bluuebunny/crossref_metadata_2025 huggingface dataset:
Testicular Sperm Extraction Combined with Cryopreservation of Testicular Tissue in the Treatment of Azoospermia
Authors: Trombetta C. , Liguori G. , Gianaroli L. , Magli M.C. , Selman H.A. , Colpi G. , Belgrano E. , Vitali G. , Ferraretti A.P.
Published: April 2003

Background: The aim of the present study was to verify the feasibility of cryopreserving testicular tissue during the first diagnostic biopsy and then using thawed sperm to inseminate the partner’s oocytes. The expected advantages are: (i) minimal risk of not having spermatozoa available at the time of intracytoplasmic sperm injection; (ii) no repeated surgical interventions, and (iii) programming the treatment cycle at the couple’s convenience. Materials and Methods: Between May 1996 and May 1998, 64 azoospermic patients underwent investigative testicular biopsy combined with cryopreservation of spermatozoa which were retrieved in a simultaneously examined fresh sample. Testicular tissue cryopreservation was carried out in 43 cases (67%) for later intracytoplasmic sperm injection attempts. Results: In all, 23 couples underwent 26 assisted conception cycles; the fertilization rate was 64% with spermatozoa (139/218, 24 cycles), 40% with round spermatids (2/5, 1 cycle), and 69% with elongated spermatids (9/13, 1 cycle). The embryo cleavage rate was 84%. The mean number of embryos replaced in 24 patients was 2.7 ± 0.7. In 2 cases, embryo quality was very poor, and they were not transferred to the patients. Eight clinical pregnancies resulted (35%/patient and 33%/transferred cycle) with an implantation rate of 14.1%; 2 patients have already delivered and 6 pregnancies are ongoing normally. Conclusions: Testicular tissue cryopreservation during the first diagnostic biopsy is an alternative to repeated surgical interventions. Patients can initiate an ovarian stimulation cycle, confident of having spermatozoa available. Moreover, since only one straw is routinely used for each intracytoplasmic sperm injection cycle, the frozen tissue remains as a sperm source for multiple attempts.
Inverted Papilloma Arising in a Juvenile
Authors: Miyajima Akira , Mochizuki Tsutomu , Seta Kaori , Mizuguchi Yasunori , Hayakawa Masamichi
Published: April 2003

A 15-year-old man presented with painless, gross hematuria. Excretory pyelography showed a filling defect in the bladder and ultrasonography revealed a solitary bladder tumor. Cystoscopy showed a solitary, papillary tumor on the bladder neck. Transurethral resection was then performed and histological examination showed an inverted papilloma. In addition, the expression of proliferative cellular nuclear antigen and p53 in the surgical specimen were 37.1 and 0%, respectively. Since an inverted papilloma arising during the first two decades of life is quite rare, we herein report the above case and review previous reports.
Transurethral Microwave Thermotherapy for Symptomatic Benign Prostatic Hyperplasia: Short-Term Experience with Prostcare
Authors: Tsai Yuh-Shyan , Lin Johnny S.N. , Tong Yat-Ching , Tzai Tzong-Shin , Yang Wen-Horng , Chang Chien-Cheng , Cheng Hong-Lin , Lin Yung-Ming , Jou Yeong-Chin
Published: April 2003

Purpose: To assess our short-term experience with transurethral microwave thermotherapy (TUMT) for symptomatic benign prostatic hyperplasia (BPH). Patients and Methods: From August 1993 through July 1994, in total 65 patients with symptomatic BPH were enrolled into this study. The patients’ ages ranged from 56 to 95 years with a mean of 70 years. Under local anesthesia with intraurethral instillation of Xylocaine jelly only, all patients received one session of TUMT for up to 60 min with Prostcare equipment. Uroflowmetry was performed and international prostatic symptom score (IPSS) determined before 3 and 6 months after TUMT for assessment of efficacy. All adverse events were recorded and evaluated for clinical relevance. Results: At 3 and 6 months following TUMT, the mean IPSS decreased from 19.7 ± 6.8 (baseline) to 12.8 ± 8.2 (–46%) and to 15.5 ± 9.0 (–21%), respectively; the maximal urine flow rate at 3 and 6 months increased from 9.1 ± 4.8 ml/s (baseline) to 11.0 ± 4.9 ml/s (+21%) and to 10.9 ± 5.6 ml/s (+19%), respectively. During TUMT, burning sensation was the most frequent complaint (38.5%), followed by urethral discomfort (29.2%) and urgency (9.2%). Two patients (3.1%) interrupted TUMT, because of intolerable pain. Following TUMT micturition pain (73.8%) and gross hematuria (45.9%) were the most adverse events. Most of these adverse events disappeared within 2 weeks. One patient suffered from skin erosion over the penoscrotal junction 1 week later. None had retrograde ejaculation; 1 patient complained of erectile dysfunction. Conclusion: Although the efficacy of TUMT with Prostcare became less prominent 6 months after TUMT, TUMT was still a tolerable, safe alternative treatment of BPH, especially in patients who were not suitable for transurethral resection of the prostate or anesthesia.
Renomedullary Interstitial Cell Tumor
Authors: Bircan Sema , Orhan Diclehan , Tulunay Özden , Şafak Mut
Published: April 2003

Renomedullary interstitial cell tumor was first introduced by Lerman and co-workers. These lesions have been referred to as medullary fibromas. The ultrastructural studies showed that the spindle cells throughout the stroma have the features of medullary interstitial cells. These benign tumors with specific histology are rare since they are incidental findings at autopsies. We report here a case of renomedullary interstitial cell tumor in a 55-year-old woman.
Carcinosarcoma in a Bladder Diverticulum
Authors: Sousa Escandón A. , Garcia R. , Argüelles M. , Maceiras F. , Perez-Valcarcel J.
Published: April 2003

