bluuebunny/crossref_metadata_2025 huggingface dataset:
Photoprotection by Cichorium endivia Extracts: Prevention of UVB-Induced Erythema, Pyrimidine Dimer Formation and IL-6 Expression
Authors: Enk C.D. , Hochberg M. , Torres A. , Lev O. , Dor I. , Srebnik M. , Dembitsky V.M.
Published: December 2003

In the gradual process of evolution, plants have developed natural sun protecting substances that enable continuous survival under direct and intense ultraviolet (UV) radiation. As part of our studies of plant-derived pigments that might constitute an alternative to conventional sunscreens, we have tested the ethanolic extracts of roots, stalks, and inflorescences of populations of wild Cichorium endivia subsp. divaricatum (Asteraceae) in terms of protection against sunburn, and in prevention of UVB-induced pyrimidine dimer formation and IL-6 mRNA expression in the human keratinocyte cell line, HaCaT. Using ELISA technique for detection of pyrimidine dimers and RT-PCR for detection of IL-6, we found that the ethanolic extract of C. endivia roots absorbs radiation in the UVB spectrum and partially prevents induction of pyrimidine dimers and IL-6 expression. Application of the root extract on the skin prior to UVB irradiation totally prevented erythema. Our findings suggest that C. endivia extracts might possess sun-protective qualities that make them useful as sunscreens.
Relationship between Tear TNF-α, TGF-β1, and EGF Levels and Severity of Conjunctival Cicatrization in Patients with Inactive Trachoma
Authors: Satici Ahmet , Guzey Mustafa , Dogan Zeki , Kilic Adil
Published: December 2003

Tear tumor necrosis factor alpha (TNF-α), transforming growth factor beta 1 (TGF-β1), and epidermal growth factor (EGF) levels were determined in patients with inactive trachoma, and a possible relation between these cytokines and conjunctival cicatrization severity was investigated. Forty-four patients with inactive trachoma who were admitted to the Department of Ophthalmology at the Harran University, Sanliurfa, Turkey, were included in this study. The control group consisted of 20 age- and sex-matched healthy subjects. The levels of cytokines in tears were measured by ELISA. Tear samples were collected from the conjunctival cul-de-sac by means of blunted-tip glass capillary tubes. Eyes with inactive trachoma were classified into three subgroups with respect to conjunctiva cicatrization: mild, moderate, and severe. In 44 patients with inactive trachoma, conjunctival cicatrization was found, including mild (n = 15), moderate (n = 16), and severe (n = 13) cases. In patients with inactive trachoma, decreases in tear EGF (p = 0.000) concentrations and increases in tear TGF-β1 (p = 0.006) and TNF-α (p = 0.046) levels with respect to the control group were found to be concordant with conjunctival cicatrization severity. Statistically significant correlations in tear TNF-α (p = 0.018), TGF-β1 (p = 0.007), and EGF (p = 0.043) levels were found between mild and severe cicatrization groups. TNF-α and TGF-β1 have been implicated in the fibrogenic process. Elevated tear levels of inflammatory/fibrogenic cytokines may play an important role in scar formation in trachoma. It is possible that decreased tear levels of EGF, which may be important for the maintenance of corneal epithelial integrity, are related to fibrosis in the lacrimal gland ductules.
A New Acrylic Tissue Adhesive for Conjunctival Surgery: Experimental Study
Authors: Alió Jorge L. , Gómez Javier , Mulet Emilia , Mahiques Bujanda María M. , Martinez José M. Martin , Molina Yennis
Published: December 2003

Purpose: To evaluate the clinical efficacy and the clinical and histopathologic tolerance of a new acrylic tissue adhesive (ADAL-2) versus 8/0 polyglactin sutures (Vicryl®) for its use in conjunctival surgery. Method: Experimental study performed on New Zealand albino rabbits. The animals were divided into two groups. Surgery consisted of a conjunctival peritomy of 8 mm in the superior limbus followed by extensive subconjunctival dissection and creation of a flap by two radial cuts. The conjunctiva was then attached to the limbus again by the proposed acrylic tissue adhesive (ADAL-2) or 8/0 polyglactin suture depending on the group. Clinical efficacy of the closure of the conjunctival wound, either with adhesives or sutures, and the clinical and histopathologic tolerance were also evaluated 1, 7, 28 and 42 days after surgery. Results: Both conjunctival surgical closure methods were found to be equal in efficacy concerning their ability to fix the conjunctiva to the limbus. There were no significant clinical and histopathologic tolerance differences between the new tissue adhesive investigated (ADAL-2) and 8/0 polyglactin sutures (Vicryl). Histopathology showed no presence of the adhesive 28 days postoperatively. Conclusions: ADAL-2 tissue adhesive is an efficient conjunctival closure method, very well tolerated by the ocular surface. Its sealing efficiency and its tolerance are similar to 8/0 polyglactin sutures. This new acrylic adhesive has a potential as an alternative for surgical conjunctival sealing in ophthalmic surgery.
Effect of Acetylcysteine on Experimental Corneal Wounds in Dogs
Authors: Aldavood S.J. , Behyar R. , Sarchahi A.A. , Rad M.A. , Noroozian I. , Ghamsari S.M. , Sadeghi-Hashjin G.
Published: December 2003

