion of CCK-8S resulted in extremely high concentrations at both time points. The DNA synthesis measured by thymidine incorporation was increased by devazepide on day 2, whereas the weight or protein and DNA contents of the liver were not influenced. CCK-8S infusion decreased the body and liver weight throughout the study, and the protein and DNA contents after 7 days. Conclusions: Intermittent devazepide treatment did not affect the intact liver. Devazepide increased the DNA synthesis 2 days after liver resection but was without other influences on the liver regeneration. CCK-8S induced decreased body weight with ensuing negative effects on the liver regeneration. Neither devazepide nor CCK seem to be of any therapeutic use after liver resection or liver failure.
Expression of Human CD44v6 in Non-Small-Cell Lung Cancer
Authors: Carbognani P. , Spaggiari L. , Romani A. , Solli P. , Corradi A. , Cantoni Anna Maria , Petronini P.G. , Borghetti A.F. , Rusca M. , Bobbio P.
Published: April 2003

Introduction: The CD44 is a membrane glycoprotein that functions as lymph node homing receptor in lymphocyte activation and is involved in homo- and heterotypic cell adhesion. In several tumor cell lines the expression of splice variants (CD44v6 and CD44v7) are correlated with the metastatic potential and confer an advantage in the early steps of the metastatic cascade. In our study we examined 35 cases of non-small-cell lung cancers (NSCLC) in order to detect the presence of CD44v6 and to compare its expression with the histologic type, degree of differentiation, stage of the tumor and survival of the patients. Methods: CD44v6 expression in frozen tissue sections of 35 patients with NSCLC who underwent pneumonectomy or lobectomy was analyzed with the VFF-7 monoclonal antibody that detected the CD44v6 variant. The data on survival were analyzed by the actuarial method and compared by the log rank test. Results: The expression of CD44v6 occurred in all the 20 cases of epidermoid carcinomas tested and in 2 out of the 3 cases of undifferentiated large cell carcinoma and was absent in all the 12 adenocarcinomas. No relationship was found between the presence of this marker and the grading or the stage of the pathology. The 3-year survival rate was 73% for CD44v6-positive and 65% for CD44v6-negative cancer and the comparison was not statistically significant. Conclusion: These results suggest that in lung cancer the expression of CD44v6 is not a useful prognostic factor.
Early Hemodynamic Changes during Uncontrolled Intra-Abdominal Bleeding
Authors: Riddez L. , Johnson L. , Hahn R.G.
Published: April 2003

Central hemodynamics was studied in 32 pigs during the first 10 min after making a 5-mm laceration in the infrarenal aorta. Blood flow probes were placed proximally and distally to the site of the bleeding and also over the portal vein and renal artery. We found that the bleeding, which was indicated by a difference in the rate of blood flow between the two aortic probes, stopped spontaneously after about 3 min. The short-term changes in blood flow rates closely followed simple monoexponential functions with mean half-times of 34 (proximal aorta), ≈10 (lower aorta), 27 (splanchnic) and 21 s (kidney) to reach steady-state levels amounting to 20, 20, 27 and 8% of the baseline flow rates, respectively.
Endotoxin and Cytokine Release in Strangulation Obstruction and in Partial Occlusion of the Mesenteric Artery in Pigs
Authors: Fevang J. , Øvrebø K. , Svanes K. , Røkke O.
Published: April 2003

Background: The study was performed to determine if endotoxin or the cytokines interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF) are liberated from strangulated or partially ischemic small bowel. Methods: Strangulation obstruction was induced by elevating pressure in a gasket placed around a loop of ileum until venous pressure reached 50 mm Hg. Low arterial flow in a loop of ileum was produced by arterial clamping reducing blood flow by 70%. A proximal bowel loop was used for control. Arterial blood flow was measured by transit time flowmetry. Blood samples were collected before and after 30, 90 and 180 min of strangulation or clamping. Plasma levels of endotoxin and cytokines (TNF, IL-1 and IL-6) were measured by limulus amebocyte lysate test and bioassays, respectively. Results: Strangulation obstruction caused more extensive mucosal damage than arterial clamping. Strangulation was followed by markedly increased venous concentration and release of IL-6 in the strangulated loop. Partial arterial occlusion did not cause increased release of IL-6. Strangulation or partial clamping did not influence the concentration of endotoxin, IL-1 or TNF in intestinal venous blood. Conclusions: Strangulation obstruction causes increased release of IL-6 to intestinal venous blood. IL-6 levels did not increase after 70% reduction of arterial blood flow. The early IL-6 increase was not detected in systemic blood. Strangulation did not cause early changes in plasma levels of endotoxin, TNF or IL-1.
Improved Techniques of Applying Fibrin Glue in Lung Surgery
Authors: Morikawa T. , Katoh H.
Published: April 2003