Carcinosarcoma of the bladder is a rare neoplasm composed of a mixture of malignant epithelial and mesenchymal components. The presentation and clinical course of an infiltrating carcinosarcoma located in a bladder diverticulum coexisting with prostatic adenocarcinoma in a 69-year-old man are described. We believe this to be the fifth report of true carcinosarcoma appearing in a bladder diverticulum.
Ureteral Displacement due to a Migrated Intrauterine Contraceptive Device
Authors: Sirikci Akif , Sarica Kemal , Bayram Metin
Published: April 2003

Perforation of the uterus is rare but potentially fatal. During puerperium when the uterus is small and its wall is thin, the risk of perforation increases. We report a rare complication from an intrauterine contraceptive device (IUD) which caused deviation of the right ureter in a 31-year-old woman who presented with complaints of insomnia and abdominal pain. Our case shows that perforation of the uterus by an IUD can cause a silent urological complication. The possibility of ureteral involvement and displacement should be kept in mind in a woman in whom a missing IUD is encountered.
Extravesical Foreign Body Presenting as a Bladder Tumor
Authors: Kyriakou George , Kalahanis Nikolaos , Kyroudi-Voulgari Aspasia , Zervas Anastasios , Mitropoulos Dionisios
Published: April 2003

Although foreign bodies left in the abdominal cavity may remain asymptomatic for long periods, they may also cause serious complications. We present a case of gauze forgotten in the lower abdomen which remained asymptomatic for almost 1 year. When a granuloma had formed, it infiltrated the bladder wall giving the clinical and imaging appearance of an invasive bladder tumor.
Jungs Wurzeln – Überlegungen zur ideellen Grundlegung seiner Psychologie unter Traditions- und Gegenwartsaspekten
Authors: Lesmeister Roman
Published: April 2003

Der Beitrag gibt eine Übersicht über geistesgeschichtlich bedeutsame Strömungen des 19. Jahrhunderts, die auf Jungs Persönlichkeit und die Entstehung seiner psychologischen Ideen eingewirkt haben. Zunächst wird der Einfluss des Spiritismus untersucht, der ein wichtiger Bestandteil der geistigen Atmosphäre in Jungs Elternhaus war. Die Transformation von der spiritistischen Idee des Totengeistes zu den Konzepten von Archetypus und Komplex wird nachvollzogen. Es folgt eine Erörterung der Quellen, die Jungs Psychologie mit der Ideenwelt der romantischen Psychologie und Naturphilosophie (Carus) und des Deutschen Idealismus (Schelling) verbinden. Romantische Konzepte wie das des Vitalismus, der Polarität, der Urphänomene und ihrer Metamorphose werden hinsichtlich ihrer überragenden Bedeutung für die Grundlegung des Jungschen Denkens nachgewiesen. Theorie- und erkenntniskritisch wird die Frage des metaphysischen Charakters der Jungschen Psychologie diskutiert. Der dritte Teil befasst sich mit den Einflüssen Schopenhauers und Nietzsches. Die Postmodernität in Jungs Denken zeigt sich in seiner spezifischen Verarbeitung der nihilistischen Krise sowie der Krise des Subjektes, die in der Nachfolge Nietzsches einen hochaktuellen Beitrag zum Subjektverständnis und zum Standort des Individuums in einer pluralisierten, dezentrierten Welt darstellt.
Die Entwirklichung des Bösen
Authors: Emrich Hinderk M.
Published: April 2003

Im Hinblick auf die Tendenz der philosophischen Tradition des Psychologismus, die Dimension des Moralischen zu eliminieren, wird die Frage nach dem Verhältnis zwischen Wirklichkeitsbegriff und dem «Bösen» gestellt. Es zeigt sich, dass die Entwirklichung des Bösen durch Verabsolutierung psychologischer Mechanismen das Problem des Ethikverlustes massiv verstärken kann und dass eine spezifische Auffassung des Archetypischen im Menschen dem entgegenzuwirken vermag.
Multisensory Contributions to the Shelter-Seeking Behavior of a Mormyrid Fish, Gnathonemus petersii Günther (Mormyridae, Teleostei): The Role of Vision, and the Passive and Active Electrosenses
Authors: Rojas Roland , Moller Peter
Published: April 2003

This study examined how weakly electric fish, Gnathonemus petersii, integrate multiple sensory modalities (passive and active electrosenses, and vision) to maintain proximity to tubular structures, serving as the fish’s hiding place or shelter during the daytime. By moving the shelter along a linear 2-meter path, causing a mechanical disturbance, we challenged the fish’s shelter-seeking behavior and used the length of travel that shelter proximity was maintained (contact distance) as an indicator of how well the animal maintained its shelter. In order to determine the contribution of vision and electrosense to this behavior, four groups of fish were tested in which: (1) all three modalities were intact; (2) vision alone was eliminated by optic nerve transection; (3) the active electrosense was silenced by spinal cord transection rendering the electric organ inoperative; and (4) both vision and active electrosense were deactivated. Further elimination or minimization of various sensory cues was achieved by testing the fish with optically transparent, acrylic shelters (Plexiglas) that stimulate active, but not passive, electrosense, and aluminum shelters that theoretically stimulate all three modalities. As expected, performance was optimal when all three modalities were operating, but better than expected from quantitative models based on additive processes alone. Although the absence of one sense (vision or active electrosense) caused initial deficits, these were fully compensated for over repeated daily exposure to the task, suggesting that learning might generate sensory substitution and/or the formation of sensory expectation. Finally, environmental conditions, such as shelter opacity, also affected shelter-seeking performance, sometimes in a negative direction. These results demonstrate that: (1) the integration of multiple sensory inputs in G. petersii can be synergistic, additive, redundant, or even inhibitory, and (2) multisensory processes also take into account the respective sensory cues; i.e. (a) the prevailing ambient light intensity and optical qualities of the object; (b) the geometry and strength of the DC potential emanating from the object (‘battery effect’); and (c) the complex perceived impedance differential with the surrounding medium.
Multiple-Dose Pharmacokinetics and Excretion Balance of Gatifloxacin, a New Fluoroquinolone Antibiotic, following Oral Administration to Healthy Caucasian Volunteers
Authors: Mignot Alain , Guillaume Michel , Brault Muriel , Gualano Virginie , Millérioux Laurette , Göhler Karin , Stahlberg Hans-Juergen
Published: April 2003