The effects of 3, 10 and 20% concentrations of acetylcysteine on experimental corneal wound healing in dogs were evaluated. Experimental corneal wounds were induced surgically, up to the depth of the anterior third of the stroma, in both eyes of 18 dogs. One of the eyes was treated topically with 0.9% NaCl solution three times a day. The contralateral eye was treated topically with acetylcysteine (3, 10 and 20% concentrations) in each of 6 cases separately. Corneal wounds were measured by fluorescein staining every day. The mean time of healing in the 3% group was significantly different from control eyes (6.17 ± 1.94 days). It was 7.19 ± 0.75 days in the 20% group and 7 ± 2 days in the 10% group. The last two groups were not significantly different from the controls (9.67 ± 3.01 days and 8.17 ± 3.60 days, respectively).
Corneal Endothelial Cytotoxicity of Riboflavin/UVA Treatment in vitro
Authors: Wollensak Gregor , Spörl Eberhard , Reber Friedemann , Pillunat Lutz , Funk Richard
Published: December 2003

Recently, we have developed collagen crosslinking induced by combined riboflavin/UVA treatment, thus increasing the biomechanical rigidity of the cornea to treat progressive keratoconus. The present safety study was performed to evaluate possible cytotoxic effects of combined riboflavin/UVA treatment on the corneal endothelium in vitro. Endothelial cell cultures from porcine corneas were treated with 500 µM riboflavin solution, exposed to various endothelial UVA irradiances (370 nm) ranging from 0.1 to 1.6 mW/cm2 for 30 min and evaluated 24 h later using trypan blue staining and Yopro fluorescence staining. The effect of either treatment alone (UVA irradiation ranging from 0.2 to 6 mW/cm2) was also tested. An abrupt cytotoxic threshold irradiance level was found at 0.35 mW/cm2 after combined treatment with riboflavin plus UVA irradiation and at 4 mW/cm2 with UVA irradiation alone. Riboflavin alone was not toxic. A cytotoxic effect of the combined riboflavin/UVA treatment on corneal endothelial cells is to be expected with a corneal thickness of less than 400 µm. Therefore, pachymetry should be routinely performed before riboflavin/UVA treatment to exclude patients at risk.
Correlation of Human Age-Related Cataract with Some Blood Biochemistry Constituents
Authors: Mirsamadi Mansour , Nourmohammadi Issa
Published: December 2003

Purpose: The causes of age-related cataract are multifactorial and particular consideration has been given to the role of nutritional factors in cataract formation. The purpose of this study was to determine the levels of certain blood biochemistry constituents in cataract patients and controls and evaluate their potential, if any, as identifying risk factors in cataractogenesis. Methods: This is a case-control study where 155 cataract patients and 155 matched controls were chosen for evaluation. Cataract subjects were further divided into subgroups depending on the location of the cataract. All underwent routine eye examinations and blood samples were taken from each one for blood biochemistry analysis including serum levels of glucose, urea, cholesterol, triglycerides, total protein, albumin, bilirubin, calcium, sodium and potassium and the enzymes aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase. Results: Mean levels of total protein, bilirubin, calcium, sodium, alanine aminotransferase and alkaline phosphatase differed significantly between patient and control groups. Patients with posterior subcapsular cataract had significantly higher glucose levels (p = 0.05) compared with patients with other types of cataract. It was also found that those patients with a cortical cataract had the highest level of urea, differing significantly from other subgroups and controls. Conclusions: The mean levels of all constituents under study fell within normal body range. However, the levels of several important factors demonstrated a positive and significant correlation with cataract. While we do not presume to present these results as conclusive, it is possible that a gradual and constant variation in these parameters may be predisposing factors in cataractogenesis.
Histological Toxicity of Grepafloxacin after Intravitreal Injection
Authors: Pinilla I. , Peréz-Oliván S. , Solans C. , Bregante M.A. , Ramirez M.T. , Larrosa J.M. , Pablo L.E. , Honrubia F.M.
Published: December 2003

Purpose: To determine the intravitreal levels of grepafloxacin after intravitreal injection of 80 µg and to evaluate the retinal toxicity after intravitreal injection of different doses of grepafloxacin in rabbit eyes. Methods: Fifteen female New Zealand white rabbits and 15 female pigmented ‘Gigantes de España’ rabbits were injected with 80 µg of grepafloxacin into the vitreous cavity. The grepafloxacin concentration was determined with HPLC after 2, 4, 8, 12 and 24 h. Eighteen female rabbits (9 New Zealand white rabbits and 9 pigmented ‘Gigantes de España’ rabbits) were used for a study of toxicity. The rabbits were divided into 6 treatment groups: group 1 (3 pigmented rabbits) received an intravitreal injection of 80 µg of grepafloxacin in 0.1 ml of saline solution, group 2 (3 white rabbits) 80 µg of grepafloxacin in 0.1 ml, group 3 (3 pigmented rabbits) 800 µg of grepafloxacin, group 4 (3 white rabbits) 800 µg of grepafloxacin, group 5 (3 pigmented rabbits) and group 6 (3 white rabbits) 0.1 ml of saline solution. Clinical examination was performed prior to injection and 24 h and 10 days after surgery. The animals were sacrificed 10 days after the injection, and the eyes were enucleated and fixed for histopathology. The specimens were stained with hematoxylin-eosin and toluidine blue. Results: No relevant complications were found during the clinical follow-up. All the eyes showed no abnormalities in the histologic evaluation. Conclusion: Grepafloxacin can be considered as a safe alternative for intravitreal injection for the treatment of intraocular infections.
Effects of Topical Corticosteroids and Nonsteroidal Anti-Inflammatory Drugs on Prostaglandin E2-Induced Aqueous Flare Elevation in Pigmented Rabbits
Authors: Hayasaka Yoriko , Hayasaka Seiji , Zhang Xue-Yun , Nagaki Yasunori
Published: December 2003