To enhance the adhesive property of fibrin glue, two techniques were developed. The first is an improvement of the conventional layer method, and the second is a further improvement of the first technique. Their adhesive properties were tested in canine lungs in two phases. In phase 1 of the experiment, two new techniques were compared with the conventional methods in the retrieved lung. In phase 2 of the experiment, the second technique examined how its adhesive properties changed after treatment comparing them with gelatin-resorcinol-formaldehyde-glutaraldehyde (GRFG) glue. In phase 1, the first technique showed a 3-fold enhancement of the adhesive properties as compared with the conventional methods, and with the second technique the adhesive properties were further improved by more than 2-fold in the retrieved canine lung. In phase 2, it was revealed that the bursting pressure of both the second new technique and GRFG glue was eventually equal, and enough to close the cut surface of the lung. In the clinical setting, two techniques showed a safe and satisfactory performance in closing the cut surface of the lung. Due to the low toxicity of fibrin glue and absorbable material, these two techniques, especially the second technique, provide better circumstances for the healing of lung injury.
Azoxymethane-Induced Aberrant Crypt Foci and Colorectal Tumors in F344 Rats: Sequential Analysis of Growth
Authors: Ghirardi M. , Nascimbeni R. , Villanacci V. , Fontana Maria Grazia , Di Betta E. , Salerni B.
Published: April 2003

Previous studies are consistent with the hypothesis that aberrant crypt foci (ACF) could be intermediate biomarkers in colorectal carcinogenesis. The present controlled experimental trial was performed to sequentially analyze ACF progression in rat colonic mucosa. F344 rats were administered 2-weekly doses of azoxymethane (15 mg/kg body weight, s.c.) and sacrificed 6, 12, 20, 30 and 36 weeks after the first carcinogen injection. Control groups of untreated rats were sacrificed at the same time points. The number of ACF per area, their multiplicity (number of crypts per focus), ACF frequency and multiplicity according to each colonic site, histology of ACF and macroscopic lesions were recorded. No ACF were found in control animals. In treated animals, the number of ACF per area and the multiplicity progressively and significantly increased throughout the study. ACF were prevalent in the mid colon. Lower frequencies were registered in the distal colon and rectum. ACF were rare in the proximal colon and cecum. By histology, ACF presented superficial and extensive hyperplasia. Tumors were found in the 30th and 36th week. Adenomas and well-differentiated adenocarcinomas were in the distal colon. All proximal neoplasms were signet ring cell carcinomas. In our study, ACF growing features and distribution are not correlated to adenoma and adenocarcinoma distribution. It is conceivable that signet ring cell carcinomas arising in the proximal colon, where ACF are rare, could present a different pathway of growth. The preneoplastic role of ACF and their function as intermediate biomarkers in colorectal carcinogenesis remain to be clarified.
Intestinal Ischaemia-Reperfusion Increases Plasma Amylin Concentration in Rats
Authors: Phillips A.R.J. , Abu-Zidan Fikri M. , Bonham M.J.D. , Simovic Misho O. , Cooper G.J.S. , Windsor J.A.
Published: April 2003