The multiple-dose pharmacokinetics and excretion balance of gatifloxacin were evaluated in 42 healthy Caucasian volunteers. Following multiple oral doses of 400 and 600 mg, the pharmacokinetics of gatifloxacin were similar on days 1 and 15, suggesting no therapeutically relevant time-dependent changes in the pharmacokinetics of gatifloxacin at the doses and duration of dosing studied. Gatifloxacin was rapidly absorbed and a favourable elimination half-life of 7–8 h was evaluated. Saliva concentrations were similar to plasma concentrations. The main route of excretion is the urine. After a single dose of 400 mg of gatifloxacin, the recovery in urine was 83% and 5.2% in faeces. Following multiple doses of 400 or 600 mg, the renal excretion was 80 and 77%, respectively. The drug was well tolerated.
Influence of Mucin on the Activity of the Antiseptic Lavasept® against Staphylococcus aureus
Authors: Ansorg Rainer A.M. , Azem Tareq , Fabry Werner H. , Rath Peter-M.
Published: April 2003

Background: Lavasept®, containing the polymeric biguanide polyhexanide, may be effective against Staphylococcus aureus colonizing the nasal mucosa. To obtain basic data on its suitability for that purpose, its antimicrobial activity was examined in the presence of mucin. Methods: A disk diffusion test was applied using Mueller-Hinton agar, and disks soaked with a therapeutic and a 10-fold higher concentration of Lavasept. Commercially available mucin preparations from porcine stomach were added to the test system. Reference strains and 20 clinically isolates of S. aureus, and reference strains of Escherichia coli, Pseudomonas aeruginosa, Enterococcusfaecalis, and Candida albicans were tested. Results: Supplementation of the test medium with 1% mucin completely abolished the activity of disks loaded with the therapeutically used concentration of the antiseptic. The neutralizing effect of mucin occurred with all test strains. Conclusions: The inactivation of Lavaseptby mucin may hamper a reliable clearance of nasal S. aureus carriage.
Effect of Micafungin (FK463) on Candida albicans Adherence to Epithelial Cells
Authors: Borg-von Zepelin Margarete , Zaschke Karen , Gross Uwe , Monod Michel , Müller Frank-Michael C.
Published: April 2003

Background: Adherence is considered a major virulence trait of Candida albicans. FK463 is a new investigational intravenous antifungal of the ‘candin family’ with potent in vitro and in vivo activity against Candida spp. Objective: The aim of the present study was to investigate the effect of Micafungin (FK463) on Candida adherence to epithelial cells of azole-sensitive and azole-resistant C. albicans isolates. Methods: An in vitro assay using microtest plate technology and fluorescence measurement was developed to compare the adherence of C. albicans SC5314 and of paired C. albicans isolates to epithelial cells in the presence and in the absence of FK463. Results: FK463 showed a marked inhibitory effect on the adherence of C. albicans SC5314. The addition of FK463 reduced the adherence of C. albicans SC5314 to 90% of the value of control without drug. A dose-dependent adherence inhibition was observed with FK463 in the range of 10–0.015 µg ml–1. The comparison of paired C. albicans isolates, either a fluconazole-susceptible and a fluconazole-resistant isolate of one patient, revealed no significant difference in the adherence behavior between azole-susceptible and azole-resistant. Conclusion: Micafungin (FK463) has the capacity to reduce adherence of C. albicans azole-susceptible and azole-resistant strains to epithelial cells.
Infectious Endocarditis due to Yersinia enterocolitica
Authors: Karachalios G. , Bablekos G. , Karachaliou G. , Charalabopoulos A.K. , Charalabopoulos K.
Published: April 2003

Yersinia enterocolitica is a gram-negative coccobacillus. Y. enterocolitica infection is acquired by humans via the oral route. Infection due to Y. enterocolitica was first observed in 1933 in New York. Y. enterocolitica septicemia has been increasingly recognized in recent years, whereas endocarditis due to Y. enterocolitica is a rare manifestation. We herein describe a patient who developed Y. enterocolitica endocarditis and was successfully treated with a combination of drugs consisting of a quinolone (ofloxacin) and an aminoglycoside (netilmicin).
Education, Occupation, and Prevalence of Dementia: Findings from the Conselice Study
Authors: Ravaglia Giovanni , Forti Paola , Maioli Fabiola , Sacchetti Loredana , Mariani Erminia , Nativio Valeria , Talerico Teresa , Vettori Chiara , Macini Pier Luigi
Published: April 2003