We evaluated the effects of anti-inflammatory potency of corticosteroids and nonsteroidal anti-inflammatory drugs on prostaglandin E2 (PGE2)-induced aqueous flare elevation in pigmented rabbits. Transcorneal diffusion of PGE2, 25 µg/ml (7.09 × 10–2 mmol/l), with the use of a glass cylinder was achieved to produce aqueous flare elevation. Anti-inflammatory drugs were topically administered once before PGE2 application. Aqueous flare was measured with a laser flare-cell meter. Topical single instillation of dexamethasone sodium metasulfobenzoate 0.1%, dexamethasone sodium phosphate 0.1%, and fluorometholone 0.1% 6 h before PGE2 application inhibited 56, 59, and 43% of flare elevation, respectively. Topical single instillation of bromfenac sodium 0.1% and pranoprofen 0.1% 1 h before PGE2 application inhibited 33 and 15% of flare elevation, respectively. Indomethacin 0.5% did not inhibit flare elevation. Corticosteroid eyedrops needed several hours from topical instillation to exhibit inhibition of flare elevation. Most nonsteroidal anti-inflammatory drug eyedrops inhibited aqueous flare elevation when instilled 1 h before PGE2 application.
Variants of the Myocilin Gene in Japanese Patients with Normal-Tension Glaucoma
Authors: Izumi Kanako , Mashima Yukihiko , Obazawa Minoru , Ohtake Yuichiro , Tanino Tomihiko , Miyata Hiroshi , Zhang Qiang , Oguchi Yoshihisa , Tanaka Yasuhiko , Iwata Takeshi
Published: December 2003

Myocilin (MYOC) mutations are associated with juvenile- and adult-onset primary open-angle glaucoma (POAG). The purpose of this study was to determine whether MYOC gene mutations are associated with normal-tension glaucoma (NTG). The prevalence of MYOC mutations was determined in 80 Japanese NTG patients and 100 control subjects. In addition, the expression of mutant MYOC was determined by transforming COS-1 cells with five myocilin variants (R158Q, D208E, I360N, A363T, and I477S) and examining whether myocilin was present in the cultured cells and/or the culture medium by western blotting. Six different nucleotide sequence variants, R46Stop, R76K, R158Q, D208E, A488A, and one in the 3′ non-coding region, were identified in 80 NTG patients. Variants in codon 46 (R46Stop), codon 158 (R158Q), and codon 488 (A488A) were not found in the 100 normal controls. The frequency of other sequence changes (R76K, D208E, and 3′ non-coding) in NTG patients did not differ significantly from the frequencies in the control subjects. COS-1 cells transfected with the wild type, R158Q, or D208E variants secreted myocilin into the culture medium. On the other hand, the detected myocilin was significantly reduced in the medium of cells transfected with the I360N, A363T, or I477S variants that were previously identified as mutations for POAG. Definitive evidence of MYOC variants associated with NTG was not found.
CS-088, an Angiotensin Type 1 Receptor Antagonist, Ameliorated the Impaired Blood Flow in the Optic Nerve Head of Rabbits
Authors: Inoue Tatsuya , Yokoyoma Tomihisa , Koike Hiroyuki
Published: December 2003

The effect of CS-088, an angiotensin type 1 receptor antagonist, on optic nerve head (ONH) circulation was investigated in anesthetized rabbits. ONH blood flow was measured for 3 h using laser Doppler flowmetry. ONH blood flow disturbance was induced by intravenous injection of endothelin-1. Blood flow was decreased by 30%; this decrease was reversed by the injection of CS-088. A single injection of CS-088, however, did not alter the baseline ONH blood flow. It is concluded that CS-088 can have a beneficial effect on disturbed ONH blood flow.
Ureaplasma urealyticum and Mycoplasma hominis in Men Attending for Routine Semen Analysis
Authors: Andrade-Rocha Fernando Tadeu
Published: December 2003

Aim: To investigate the clinical value of the screening of Ureaplasma urealyticum and Mycoplasma hominis in routine semen analysis. Material and Methods: Semen samples of 234 patients with several clinical settings (infertility, varicocele, spontaneous abortion, genital infections, undescended testicles, hemospermia, etc.) were distributed in three study groups: group 1 -- negative cultures; group 2 – normal colonization (≤103 colony-forming units (cfu)/ml), and group 3 – pathogenic colonization (>103 cfu/ml). Frequency rates, incidence by age and clinical settings, association with abnormal sperm characteristics (density, vitality, motility and morphology) and with the leukocyte count were investigated. Results: Prevalence of U. urealyticum was higher than M. hominis (≤103 cfu/ml: 28.2 vs. 24.8%; >103 cfu/ml: 20.5 vs. 13.3%). No difference was detected on the incidence of mycoplasmas by age and clinical settings, as well as in regard to the mean values of sperm density, vitality, motility, oval-headed sperm and leukocyte count (p > 0.05). Conclusion: In spite of the high incidence of mycoplasmas, not enough information was available regarding the influence of these microorganisms on the sperm quality and their relationship with the leukocyte count. Therefore, screening of U. urealyticum and M. hominis for routine semen analysis is not clinically relevant.
Nephrostomy Tract Dilation Using a Balloon Dilator in Percutaneous Renal Surgery: Experience with 95 Cases and Comparison with the Fascial Dilator System
Authors: Şafak Mut , Gogus Çaǧatay , Soygür Tarkan
Published: December 2003