Intestinal ischaemia-reperfusion and hyperamylinaemia are both associated with severe acute pancreatitis. The aim of this study was to examine the relationship between intestinal-ischaemia reperfusion and plasma amylin in an experimental model. Wistar rats (n = 24, 400–450 g) were divided into three groups: (1) a sham (S)-operated group (n = 7) that underwent laparotomy and isolation (without clamping) of the superior mesenteric artery, (2) an ischaemia-reperfusion (IR) group (n = 7) that had clamping of the superior mesenteric artery for 60 min followed by 15 min reperfusion, and (3) a control (C) group (n = 10) that underwent no surgery. Amylin was significantly elevated in the IR group (median 39 pM, range 30–44) compared with the S group (19 pM, range 15–45; Mann-Whitney U, p < 0.05) and the C group (24 pM, range 15–55; p < 0.01). Insulin was significantly elevated in the IR group (2,060 pM, range 1,000–4,650) compared with the S group (558 pM, range 424–2,020; p < 0.01). There was a significant positive correlation between amylin and insulin (R = 0.82, F = 46.6, p < 0.0001), but not between amylin and glucose or insulin and glucose. Intestinal histology was consistent with an ischaemia-reperfusion injury, whereas pancreatic histology was normal. The unique finding that plasma amylin concentration is increased with intestinal ischaemia-reperfusion injury warrants further investigation.
Evaluation of Seprafilm and Amniotic Membrane as Adhesion Prophylaxis in Mesh Repair of Abdominal Wall Hernia in Rats
Authors: Szabo A. , Haj M. , Waxsman I. , Eitan A.
Published: April 2003

Introduction: Adhesion formation following abdominal wall hernia repair with prosthetic mesh may lead to intestinal obstruction and enterocutaneous fistula. Physical barriers, namely, human amniotic membrane (HAM) or Seprafilm (Genzyme, Cambridge, Mass., USA), a bio-absorbable, translucent membrane composed of carboxymethylcellulose and hyaluronic acid, have been reported to prevent postsurgical intra-abdominal adhesions. Objective: Evaluating the effect of HAM and Seprafilm in preventing adhesion formation in the rat model of ventral hernia repair with polypropylene mesh (PPM). Material and Methods: Sixty female Sprague-Dawley rats were divided into three groups. A full-thickness abdominal wall defect was created in each animal. Control animals had the PPM sutured into the defect, whereas in the other two groups, either HAM or Seprafilm were laid over the abdominal viscera before the repair with PPM. Half of the animals in each group were sacrificed on the 21st postoperative day. The remaining rats of the same group were re-operated on the 42nd day for investigation and measurement of the adhesion area in relation to the graft area. Results: Direct mesh repair showed 52.8 and 56% area adhesion formation 3 and 6 weeks postoperatively, respectively. The HAM barrier covered with mesh repair demonstrated 0 and 0.96% area adhesion formation, and the Seprafilm-covered mesh repair showed 0 and 0% area adhesion formation 3 and 6 weeks postoperatively, respectively. Uncovered mesh showed a significantly larger adhesion area than both covered mesh (p = 0.001 and 0.001). Both HAM and Seprafilm were equally effective in preventing postoperative adhesions. Conclusions: HAM and Seprafilm proved to be an effective antiadhesive barrier in PPM repair of abdominal wall hernia.
Function of Fast- and Slow-Twitch Rat Skeletal Muscle following Ischemia and Reperfusion at Different Intramuscular Temperatures
Authors: Gürke L. , Marx A. , Sutter P.-M. , Stierli P. , Harder F. , Heberer M.
Published: April 2003

Fast- (peroneal) and slow-twitch (soleus) skeletal muscles of anesthetized Wistar rats were subjected to 3 h of tourniquet ischemia. The intramuscular temperature of the leg was adjusted to 22, 30 or 35°C (n = 12 per group) during ischemia. After 2 h of reperfusion, the muscles were electrically stimulated in vitro and muscular function was analyzed for maximal force, performance, contractility and fatigue. Contralateral nonischemic muscles served as controls. Three hours of ischemia at 30°C did not reduce the function of the peroneal muscles compared to nonischemic controls. The same ischemic stress significantly reduced the function of the soleus muscles compared to nonischemic controls. The postischemic function of the soleus muscles declined with increasing temperature. The postischemic function of the 35°C group of peroneal muscles was significantly reduced compared to the 22 and the 30°C groups, which did not differ. These results provide evidence that fast-twitch muscles are more resistant to ischemia than slow-twitch muscles. They furthermore show a fiber type-specific dependency of postischemic muscle function on intramuscular temperature during ischemia. Hypothermia-sensitive fast-twitch fibers predominate in the skeletal muscles of the extremities. Mild hypothermia could, therefore, reduce tourniquet ischemia-induced injury after surgery of the extremities.
Experimental Liver Preservation with Celsior:A Novel Alternative to University of Wisconsin and Histidine-Tryptophan-α-Ketoglutarate Solutions?
Authors: Tolba R.H. , Akbar S. , Müller A. , Glatzel U. , Minor T.
Published: April 2003