Information about the epidemiology of dementia in Italy is still limited, although this cognitive disorder represents a serious public health concern. We estimated the prevalence of dementia and dementia subtypes in the elderly population of a Northern Italian municipality, Conselice, in the Emilia Romagna region (n = 1,016 subjects aged 65–97 years). The associations of dementia with two modifiable risk factors, education and occupation, were also evaluated. Overall dementia prevalence was 5.9% (95% confidence interval 4.3–7.8), exponentially increased with age, and was higher among women. Of the dementia cases, 50% were Alzheimer’s disease (AD), but an unusually high prevalence (45%) was found for vascular dementia (VD). After adjustment for age and gender, education but not occupation was associated with both AD and VD. This association could not be explained by occupation, life habits, and previous history of hypertension or cardiovascular disease.
Apotransferrin Decreases Migration and Enhances Differentiation of Oligodendroglial Progenitor Cells in an in vitro System
Authors: Paez Pablo M. , Marta Cecilia B. , Besio Moreno Marcos , Soto Eduardo F. , Pasquini Juana M.
Published: April 2003

We have previously shown that a single intracranial injection of apotransferrin (aTf) in neonatal rats produces an accelerated mylinogenesis and increases the expression of certain myelin proteins such as myelin basic protein (MBP). In the present work, we studied the effects of aTf upon oligodendrocyte progenitor cell (Opc) cultures. In the presence of aTf, cells developed a multipolar morphology and showed an increased expression of O4, MBP, O1 and myelin-associated glycoprotein compared to controls. Migration studies using the agarose drop assay showed that aTf strongly inhibited OPc migration. This effect was not observed when an antibody against the transferrin receptor was added. The expression of two cell adhesion molecules, neural cell adhesion molecule (NCAM), N-cadherin and of polysialylated NCAM (PSA-NCAM) was evaluated by immunocytochemistry and by Western blot. Although NCAM expression did not change, there was a significant increase in N-cadherin expression and a decrease in PSA-NCAM in the aTf-treated cells. Time lapse studies of the expression of PSA-NCAM as an indicator of migration and of MBP as a marker of differentiation showed that in the cultures treated with aTf there is first a decrease in the percentage of cells expressing the former molecule which is followed by an increase in the percentage of cells expressing MBP. These results suggest that aTf added in vitro to cultured OPcs inhibits first their migration and then enhances their differentiation.
Prenatal Diazepam Exposure Functionally Alters the GABAA Receptor That Modulates [3H]Noradrenaline Release from Rat Hippocampal Synaptosomes
Authors: Martire Maria , Altobelli Debora , Cannizzaro Carla , Maurizi Silvia , Preziosi Paolo
Published: April 2003

In rats, exposure to diazepam (DZ) during the last week of gestation is associated with behavioral alterations (in some cases sexually dimorphic) that appear when the animals reach adulthood. This study was conducted to evaluate the effects of prenatal DZ exposure on the function of the γ-aminobutyric (GABA)A receptor complex. The method used – perfusion of rat hippocampal nerve terminals labeled with [3H]noradrenaline (NA) – allowed us to evaluate the effects of DZ on a specific native GABAA receptor subtype which is located on hippocampal noradrenergic nerve endings and mediates the release of NA. Muscimol stimulated synaptosomal release of [3H]NA in a concentration-dependent manner; maximal stimulation (50%) was achieved with a concentration of 30 µM, and the ED50 was 1.7 µM. The effect of muscimol was potentiated by the positive allosteric modulators DZ and 3α-pregnan-5α-ol-20-one (3α,5α-P; allopregnanolone), which displayed similar maximal effects and affinities. In the presence of DZ (0.1 µM), muscimol stimulated the release of [3H]NA with an ED50 of 0.5 µM; in the presence of 3α,5α-P (0.1 µM), the ED50 of muscimol was 0.3 µM. Prenatal DZ exposure did not modify the concentration-effect curve for muscimol, but it did abolish the potentiating effects of DZ and 3α,5α-P. These findings demonstrate that prenatal exposure to DZ produces functional modifications of the GABAA receptor subtype we investigated. This effect may be related to the relative contributions of the various protein subunits that compose the GABAA receptor complex. Exposure to DZ while the GABAA receptors are developing might influence the expression of these subunits, giving rise to a receptor that can be activated by muscimol but is not susceptible to allosteric modulation by DZ or 3α,5α-P.
Notch Signaling Inhibits PC12 Cell Neurite Outgrowth via RBP-J-Dependent and -Independent Mechanisms
Authors: Levy Oren A. , Lah James J. , Levey Allan I.
Published: April 2003

The Notch signaling pathway has been implicated in the control of neurite extension, although the mechanisms are unknown. In this report, we studied the role of RBP-J/CBF-1 activation, the primary mediator of Notch signaling, in Notch-mediated regulation of neurite outgrowth in PC12 cells. Expression of constitutively active Notch proteins decreased neurite length and number after NGF treatment. In contrast, an inactive Notch protein had no effect on neurite extension. A dominant negative RBP-J construct prevented the reduction of neurite outgrowth by Notch. Conversely, an activated form of RBP-J decreased neurite length but failed to reduce neurite number. In summary, Notch activation inhibited PC12 cell neurite outgrowth by both RBP-J-dependent and -independent pathways.
Exercise-Induced ST Depression as a Prognostic Indicator of Cardiac Morbidity in Thrombolytic-Treated Post-Myocardial Infarction Patients with Silent Ischemia
Authors: Nielsen W.B. , Madsen J.K. , Grande P. , Saunamäki K. , Thayssen P. , Kassis E. , Eriksen U. , Aarøe J. , Haunsø S. , Nielsen T.T. , Haghfelt T.H.
Published: April 2003