Introduction: Nephrostomy tract dilation is one of the important steps of percutaneous renal surgery. In this study, we present our initial experience with the balloon dilator in 95 patients and compare our results retrospectively with a group of 30 patients in whom Amplatz dilators were used. Patients and Methods: The medical records of 95 patients who underwent percutaneous renal operations, including percutaneous nephrolithotomy and antegrade endopyelotomy, between September 1999 and September 2002 were reviewed. All procedures were performed using balloon dilators. The operative technique is the same as the other dilation procedures. Thirty consecutive patients who had previously undergone percutaneous renal surgery using the Amplatz dilators were taken as the control group and their charts were reviewed retrospectively, and the results compared with the results of patients in whom balloon dilation was used. Results: There were no major perioperative complications or deaths in both groups. The mean operative time and tract formation times for the balloon dilation group and the Amplatz dilation group were 106.8 ± 41.4 and 11.2 ± 3.0, and 116.4 ± 23.7 and 16.3 ± 2.4 min, respectively. Thirteen (13.7%) patients had significant bleeding and required blood transfusion in the balloon dilation group, whereas 5 (16.6%) patients had significant bleeding in the Amplatz dilation group. Collecting system perforation due to too far advancement of the dilator occurred in 11 (11.6%) patients but there was no major parenchymal or vascular injury medially in the balloon dilation group. On the other hand, collecting system perforation occurred during sequential Amplatz dilation in 5 (16.6%) patients. Conclusion: We believe that the balloon system allows one-step dilation and shortens the dilation procedure. It may minimize bleeding which can occur during the stepwise fascial dilation. When using fascial dilators it is sometimes possible to go out of the collecting system by changing the size of the dilators. We think that balloon dilation may prevent these intraoperative and time-consuming situations.
Stage I Testicular Seminoma: Para-Aortic and Iliac Irradiation with Reduced Dose after Orchiectomy
Authors: Gürkaynak Murat , Akyol Fadil , Zorlu Faruk , Akyurek Serap , Yildiz Ferah , Atahan İ. Lale
Published: December 2003

Background and Purpose: Radiotherapy remains the treatment of choice for patients with stage I seminoma. The aim of this study is to report preliminary results of reduced dose radiotherapy to ipsilateral pelvic and para-aortic lymph nodes. Materials and Methods: Between February 1996 and December 2001, 53 patients with stage I testicular seminoma were treated with adjuvant radiotherapy after orchiectomy. The median age was 34 years (19–59 years). Four (7.5%) patients had a history of cryptorchidism. Eleven (20.8%) patients showed elevated β-human chorionic gonadotropin. All patients had a radical inguinal orchiectomy and histopathological analysis yielded classic seminoma in 47 (88.7%), spermatocytic in 5 (9.4%) and anaplastic in 1 (1.9%) patients. A total of 19.6–20 Gy in 1.8- to 2-Gy daily fractions was administered to the para-aortic and ipsilateral iliac lymphatics. Results: Median follow-up time was 42 months (12–77 months). One patient developed para-aortic lymph node recurrence at month 28 of the follow-up. Five-year overall and disease-free survivals were 100 and 98%, respectively. Only grade I–II of the Radiation Therapy Oncology Group acute gastrointestinal complications without any severe late toxicity was detected. Conclusion: Reduced dose radiotherapy seems to be as effective as higher doses in the management of stage I seminoma with an acceptable toxicity.
Is Using Lignocaine Gel prior to Flexible Cystoscopy Justified?
Authors: Palit V. , Ashurst H.N. , Biyani C.S. , Elmasray Y. , Puri R. , Shah T.
Published: December 2003

Objective: We evaluate the discomfort and efficacy of instilling 2% lignocaine gel (Instillagel) versus smearing water-soluble gel (Aquagel) around the flexible cystoscope and external urethral meatus in men undergoing flexible cystoscopy for the first time and the overall efficacy of lignocaine gel in completion of the procedure. Materials and Methods: A total of 140 patients divided into two groups, were randomized for this study: group A (n = 70) received approximately 11 ml of 2% lignocaine gel (Instillagel) intraurethrally for approximately 15 min, while in group B (n = 70) approximately 10–15 ml of water-soluble gel (Aquagel) was smeared around the scope and external urethral meatus. Total completion time for each procedure was recorded. Primary outcomes were pain during instillation of lignocaine, during insertion of scope and cystoscopy. Pain was recorded by the patient using a 100-mm nongraphic rating visual analogue scale. Secondary outcome included procedure time and cost analysis. Results: The majority of patients in both groups reported mild pain with VAS 3 or less throughout the whole procedure. No significant difference was noted in the two groups at any stage of the procedure. Use of lignocaine gel added approximately 10 min to the procedure time. Conclusions: In our study there was no significant difference in patient discomfort between instilling lignocaine gel and smearing of Aquagel in completion of flexible cystoscopy. However, application of lignocaine gel added extra time, effort and cost to the procedure.
Volume of Nerve Fibers in the Stress-Induced Bladder of Adult Rats following Capsaicin Treatment
Authors: Ercan Feriha , Çetinel Şule , Erin Nuray , Aydin Hakan , Hürdağ Canan , Parker Terry , Parker Kate , Mayhew Terry
Published: December 2003