Celsior, a low viscosity and low potassium preservation solution, has recently been tested successfully in the cold preservation of heart, lung, kidney and small intestine. The purpose of the present study was to evaluate the potential of Celsior in the cold preservation of the liver. Livers were harvested from male Wistar rats and then flushed with either Celsior (CE), University of Wisconsin solution (UW) or histidine-tryptophan-α-ketoglutarate solution (HTK) and stored for 24 h at 4°C in the respective solution. The reperfusion was performed in vitro using a recirculating model with oxygenated (95% O2, 5% CO2) Krebs-Henseleit buffer at 37°C. To simulate the slow rewarming during the surgical implantation in vivo, all livers were stored for 30 min at room temperature prior to reperfusion. After ischemic storage and also after reperfusion some samples were freeze-clamped for analysis of tissue metabolites while others were tested for structural and functional integrity by the isolated perfusion. CE vs. UW vs. HTK: Metabolic preservation of tissue ATP (μmol/g dry weight) during cold storage was best with Celsior (0.46 ± 0.17 vs. 0.26 ± 0.03 vs. 0.35 ± 0.07; p < 0.05 CE vs. UW), but upon reperfusion energetic recovery was comparable in the three groups (3.45 ± 0.66 vs. 4.27 ± 0.41 vs. 3.63 ± 0.64 μmol/g/dry weight). There appeared to be structural integrity during reoxygenation irrespective of the used preservation solution with comparable values of parenchymal enzyme release (ALT: 575 ± 82 vs. 547 ± 106 vs. 593 ± 38 mU/g/l), bile production (18.0 ± 1.0 vs. 18.5 ± 2.5 vs. 18.7 ± 1.4 μl/g/ min), and the release of acid phosphatase, an indicator for activated Kupffer cells (89 ± 13 vs. 90 ± 5 vs. 123 ± 21 mU/g/l) in this in vitro model. Vascular flow characteristics were approximated by the portal perfusion pressure, which tended to be elevated upon initial reperfusion in the UW group (8.4 ± 0.6 mm Hg) compared to 6.6 ± 1.0 and 7.3 ± 0.4 mm Hg in Celsior and HTK, respectively. However, the pressure values decreased to the normal range even in the UW group with ongoing perfusion. The sensitivity of our model in detecting protective effects of the tested solution was confirmed by a negative control group of livers stored in Ringer’s solution at 4°C, yielding an impaired recovery which differed by one magnitude from the three other groups. Within the limits of an in vitro study it is concluded from these results that Celsior may become a suitable alternative for liver preservation and further studies including a transplantation in vivo are strongly encouraged.
Intramucosal pH and pCO2 Do Not Strictly Correlate with Intestinal Energy Metabolism in Experimental Peritonitis
Authors: Ljungdahl M. , Rasmussen I. , Ronquist G. , Haglund U.
Published: April 2003

This study aimed to investigate tissue hypoxia on the cellular level in sepsis. Eighteen pigs weighing 18–27 kg were studied. Intramucosal-arterial PCO2 gradient (PCO2-gap) and intramucosal pH (pHi) were calculated using tonometry. A blind loop of the small intestine was constructed for repeated tissue biopsies to measure intestinal energy-related metabolites and lactate concentration. Six animals served as controls. In 12 animals, faecal peritonitis was induced. Six of these animals were studied without further interventions, while the others were resuscitated with dextran to maintain cardiac index at baseline level. Untreated peritonitis caused an increase in PCO2-gap and a drop in pHi. The intestinal energy metabolism was not disturbed until the end of the experimental period, with a decreased energy charge value and a moderately increased lactate concentration. In peritonitis-dextran animals, PCO2-gap and pHi remained at baseline level and the energy metabolism was not disturbed. We conclude that in peritonitis, PCO2-gap – like pHi – can be influenced by other factors than strictly anaerobic tissue metabolism.
The Effects of Allopurinol in Hepatic Ischemia and Reperfusion: Experimental Study in Rats
Authors: Rhoden E. , Pereira-Lima L. , Lucas M. , Mauri M. , Rhoden Cláudia , Pereira-Lima J.C. , Zettler C. , Petteffi L. , Belló-Klein Adriane
Published: April 2003