Background: The significance of silent ischemia after acute myocardial infarction (MI) has been questioned. Objective: The aim of this study was to assess the risk for cardiac events in patients with silent ischemia after thrombolytic-treated first acute MI. Methods and Results: The Danish Trial in Acute Myocardial Infarction randomized 505 patients to conservative treatment after thrombolytic-treated first acute MI. For this analysis, patients were included if they demonstrated silent ischemia, i.e. ST deviations during exercise but without angina, during a symptom-limited bicycle exercise test. A total of 287 patients had silent postinfarct inducible ischemia. The 1-year incidence rate of combined cardiac endpoints, defined as death, reinfarction, need for revascularization or admission with unstable angina, was 22%. The level of maximum ST change during a stress test was used to categorize patients into three groups: group A: ST elevation (n = 54, 1-year event rate 15%); group B: >1 to <2 mm of ST depression (n = 86, 1-year event rate 22%); group C: >2 mm of ST depression during a stress test (n = 147, 1-year event rate 29%). Using a Cox proportional hazards model, the predictor of cardiovascular endpoints was the level of ST depression during a stress test (relative risk 2.4, 95% confidence limits 1.1–5.0, group C versus group A). Conclusion: This study identifies ST depression of more than 2 mm during a stress test as a significant risk factor for cardiac morbidity.
Gold Standard Treatment of Carotid Stenosis: Carotid Surgery or Stent?
Authors: Balzer K. , Müller K.M.
Published: April 2003

In carotid stenosis, conflicting conclusions have been drawn about the correlation between plaque morphology, patients’ embolic risk and its treatment by carotid endarterectomy when compared with angioplasty and stenting. In a prospective interdisciplinary study of 468 patients with carotid artery stenoses, we compared plaque morphology, examined by ultrasound, with the histological diagnosis. High-intensity transient signals (HITS) were detected by transcranial Doppler during carotid endarterectomy and carotid stenting. Preoperative ultrasound examinations were found to have a sensitivity of 80% in detecting soft and hard plaques. The accuracy for estimating the degree of stenosis was 98%. In the case of stroke in progression and complete stroke, histological examination found ulcerations in 72% of patients, whereas ultrasound had detected these ulcerations in only 53%. A significantly higher number of transient ischemic attacks and strokes occurred in patients with soft plaques than in asymptomatic patients, who tend to present with hard plaques. The number of HITS during carotid angioplasty and stenting was 8–10 times higher than during operation. Patients with soft plaques seem to have a higher risk of postoperative permanent neurological deficit. Dangerous plaque formation with thrombotic or ulcerous material was not accurately detected by ultrasound. Therefore the risk of embolisation cannot be predicted efficiently by means of Duplex scanning, which, however, is especially important for carotid stenting.
Impact of Treatment of Dyslipidemia on Renal Function, Fat Deposits and Scarring in Patients with Persistent Nephrotic Syndrome
Authors: Gheith Osama Ashry , Sobh Mohamed Abel-Kader , Mohamed Kefaia El-Sayed , El-Baz Mahmoud Abdo , El-Husseini Fatma , Gazarin Sana Sayed , Ahmed Hassan Abd-El-Hady , Rasem Mahmoud Wageh , Amer Galal Mohamed
Published: April 2003

In this study 43 patients with idiopathic nephrotic syndrome were randomly distributed into 2 age- and sex-matched groups. The first group was given fluvastatin while the second was used as control. The cases in the 2 groups were evaluated clinically, biochemically (creatinine clearance, albumin, 24-hour proteinuria, and lipogram), neurologically, and histopathologically (examination of renal biopsies obtained basally and after 1 year of treatment with fluvastatin). In the fluvastatin-treated group but not in the control group, we observed a significant reduction in cholesterol, low-density lipoprotein, and triglyceride. Clinical and laboratory assessment showed satisfactory tolerance of the drug by the patients. Proteinuria, serum albumin and creatinine clearance values were significantly better in the statin-treated patients. There was no difference in glomerular sclerosis between the 2 groups while interstitial fibrosis and renal fat deposits were less in the statin-treated group. The reduction in renal fat deposits in the statin-treated group was highly significant, while that of interstitial fibrosis was not. We conclude that: (1) statin can be safely and effectively used in the treatment of dyslipidemia in patients with persistent idiopathic nephrotic syndrome; (2) control of dyslipidemia in nephrotic patients is associated with better control of proteinuria and creatinine clearance; (3) statin treatment may cause regression of renal fat deposits in patients with nephrotic syndrome, and (4) longer term studies are still required to study further possible beneficial effects on renal histology and disease progression.
Effect of Fasting for Two Days on the Excretion of Ammonium in Dogs with Chronic Metabolic Acidosis
Authors: Halperin Mitchell L. , Cheema-Dhadli Surinder , Chen Ching-Bun
Published: April 2003

Background: The source of glutamine for renal ammonium production is ultimately dietary protein in the fed state and body proteins in fasting. Objective: Our objective was to determine if less NH+4 would be excreted by fasted dogs with chronic metabolic acidosis resulting in conservation of lean body mass. Methods: Acid-loaded fed and fasted dogs were given 10 mmol NH4Cl/kg for 5 days; the fasted group had food withheld on days 4 and 5. Results: The renal production of NH+4 was not significantly different in both acid-loaded groups, yet the rate of NH+4 excretion was significantly lower in the fasted dogs (8 vs. 21 mmol NH+4/mmol creatinine). The urine pH was significantly higher (6.0 versus 5.5) while titratable acid and the urine flow rate were significantly lower in these fasted dogs. Despite nearly equal urine flow rates and Na+ excretion rates after an infusion of saline, the fasted dogs failed to increase the rate of excretion of NH+4 to rates seen in the fed group. Conclusions: The lower rate of excretion of NH+4 in fasted, acidotic dogs appeared to be due to a lower distal H+ secretion. This may help preserve lean body mass during fasting.
Syndrome of Inappropriate Secretion of Antidiuretic Hormone due to Malignant Thymoma
Authors: Galesic K. , Krizanac S. , Vrkljan M. , Ljubanovic D.
Published: April 2003