Introduction: We have investigated the volume of nerve fibers in the rat urinary bladder following systematic exposure to cold-restraint stress and capsaicin treatment. Materials and Methods: Adult Wistar albino rats were either exposed to cold-restraint stress (vehicle group) or treated with capsaicin before exposure to cold-restraint stress (capsaicin group). In the control group, animals were neither exposed to cold-restraint stress nor given capsaicin. From each group, samples of bladder were prepared for morphological investigation and stereological evaluation of the volume of nerve fibers. Results: Stress exposure was associated with urothelial degeneration, a higher incidence and degranulation of mast cell profiles in the mucosa, and an increased volume of nerve fibers in the muscular layer of the bladder wall. Capsaicin treatment prevented the stress-induced degenerative changes. In the capsaicin group, the volume of nerve fibers in the muscular layer was also significantly smaller than that in the stress group. Conclusions: Exposure of adult rats to capsaicin prevented the stress-induced degeneration of the bladder and changed the volume of capsaicin-sensitive fibers in muscular layer. We conclude that capsaicin and related compounds may be useful in treating stress-induced bladder problems.
Effects of Diabetes on Nitric Oxide-Mediated Relaxations in Male Rat Corpus cavernosum Smooth Muscle
Authors: Kuwahara Tomohiro , Wada Yoshihiro , Takahashi Wataru , Yoshida Masaki , Iwashita Hitoshi , Kikukawa Hiroaki , Nakanishi Juro , Ueda Shoichi
Published: December 2003

Introduction: We evaluated the effects of diabetes on nitric oxide-mediated relaxations and nitric oxide synthase activity in male rat corpus cavernosum smooth muscles. Methods: Eight-week-old male rats were assigned to three groups: control (injected with the vehicle), DM (diabetes mellitus, induced by injection with 65 mg/kg streptozotocin), and TES (testosterone, testosterone supplemented after induction of diabetes). After 8 weeks, corpus cavernosum smooth muscle strips were mounted in an organ bath for isometric tension recordings. Electrical field stimulation (EFS, 2-ms pulse duration, 0.3–20 Hz and 3 s train) was applied to the strips precontracted with 30 µM phenylephrine. The microdialysis probe was inserted into the strip, and Krebs-Henseleit solution was perfused into the probe. The dialysate during EFS was collected, and the amount of NO–2/NO–3 (NOx) released in the dialysate was measured by the Greiss method. Sodium nitroprusside (0.1 nM to 10 mM) and carbachol (1 nM to 10 mM) were cumulatively added to the strips precontracted with 30 µM phenylephrine. Results: EFS caused frequency-dependent relaxations and NOx releases of the strips. Pretreatment with Nω-nitro-L-arginine (100 µM) and tetrodotoxin (1 µM) completely inhibited the relaxations and NOx releases. The maximum relaxation was significantly greater in the DM group than in the control or TES group. The release of NOx was significantly greater in the DM group than in the control or TES group. Sodium nitroprusside, the endothelium-independent vasodilator, relaxed the tissues in all three groups. There were no significant differences among control, DM and TES groups in the maximum relaxation to sodium nitroprusside. Conclusion: The present data suggest that diabetes enhances nitric oxide synthase activity and nitric oxide-mediated relaxations in the male rat corpus cavernosum by the reduced testosterone level in the diabetic animals.
Synchronous Bilateral Testicular Germ Cell Tumor with Different Histology
Authors: Coli Antonella , Bigotti Giulio , Dell’Isola Carlo , Castri Federica , Rulli Francesco , Massi Guido
Published: December 2003

A rare case of synchronous bilateral testicular germ cell tumor of different histological type is described. We report the case of a 39-year-old man with this unusual condition and discuss the value of the histopathological diagnosis in therapy and prognosis. A thorough review of the literature is also presented, and for the first time the precise histological subtype of each reported tumor, as diagnosed by the authors of the original paper, is illustrated.
Lingual Metastasis from Renal Cell Carcinoma Management and Review of the Literature
Authors: Goel Mahesh C. , Williams D.W. , Evans H. , Roberts J.G.
Published: December 2003

A case of anterior lingual swelling, which on excision biopsy was diagnosed as a secondary from renal cell carcinoma, is presented. We reviewed the indexed literature and present a review of the literature and current management of this uncommon problem.
Renal Smooth Muscle Tumor with Features of Lymphangioleiomyomatosis
Authors: San Miguel P. , Fernández G. , Sacristán F. , Álvarez C. , Ortiz-Rey J.A. , Antón I. , Zungri E. , De la Fuente A.
Published: December 2003

A 44-year-old woman with left kidney tumor involving the perirenal and retroperitoneal lymph nodes is presented. Imaging findings including ultrasonography and computerized tomography showed renal and para-aortic masses and no features of lymphangioleiomyomatosis or angiomyolipoma were seen. The histopathological examination was considered as a renal smooth muscle tumor with features of lymphangioleiomyomatosis. Diagnosis considerations, particularly histopathological, immunohistochemical and hormonal studies are discussed and we comment the distinction of this case from the benign mesenchymal tumors.
Mycotic Aneurysm of the Popliteal Artery as a Complication of Intravesical BCG Therapy for Superficial Bladder Cancer
Authors: Witjes J.A. , Vriesema J.L.J. , Brinkman K. , Bootsma G. , Barentsz J.O.
Published: December 2003

A 67-year-old man was treated with maintenance intravesical BCG for superficial bladder cancer. As a culture-proven complication of this therapy, he developed general malaise, high fever, granulomatous hepatitis and a mycotic aneurysm in his left knee. All complications were treated successfully with antituberculous therapy. No vascular surgery was necessary. This case report again stresses the necessity to recognise complications of BCG treatment and to start adequate therapy as soon as possible.
Severe Neurotoxicity in Tacrolimus-Treated Living Kidney Transplantation in Two Cases
Authors: Veroux Pierfrancesco , Veroux Massimiliano , Puliatti Carmelo , Valvo Mariachiara , Macarone Maurizio , Cappello Dario
Published: December 2003