Background/Aims: Some studies have shown that postischemic hepatic dysfunction is mainly due to oxygen free radicals that are generated by xanthine oxidase. The present study was undertaken to determine the effect of allopurinol, an inhibitor of xanthine oxidase, on oxidative stress, liver injury and histologic alterations induced by hepatic ischemia-reperfusion in rats. Methods: One hundred and sixty Wistar rats were used and divided into three groups. Group 1: sham operation; group 2: 50 min of ischemia followed by 1 h of reperfusion, and group 3: pretreatment with allopurinol and 50 min of ischemia followed by 1 h of reperfusion. The effect of allopurinol was evaluated by plasma levels of alanine aminotransferase and aspartate aminotransferase, histopathologic studies, and lipid peroxidation measured by the thiobarbituric acid reactive substances method and chemiluminescence initiated by tert-butyl hydroperoxide technique. Results: Ischemia followed by reperfusion promoted an increase in lipid peroxidation of the hepatic cells when compared to the sham-operated group (p < 0.05). This increase was attenuated in the group treated with allopurinol (p < 0.05). Allopurinol also showed a protective effect on hepatocellular necrosis (p < 0.05), and the plasma levels of liver enzymes returned earlier to the normal range in rats pretreated with allopurinol in comparison to those that did not receive the drug (p < 0.05). Conclusions: Allopurinol exerted a protective effect on hepatic ischemia and reperfusion in rats. The administration of this drug prior to liver operations should be considered to be submitted to trials in humans.
Intra- and Post-Operative Assessment of Renal Cortical Perfusion by Laser Doppler Flowmetry in Renal Transplantation in the Rat
Authors: Hammad F.T. , Davis G. , Zhang X.-Y. , Wheatley A.M.
Published: April 2003

Renal blood flow (RBF) in the period immediately following transplantation has an important prognostic value. Here we report for the first time on the use of laser Doppler flowmetry (LDF) for the measurement of renal cortical perfusion (RCP) during all the important steps in renal transplantation. Left orthotopic kidney transplantation was performed in Lewis rats (n = 14) after 2 h of cold ischaemia and preservation in EuroCollins solution. Under baseline conditions, RCP in the donor and recipient kidneys were similar with a coefficient of variability of 11 and 12%, respectively. There was a progressive increase in RCP during the first 60 min after transplantation with a return to normal values 2 weeks later. In conclusion, LDF provides a rapid and continuous measure of RCP without interference to the operative site and may prove a useful tool for the measurement of RBF during kidney transplantation.
Can Labor with Breech Presentation Be Induced?
Authors: Fait G. , Daniel Y. , Lessing J.B. , Bar-Am A. , Gull I. , Shenhav M. , Kupferminc M.J.
Published: April 2003

Our objective was to evaluate the efficacy and safety of labor induction in women with a breech presentation, and an unripe cervix. We conducted a retrospective, matched-paired study on patients with breech presentation and an unripe cervix (n = 23), who underwent induction of labor using extra-amniotic saline instillation. The women were compared to three matched control groups: 46 women with vertex presentation and an unripe cervix, whose labor was induced by the same method, 23 with breech presentation who underwent a vaginal trial of labor, and 23 women with breech presentation who underwent a cesarean section without a trial of labor. In the study group, 12 women (52.2%) delivered vaginally. Rates of Apgar score, birth trauma, and maternal morbidity were similar in all groups. Induction of labor in patients with a breech presentation and an unripe cervix may be attempted in selected cases as it seems to be efficacious (vaginal delivery rate of 52.2%) and safe for both fetus and mother.
Electromyographic Activity of the Uterus Above the Placental Implantation Site
Authors: Kavšek G. , Pajntar M. , Leskošek B.
Published: April 2003