The authors present the case of a 51-year-old female with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to a malignant thymoma. Laboratory examinations of the patient showed hyponatremia, plasma hypoosmolarity in the presence of concentrated urine and normal urine excretion of sodium. CT revealed a mass lesion in the mediastinum. A biopsy of the mediastinal mass was performed and the diagnosis of thymoma with SIADH was established. This is a rare description of a malignant thymoma associated with SIADH.
Correlation between Laminin-5 γ2 Chain Expression and Epidermal Growth Factor Receptor Expression and Its Clinicopathological Significance in Squamous Cell Carcinoma of the Tongue
Authors: Katoh Kazuhide , Nakanishi Yukihiro , Akimoto Shingo , Yoshimura Kimio , Takagi Minoru , Sakamoto Michiie , Hirohashi Setsuo
Published: April 2003

Recent investigations have revealed that growth factors may influence the invasive activity of tumor cells. Expression of laminin-5 γ2 chain (LN-5 γ2) and epidermal growth factor receptor (EGFR) in squamous cell carcinomas of the tongue in 104 patients with stage II, III, and IVA, B (excluding the cases with distant metastasis) was examined immunohistochemically to determine the correlation between the two molecules and the associations with the clinicopathological features of each tumor. LN-5 γ2 expression was clearly demonstrated in the cytoplasm and EGFR in the cell membranes of cancer cells. A significant increase in positivity for LN-5 γ2 was observed in tumors showing poor differentiation (p < 0.001), infiltrative growth (p < 0.001), and deep invasion (p = 0.038). In a multivariate analysis, increased positivity for LN-5 γ2 was an independent predictor of an unfavorable outcome (p < 0.001). A significant increase in positivity for EGFR was observed in tumors showing infiltrative growth (p = 0.032) and poor prognosis (p = 0.008). The LN-5 γ2 expression was correlated significantly with EGFR expression (p < 0.001). Patients with tumor positivity for both molecules showed the worst prognosis (p < 0.001). LN-5 γ2 overexpression and EGFR overexpression is evident in tumors showing infiltrative growth, suggesting that EGFR may influence the invasive activity of tumor cells through overexpression of LN-5 γ2.
Prognostic Factors in Children and Adolescents with Low-Grade Oligodendrogliomas
Authors: Bowers Daniel C. , Mulne Arlynn F. , Weprin Bradley , Bruce Derek A. , Shapiro Kenneth , Margraf Linda R.
Published: April 2003

Few reports exist describing the progression-free and overall survival of children with low-grade (WHO grade II) oligodendrogliomas treated uniformly with aggressive surgery but without adjuvant chemotherapy or radiation therapy. Furthermore, significant prognostic features, including the MIB-1 labeling index (LI), have not been reported for children with oligodendrogliomas. The medical records of 20 consecutive patients with low-grade oligodendrogliomas were reviewed. All patients had been treated with aggressive surgical resection. Adjuvant chemotherapy and radiation therapy were reserved for radiographic or clinical progression. These patients have been followed for a median of 5.5 years (range 0.5–11.5 years) after diagnosis. To date, there have been no patient deaths. Six of the 20 patients experienced tumor progression at a median of 2.2 years (range 0.4–4.8 years) following the initial surgery. The MIB-1 LI was infrequently greater than 5. Of several prognostic factors for subsequent tumor progression that were examined, only tumors located within the parietal lobes were associated with a worse progression-free survival. Other risk factors, including presenting symptoms, age at diagnosis, MIB-1 LI and the extent of tumor resection, were not associated with an increased frequency of tumor progression.
Zwischenbericht über die Anwendung des ‘Advanced Breast Biopsy Instrumentation’- Systems im Rahmen einer Multizenterstudie
Authors: Kwasny W. , Tausch C. , Haid A. , Stierer M. , Konstantiniuk P. , Wayand U. , Sevelda P.
Published: April 2003

Im Rahmen einer österreichischen Multizenterstudie wurden zwischen September 1998 und Dezember 2001 474 Eingriffe mit der Advanced Breast Biopsy Instrumentation (ABBI) dokumentiert und davon 389 in das Protokoll aufgenommen. Die stereotaktische Exzisionsbiopsie mit dem ABBI-System stellt auf Grund des Patientinnenkomforts, der radiologischen Genauigkeit und der komplikationsarmen Anwendung eine sinnvolle Alternative zur offenen Biopsie nicht tastbarer Brustläsionen dar. Es gibt jedoch technische Einschränkungen. Die Frage der therapeutischen Option beim Mammakarzinom muss vorerst noch unbeantwortet bleiben.
Vorteile und Grenzen der Brust-Ultraschalldiagnostik
Authors: Madjar Helmut
Published: April 2003

Die Indikationen für den Einsatz der Mammasonographie haben sich in den letzten Jahren hauptsächlich aufgrund der technischen Weiterentwicklung und Qualitätsverbesserung der Ultraschallgeräte ständig erweitert. Dies betrifft die Tumordifferenzierung, das präoperative Staging, die Nachsorge und die interventionelle Diagnostik. Die Vorsorge bezüglich eines flächendeckenden populationsbezogenen Screenings wird nach wie vor ausschliesslich durch die Mammographie gewährleistet, jedoch ermöglicht der hochauflösende qualitätsgesicherte Ultraschall auch auf dem Gebiet der Früherkennung eine Verbesserung. Dies kann in Risikosituationen und bei Patientinnen mit mammographisch schwierigen Parenchymverhältnissen die Diagnostik erheblich verbessern. Bevor die hier diskutierten Indikationen jedoch der Allgemeinheit angeboten werden können, müssen die gerätetechnischen Mindestanforderungen und die Untersuchungsstandards klar definiert und überprüft werden.
Difficult Decisions: Social and Ethical Implications of Changing Medical Technology
Authors: Chapman Elizabeth
Published: April 2003