Two living kidney-transplant recipients under tacrolimus-based immunosuppressive therapy experienced severe neurotoxicity, with tonic-clonic seizures. In both cases the dosage reduction did not result in improvement of symptoms, which completely disappeared after modification of the immunosuppressive regimen from tacrolimus to cyclosporine. Severe neurotoxicity, with seizures or uncommon clinical features, such as serious myalgias, is not foreseeable. We recommend the conversion to cyclosporine-based immunosuppression in such cases.
Inguinal Fibrolipoma of the Spermatic Cord: Discrepancies between Clinical and Histopathological Findings
Authors: Hegele A. , Olbert P. , Roessler M. , Heidenreich A. , Hofmann R.
Published: December 2003

Tumors of the spermatic cord are rare. Up to 20% are malignant and usually located in the paratesticular region. We report the rare case of an inguinal fibrolipoma of the spermatic cord with discrepancies between clinical and histopathological findings.
The Immunology of Contact Dermatitis
Authors: Markert Udo R. , Elsner Peter
Published: December 2003

Contact dermatitis can be induced by a variety of small antigens. After binding of such antigens to a skin protein, they form a hapten-protein complex which can be incorporated into Langerhans cells or which can develop intracellularly. These complexes or their fragments can be presented via major histocompatibility complex (MHC) II by professional antigen-presenting cells or via MHC I by any cell present in the skin. The following activation of cytotoxic CD8+ T cells induces death of the presenting cell, including Langerhans cells or keratinocytes, which leads to an enormous release of immunoactive and chemoattractant cytokines and chemokines, initiating a strong inflammation.
Atopic Dermatitis in Tunisia
Authors: Amri M. , Youssef M. , Kharfi M. , Cherif F. , Masmoudi A. , Kourda M. , Fenniche S. , Dhaoui M.R. , Kamoun M.R. , Ben Osman Dhahri A. , Zahaf A. , Nouira R. , Mokhtar I. , Doss N. , Zili J.
Published: December 2003

Our aim was to investigate the epidemiology and clinical features of atopic dermatitis in Tunisia. To reach this object, a retrospective multicentre study was carried out at the 7 Tunisian departments of dermatology covering a period of 5 years. We observed 1,032 cases of atopic dermatitis during the studied period. These cases represent 0.52% of all new diagnoses in the same period. The mean age at onset was 3.5 years. Atopic dermatitis began after the age of 5 years in 14.05% of patients and was assessed to be severe in 5% of cases. Atopic dermatitis seems to be less frequent in Tunisia than in western countries. Its age at onset is higher, and this may be correlated with the less severe forms of the disease seen.
Detection of Herpes simplex Virus Genomic DNA in Various Subsets of Erythema multiforme by Polymerase Chain Reaction
Authors: Ng Patricia P.L. , Sun Yong Jiang , Tan Hiok Hee , Tan Suat Hoon
Published: December 2003

Background: The wide variation in the detection of herpes simplex virus (HSV) DNA (36–75%) by polymerase chain reaction (PCR) in erythema multiforme (EM) may be partly attributed to differences in case selection in terms of subsets of EM studied. Objective: To determine the frequencies of detection of HSV DNA in specific subsets of EM. Methods: Nested PCR was used to detect HSV DNA in skin biopsies with histologically proven EM. Results: PCR was performed on skin biopsies from 63 patients with EM. HSV DNA was detected in 3/11 (27.2%) of single-episode HSV-associated EM (HAEM), 6/10 (60%) of recurrent HAEM, 1/4 (25%) of single-episode idiopathic EM and 6/12 (50%) of recurrent idiopathic EM. HSV DNA was not detected in atypical EM (0/11), suspected drug-induced EM (0/9) or Stevens-Johnson syndrome (0/6). Conclusion: The overall PCR positive rates of HAEM (42.9%) and idiopathic EM (43.8%) were comparable suggesting that idiopathic EM is likely to be related to a subclinical HSV infection.
Increased Serum Levels of Tumor Necrosis Factor Alpha in Lichen planus
Authors: Erdem M. Teoman , Gulec A. Ihsan , Kiziltunc Ahmet , Yildirim Abdulkadir , Atasoy Mustafa
Published: December 2003

Background: Lichen planus (LP) is a common, pruritic, inflammatory mucocutaneous disease. There are several opinions and approaches to the etiopathogenesis of LP. Immunologic mechanisms almost certainly mediate its development. T-cell-mediated immunity plays the major role in triggering the clinical expression of the disease. The cytokines that are produced by lymphocytes also play an important role in the development of LP. Objective: The goal of our study was to investigate the possible role of tumor necrosis factor α (TNF-α) in the pathogenesis of LP. Methods: Serum TNF-α levels were determined with the enzyme-linked immunosorbent sandwich assay method in the sera of 40 patients suffering from LP and in those of 40 healthy controls. Results: The serum levels of TNF-α were found to be significantly higher in the patient group compared to the healthy controls (patients: 35.64 ± 9.59 pg/ml, controls: 15.6 ± 3.97 pg/ml, p < 0.001). Conclusion: Our results revealed that TNF-α might play a major role in the pathogenesis of LP.
Lack of Association between the Promoter Polymorphisms at Positions –308 and –238 of the Tumor Necrosis Factor Alpha Gene and Psoriasis vulgaris in Japanese Patients
Authors: Tsunemi Yuichiro , Nishibu Akiko , Saeki Hidehisa , Oyama Noritaka , Nakamura Koichiro , Kishimoto Megumi , Mitsui Hiroshi , Tada Yayoi , Torii Hideshi , Komine Mayumi , Asahina Akihiko , Kaneko Fumio , Tamaki Kunihiko
Published: December 2003