The aim of this study was to evaluate the electromyographic (EMG) activity of the uterus concerning the placental implantation site. In a clinical trial, 55 pregnant women in the last trimester of pregnancy were enrolled. They were divided into two major groups: 25 women had placental implantation site on the anterior and 30 women on the posterior uterine wall. With regard to the presence/nonpresence of contractions, each group was further divided into two subgroups. Uterine EMG activity was recorded by electrodes placed on the abdominal wall. All signals were transferred through a series of amplifiers. Amplified and filtered EMG signals were digitized and written on a hard disk, simultaneously with the signals of external tocodynamometry. From the 30-min EMG recording, we calculated the average root mean square (RMS) and the average median frequency (MF) of the signal. A significant difference of the abdominal EMG activity concerning the placental implantation site was found only in pregnant women with contractions. The RMS was significantly lower in the placental implantation site on the anterior uterine wall, whereas the MF was significantly higher. It can be concluded that the placental implantation site influences the uterine EMG activity registered through the abdominal wall, especially when registered above the placental implantation site.
Risk of Complications and Uterine Malignancies in Women Undergoing Hysterectomy for Presumed Benign Leiomyomas
Authors: Takamizawa Satoru , Minakami Hisanori , Usui Rie , Noguchi Saori , Ohwada Michitaka , Suzuki Mitsuaki , Sato Ikuo
Published: April 2003

Objectives: To determine the incidences of complications and uterine malignancies among women undergoing hysterectomies for presumed benign leiomyomas. Methods: We retrospectively reviewed the medical records of 923 women who underwent total hysterectomies between January 1983 and December 1997 at our hospital due to presumed benign leiomyomas. Results: The mean age (SD) of the patients was 44.5 ± 5.2 years, 105 ± 35 minutes was required for the procedure, and 405 ± 312 ml of blood was lost during the procedure. Forty-one (4.4%) women demonstrated complications of intraoperative hemorrhages and required transfused blood. Urinary tract and bowel injuries occurred in 10 (1.1%) and 2 (0.2%) women, respectively. One woman (0.1%) died from pulmonary embolism that occurred on postoperative day 1. One woman (0.1%) required relaparotomy to control intraabdominal hemorrhage. Uterine malignancies were discovered postoperatively in 4 (0.4%) women, including 2 endometrial carcinoma, 1 leiomyosarcoma, and 1 endometrial stromal sarcoma. Conclusions: The incidences of complications and unrecognized uterine malignancies were similar to the results of previous studies. Of patients undergoing hysterectomy for presumed benign leiomyomas, the risk of major complications was 6.0% (55/923) and the risk of preoperatively undiagnosed uterine malignancies was 0.4%.
Torsion of a Functional Ovarian Cyst in a Premenopausal Patient Receiving Tamoxifen
Authors: Nasu Kaei , Miyazaki Tami , Kiyonaga Yukie , Kawasaki Fumiko , Miyakawa Isao
Published: April 2003

We report a case of torsion of an ovarian follicular cyst that developed during treatment with tamoxifen for breast cancer. A 40-year-old Japanese woman was admitted complaining of acute lower abdominal pain. Eight months earlier, she had undergone a partial mastectomy and local irradiation for ductal carcinoma of her left breast, estrogen receptor-positive stage I (T1a N1b M₀). The administration of tamoxifen, 20 mg/day, and doxifluridine, 600 mg/day, were started immediately postoperatively. Pelvic examination after admission revealed the left ovarian cyst and enlarged uterus. Transvaginal ultrasonography and computed tomography revealed a multilocular cystic mass in the pelvic cavity. The pathological diagnosis of the tumor after total hysterectomy and bilateral salpingo-oophorectomy was a typical follicular cyst with torsion and uterine leiomyoma. This ovarian cyst was believed to have developed during tamoxifen administration.
Urodynamic Investigation of Women Operated on for Genuine Stress Incontinence
Authors: Matányi S. , Ács N. , Fontányi Z. , Paulin F.
Published: April 2003

Anterior colporrhaphy (Kelly-Stoeckel suture) was performed on 22 women suffering from grade-I or grade-II genuine stress incontinence. Urodynamic investigation was performed on every patient before surgery and 6 months postoperatively. 21 patients were cured and 1 patient improved. After operation the functional urethral length was increased by 28.8%, and urethrovesical pressure transmission was improved by 22.9%. Maximum urethral closure pressure decreased postoperatively by 21.1%. Pressure transmission was clearly improved by the surgical intervention and urinary continence was restored in spite of the fact that maximal urethral closure pressure decreased. Based on these results it is suggested to consider performing anterior colporrhaphy in cases of weak urethral closure pressure, because of the increased risk of worsening the complaints of these patients.