Objectives: A primary objective of this paper is to present data on subjective perceptions of health and quality of life in individuals living with early- or late-onset genetic conditions (cystic fibrosis, CF, and Huntington’s disease, HD, respectively). The paper will also discuss the social and ethical dilemmas raised by advances in reproductive and testing technology, consider the different emphases in definitions of quality of life, and speculate on criteria used to make reproductive decisions following prenatal testing. Methods: Adults suffering from CF and HD attending two regional centres in the UK took part in semi-structured interviews between late 1999 and summer 2001. Self-report data on how a specific body image is constructed were also collected. Interviews were analysed using thematic qualitative analysis, and the body data were analysed using SPSS. Results: Qualitative analysis uncovered themes relating to the question of how we value life, and exposed broad ethical dilemmas arising from advances in testing and treatment technology. These data are supported by findings from a body chart analysis that highlight a discrepancy between the quality of life experienced by this group of respondents and the way they believe the wider public perceives them, particularly in reference to pain. Conclusions: Although some of the data support previous findings, such as the disability paradox, other voices contradict this view. Due to their unique experiences, the accounts of individuals currently living with genetic conditions should be considered in the wider bio-ethical debates.
High-Density Oligonucleotide Array Analysis of mRNA Transcripts in Peripheral Blood Cells of Severe Atopic Dermatitis Patients
Authors: Heishi Masayuki , Kagaya Shinji , Katsunuma Toshio , Nakajima Toshiharu , Yuki Keisuke , Akasawa Akira , Maeda Miyako , Gunji Shigemiti , Sugita Yuji , Tsujimoto Gozoh , Saito Hirohisa
Published: April 2003

Background: There are few laboratory tests for evaluating atopic dermatitis (AD) with the exception of IgE levels or the eosinophil count. We attempted to identify new diagnostic markers by screening the genome-wide expression of transcripts in peripheral blood mononuclear cells (PBMC). Methods: For this study, we enrolled 7 nonatopic healthy volunteers, 5 AD patients who responded well to treatment and 6 who responded poorly. We compared genome-wide transcript levels in PBMC derived from patients with severe AD and healthy volunteers using high-density oligonucleotide arrays (GeneChip, Affymetrix). After the first screening with GeneChip, we employed real-time quantitative PCR to confirm differential expression levels. Results: Screening with GeneChip showed that the levels of a total of 92 transcripts increased at least 3-fold in one population compared to another. After further evaluation of these genes with real-time quantitative PCR, the levels of 4 transcripts were confirmed to be significantly different in PBMC from AD patients compared to controls, namely IFN-γ, TRAIL (TNF-related apoptosis-inducing ligand), ISGF-3 (STAT1) and defensin-1. With the exception of IFN-γ, none of these genes has previously been implicated in AD pathology. Conclusion: These 4 transcripts in PBMC are expected to be useful markers for evaluating AD.
Autonomic Regulation of Experimental Autoimmune Encephalomyelitis: The Role of Interferon-γ
Authors: Pál Endre , Tabira Takeshi
Published: April 2003

Objective: The effect of chemical sympathectomy on experimental autoimmune encephalomyelitis (EAE) was studied in interferon-γ (IFN-γ) knockout C57BL/6 mice. Methods: Mice were immunized with myelin oligodendrocyte glycoprotein (MOG)35–55 peptide. Sympathectomy was achieved by subcutaneous administration of 6-hydroxydopamine. Results: We showed previously that wild-type mice developed a mild form of EAE with complete recovery. Sympathectomy caused more serious disease and mice did not recover completely, indicating that the sympathetic nervous system (SNS) downmodulates the process of EAE. The clinical signs of disease were more serious in untreated IFN-γ–/– mice than in wild-type animals. Unexpectedly, sympathectomy resulted in suppression of active EAE in IFN-γ–/– mice, implying that control of actively induced EAE by the SNS depends on INF-γ and the integrity of the cytokine network. We also induced EAE by passive transfer of MOG35–55-reactive lymph node cells, and this disease was aggravated by sympathectomy in both wild-type and knockout animals. Conclusions: Our study supports the idea that the integrity of the whole cytokine network is necessary to maintain normal nervous-immune system interactions.
Feedback between Glial Tumor Necrosis Factor-α and gp120 from HIV-Infected Cells Helps Maintain Infection and Destroy Neurons
Authors: Kast Richard E.
Published: April 2003