Background: Psoriasis features an increased level and activity of tumor necrosis factor α (TNF-α). The TNF-α gene has single nucleotide polymorphisms (SNPs) at positions –308 (–308G>A) and –238 (–238G>A) in the promoter region, and the –238G>A SNP has been reported to be associated with psoriasis vulgaris (PV) and psoriatic arthritis in Caucasians. Objective: To examine whether these SNPs are associated with susceptibility to PV in Japanese patients, we investigated the genotype and allele frequencies at each SNP in Japanese PV patients and in controls. Methods: We examined 163 PV patients and 96 healthy individuals. Genotyping was performed using the polymerase chain reaction-restriction fragment length polymorphism method. Results: No significant association between the genotypes or alleles of these SNPs and susceptibility to PV was observed. Conclusion: These SNPs themselves are not associated with susceptibility to PV in the Japanese.
Evaluation of in vitro Resistance in Patients with Onychomycosis Who Fail Antifungal Therapy
Authors: Gupta Aditya K. , Kohli Yatika
Published: December 2003

Background: With the increased awareness of onychomycosis and the increasing use of antifungals for this indication, it is prudent to be concerned about the possible emergence of resistant strains. There has been substantial work on the development of standardized methods for testing the in vitro resistance of various fungi and yeasts to the currently available antifungal agents. However, relatively little research has been published concerning the resistance of dermatophyte species. Objective: We report the results of a retrospective study analyzing the relationship between in vitro and clinical resistance in strains of Trichophyton rubrum cultured from patients with recalcitrant dermatophyte toe onychomycosis. Materials and Methods: We analyzed the in vitro resistance of dermatophyte strains obtained from 18 patients with chronic onychomycosis who failed antifungal therapy with itraconazole or terbinafine. Multiple-sequential strains from 11 patients were included in the study. Susceptibility testing of these strains was performed against 4 antifungals, itraconazole, ketoconazole, terbinafine and ciclopirox, using the broth microdilution method as per the NCCLS M27-A guidelines. A record of clinical characteristics that may relate to patient treatment and therapy was maintained. Results: All of the strains were susceptible to 3 of the 4 antifungal agents tested. Although there was no direct correlation between clinical resistance and in vitro resistance, increased minimum inhibitory concentration values for ketoconazole were observed in strains obtained after treatment from 3 of 18 patients evaluated in the study. In all but 1 patient, we were able to identify other factors that may have been responsible for treatment failure. Conclusions: With the more common use of antifungals to treat various fungal infections, development of increased resistance in the causative organisms remains a possibility. However, factors other than fungal resistance may also be implicated in treatment failure.
Microcystic Adnexal Carcinoma with Lymph Node Metastasis
Authors: Ban Masanori , Sugie Shigeyuki , Kamiya Hideki , Kitajima Yasuo
Published: December 2003

Microcystic adnexal carcinoma (MAC) affects predominantly the face and seldom metastasizes. We report a case occurring in the axilla of a 63-year-old male. Histology revealed the characteristic features of MAC. Eleven months after the excision, he underwent a reexcision with wide margins because of local recurrence. Histologically, the central area of the recurrent lesion revealed the typical histologic features of MAC, and the periphery showed a proliferation of irregular duct-like and glandular structures with a mixed pattern. Two lymph nodes that were not adherent to the tumor had metastatic tumor cells. The present case confirms that MAC can metastasize, although it may also be hypothesized that the recurrent lesion represented transformation into a higher-grade carcinoma.
Increased Expression of VEGF in Glomeruloid Reactive Angioendotheliomatosis
Authors: Eming Sabine A. , Sacher Christopher , Eich Dorothee , Kuhn Andreas , Krieg Thomas
Published: December 2003

Reactive angioendotheliomatosis (RAE) is a very rare disorder characterized by marked proliferation of endothelial cells. It is often associated with infections, such as subacute bacterial endocarditis, but has also been described as an early sign of a developing hematological malignancy. We report the case of a 71-year-old Caucasian female who developed lupus-like RAE lesions. A thorough diagnostic workup and subsequent 3-year clinical follow-up revealed no sign of an underlying infectious or neoplastic disorder. Repetitive serum immunofixations were only once consistent with a monoclonal gammopathy of undetermined significance. In lesional skin, the pronounced bud-like endothelial cell formation was associated with an increased epidermal expression of vascular endothelial growth factor (VEGF), a potent angiogenic mediator. In accordance with the paracrine action of epidermally derived VEGF, vascular endothelial cells in lesional skin revealed increased expression of the VEGF receptor VEGFR-2 (KDR). This case suggests a possible role of epidermally derived VEGF in endothelial cell proliferation in RAE.
Eruptive Large Melanocytic Nevus in a Patient with Hereditary Epidermolysis bullosa simplex
Authors: Stavrianeas N.G. , Katoulis A.C. , Moussatou V. , Bozi E. , Petropoulou H. , Limas C. , Georgala S.
Published: December 2003

Hereditary epidermolysis bullosa (HEB) is a group of genetically determined mechanobullous disorders characterized by blister formation following minor trauma. Unusual melanocytic lesions may be a rare feature of all major categories of HEB. We report a large melanocytic nevus, clinically simulating malignant melanoma, which developed at a site of healing blisters in an 8-year-old male with recessive generalized epidermolysis bullosa simplex (EBS). Histological findings were consistent with a compound nevus. This is the third reported case of an eruptive melanocytic nevus developing in EBS. Due to their unique features, it has been suggested that these nevi may represent a distinct variant, referred to as epidermolysis bullosa nevi. Despite the atypical picture, no malignant transformation of HEB nevi has been seen. Therefore, after histologic verification, regular long-term follow-up rather than radical surgery is recommended.
Progressive Macular Hemangioma: A New Entity?
Authors: Saraswat Abir , Handa Sanjeev , Mohanty Sambit K.
Published: December 2003