An envelope glycoprotein, gp20, of the human immunodeficiency virus (HIV) interacts with host systems to promote HIV replication. gp120 is also involved in tissue-destructive positive feedback cycles that contribute to HIV-related but non-lymphocytic-, non-immunodeficiency-related tissue-destructive morbidity. Exposure to gp120 results in tumor necrosis factor-α (TNF) upregulation, particularly in cells of monocyte lineage. The resultant increased TNF in the microenvironment of the TNF-producing monocyte lineage cells results in increased occupancy of TNF receptors on nearby lymphocytes, monocytes or glia in which HIV does replicate. Such TNF binding increases HIV replication. Increased replication results in increased gp120 available to bind to monocyte lineage cells, further increasing or maintaining those cells’ TNF production in the face of other TNF suppressive forces. A trophic environment (TNF) for HIV replication is thereby maintained. gp120 raises cAMP levels. Increased cAMP is inherently TNF-suppressive. This is a moderating negative feedback element embedded within the larger positive feedback cycle. HIV does not effectively replicate in neurons yet many HIV infections show significant neuron loss. gp120 stimulates glia to synthesize TNF. Increased TNF stimulates HIV to replicate in the cells present in which HIV is able to replicate. TNF also damages nearby neurons. The resultant increased gp120 would further stimulate glia, and the stimulated glia’s TNF would damage local neurons. Damaged neurons make factors that activate glia to upregulate TNF synthesis. These feedback cycles centering on gp120 and TNF contribute to HIV pathophysiology, neuron loss and maintenance of infection.
Peritoneal Membrane Failure in Peritoneal Dialysis Patients
Authors: Krediet Raymond T. , van Esch Sadie , Smit Watske , Michels Wieneke M. , Zweers Machteld M. , Ho-dac-Pannekeet Marja M. , Struijk Dirk G.
Published: April 2003

A review is given of the conditions associated with peritoneal membrane failure, and the possible causes. Ultrafiltration failure is the most important manifestation. It is mostly associated with high transport rates of low molecular weight solutes suggesting the presence of a large vascular surface area. Enlargement of the peritoneal surface area can be functional (effective surface area: more perfused microvessels) or anatomic (more microvessels). The former is likely to be present in some patients in the beginning of peritoneal dialysis, and also during peritonitis. The latter can develop in long-term peritoneal dialysis.
Advanced Oxidation Protein Products, Parathyroid Hormone and Vascular Calcification in Uremia
Authors: Drüeke Tilman B. , Massy Ziad A.
Published: April 2003

Vascular calcification is a frequent complication of uremic patients. In addition to classical risk factors such as age, male gender, smoking, inflammation, hypertension, dyslipidemia, and diabetes, which also exist in the general population, patients with chronic renal failure have other risk factors such as oxidative stress, inflammation, hyperparathyroidism, hypoparathyroidism, hypercalcemia, hyperphosphatemia, and overtreatment with calcium and vitamin D. These latter risk factors may even have a better predictive value than classical risk factors for coronary heart disease in uremic patients.
Distribution of NADPH-Diaphorase/Nitric Oxide Synthase in the Brain of the Caecilian Dermophis mexicanus (Amphibia: Gymnophiona): Comparative Aspects in Amphibians
Authors: González Agustín , Moreno Nerea , López Jesús M.
Published: April 2003

The organization of nitrergic systems in the brains of anuran and urodele amphibians was recently studied and significant differences were noted between both amphibian orders. However, comparable data are not available for the third order of amphibians, the gymnophionans (caecilians). In the present study we have investigated the distribution of neuronal elements that express nitric oxide synthase (NOS) in the brain of the gymnophionan amphibian Dermophis mexicanus by means of immunohistochemistry with specific antibodies against NOS and enzyme histochemistry for NADPH-diaphorase. Both techniques yielded identical results and were equally suitable to demonstrate the nitrergic system. In addition, they were useful tools in the identification of cell groups and brain structures, otherwise indistinct in the brains of caecilians. The distribution of nitrergic structures observed in Dermophis conforms to the overall amphibian pattern but numerous distinct peculiarities were also noted. These included a dense innervation of the olfactory bulbs but a lack of reactivity in olfactory and vomeronasal fibers and glomeruli. A large population of nitrergic cells in the striatum and the presence of thalamic neurons, as well as the specific distribution of nitrergic cells in the isthmic region, are some of the differential features in the gymnophionan brain. Given the variability among species in the same class of vertebrates any discussion including amphibians should also include evidence for gymnophionans.
Anterograde Projections of the Motorcortical Tongue Area in the Saddle-Back Tamarin (Saguinus fuscicollis)
Authors: Alipour Mehrnaz , Chen Yan , Jürgens Uwe
Published: April 2003

In the New World monkey Saguinus fuscicollis, the anterograde projections of the motorcortical tongue area were studied. Three animals were analyzed. In two, biotin dextran amine was used as tracer; in the third, Phaseolus vulgaris leucoagglutinin was used. Identification of the tongue area was carried out by electrical brain stimulation. Intracortical projections were found into the neighboring primary motor cortex, ventral premotor cortex, frontoopercular cortex, and primary and secondary somatosensory cortex. Projections also ended in the ventrolateral prefrontal cortex, orbital cortex, supplementary motor area, anterior cingulate cortex and agranular as well as granular insula. In addition, weaker labeling was found in the inferior and dorsal parietal cortex, and perirhinal and inferotemporal cortex. Subcortically, there was a heavy projection into the ventral putamen, a moderate projection into the caudate nucleus and claustrum, and a weak projection into the anterior, central and lateral amygdala. In the thalamus, terminal labeling was found in the nuclei ventralis posterior medialis, ventralis lateralis, reticularis, centralis lateralis, medialis dorsalis, pulvinaris oralis, centrum medianum, reuniens and suprageniculatus in an order of intensity. Subthalamically, weak projections could be traced into the zona incerta and lateral hypothalamus. In the midbrain, labeling was found in the deep layers of the colliculus superior, area praetectalis, dorsal reticular formation and, very sparsely, in the periaqueductal gray. In the lower brainstem, fibers ended in the griseum pontis, medial and lateral parabrachial nuclei, lateral pontine and medullary reticular formation, paramedian and dorsal reticular nuclei, solitary tract nucleus and principal as well as spinal trigeminal nuclei. No terminals were found in the hypoglossal nucleus itself; there were, however, terminals in the immediately bordering reticular formation.