We report a 22-year-old man with an extensive cutaneous vascular lesion involving the left arm since the age of 2 months. The lesion was macular and had been growing steadily in extent since its appearance. It had crossed the midline in several places. There was no involvement of any internal organ. Histopathology and immunostaining revealed unmistakable evidence of vascular proliferation. The predominantly macular character of the lesion, even with passage of time, besides the absence of several other features, usually associated with a tufted angioma, led us to the use of the term ‘progressive macular hemangioma’ for this condition.
Mutation in Mitochondrial DNA as a Cause of Presbyacusis
Authors: Pickles James O.
Published: December 2003

Much of the hearing loss that occurs in old age is likely to be due to the long-term deterioration of the mitochondria in the different structures of the cochlea. The current review surveys some of the basic information on mitochondria and mitochondrial DNA, as a background to their possible involvement in presbyacusis. It is likely that oxygen radicals damage mitochondrial DNA and other components of the mitochondria, such as their proteins and lipids. This further compromises both oxidative phosphorylation and the repair processes in mitochondria, setting up a vicious cycle of degradation. Evidence is presented from inherited point mutations on the possibly most critical sites for mutations in mitochondrial DNA associated with hearing loss. It is suggested that random sorting and clonal expansion of mutations both maintain the integrity of the pool of mitochondrial DNA molecules and give rise to the apoptosis that leads to loss of vulnerable cells, and hence to deafness. It is moreover suggested that apoptosis of the vulnerable cells of the inner ear may to some extent be preventable, or at least delayed.
A Novel Mutation Identified in the DFNA5 Gene in a Dutch Family: A Clinical and Genetic Evaluation
Authors: Bischoff Anne M.L.C. , Luijendijk Mirjam W.J. , Huygen Patrick L.M. , van Duijnhoven Gerard , De Leenheer Els M.R. , Oudesluijs Grétel G. , van Laer Lut , Cremers Frans P.M. , Cremers Cor W.R.J. , Kremer Hannie
Published: December 2003

A novel DFNA5 mutation was found in a Dutch family, of which 37 members were examined. A nucleotide substitution was identified in the splice acceptor site of intron 7, leading to skipping of exon 8 in part of the transcripts. The mutation was found in 18 individuals. Sensorineural hearing impairment was non-syndromic and symmetric. In early life, presumably congenitally, hearing impairment amounted to 30 dB in the high frequencies. Progression was most pronounced at 1 kHz (1.8 dB/year). Speech recognition was relatively good with a phoneme score of about 50% at the age of 70. Onset age was 37 years, and recognition deteriorated by 1.3% per year. The recognition score deteriorated by 1.0% per decibel threshold increase from a mean pure-tone average (PTA at 1, 2 and 4 kHz) of 63 dB onwards. Vestibular function was generally normal. The second mutation identified in the DFNA5 gene results in hearing impairment, similar to that in the original DFNA5 family in terms of pure-tone thresholds, but with more favourable speech recognition.
Postnatal Development of GABAergic Synapses in the Nigral and Entopeduncular Afferent Territory of the Rat Thalamus
Authors: Kultas-Ilinsky K. , Verney C.
Published: December 2003

The time course of the development of GABAergic synapses in the basal ganglion afferent territories of the rat thalamus (the projection zones of the nigro- and entopedunculothalamic afferents) was analyzed at the electron microscopic level. The analysis was carried out in conventionally processed tissue and the tissue was processed for postembedding immunocytochemistry for GABA. It was primarily focused on the development of axosomatic synapses known as the main termination mode of the basal ganglion thalamic afferents. In neonatal rats (P0), small-to-medium-sized axons and large axonal growth cone-like GABA-immunoreactive structures were found engaged in symmetrical synapses with neuronal somata and proximal dendrites. At P7, the size of the axosomatic profiles was considerably increased and synapses appeared more mature. Between P7 and P14, there were numerous degenerating GABA-positive synaptic profiles displaying symmetrical synaptic contacts. Normal-looking GABA-positive terminals were large, extending for several micrometers along the somata and primary dendrites of thalamic neurons. By P21, these boutons acquired the appearance of axosomatic boutons in the adult, i.e., of a large elongated shape, numerous mitochondria, multiple synaptic contacts of pleomorphic vesicles and numerous puncta adherentia. The time course was different from the one described in the somatosensory thalamus by other authors, implying that anatomical and connectional differences between thalamic nuclei are also reflected in the patterns of their synaptogenesis.
Timing the Insult: Brainstem Necrosis
Authors: Stoltenburg-Didinger Gisela
Published: December 2003

Hypoxia-ischemia is the major cause of perinatal brain injury. The different types of damage are determined by the pathophysiology of the insult and the developmental neuroanatomy. We report lesions involving the basal ganglia, brain stem and spinal cord caused by circulatory failure in a preterm twin with a gestational age of 24 weeks. The child was born after prolonged umbilical cord compression. Death occurred at the age of 25 days. Autopsy showed columnar bilateral cavitation of the basal ganglia, diencephalon, brain stem and spinal grey matter together with focal calcifications in the pallidum, thalamus and brain stem.