bluuebunny/crossref_metadata_2025 huggingface dataset:
Aminopeptidase A Expression in Cervical Neoplasia and Its Relationship to Neoplastic Transformation and Progression
Authors: Fujimura Hidehiko , Ino Kazuhiko , Nagasaka Tetsuro , Nakashima Nobuo , Nakazato Hiroshi , Kikkawa Fumitaka , Mizutani Shigehiko
Published: April 2003

Aminopeptidase A (AP-A) is a cell surface metallopeptidase which specifically cleaves the amino-terminal acidic residue from peptide substrates such as angiotensin II. AP-A is identical to the differentiation-related antigen, murine BP-1 or human kidney gp160, and is involved in regulating cell differentiation and/or neoplastic transformation of certain normal and transformed cells. We examined expression of AP-A in premalignant and malignant lesions of the uterine cervix, and investigated whether its expression was related to disease progression and neoplastic transformation. Formalin-fixed, paraffin-embedded tissue sections including 14 cervical intraepithelial neoplasms (CIN) and 23 invasive squamous cell carcinomas (SCC) were immunohistochemically evaluated. AP-A was localized in the basal cell layer in normal squamous epithelium. In CIN, AP-A expression was found on dysplastic cells, and increased with the severity of the precancerous lesions. In invasive cancer, 18 of 19 non-keratinizing-type SCCs and none of 4 keratinizing-type SCCs expressed AP-A. In addition, AP-A immunoreactivity was significantly correlated with proliferating cell nuclear antigen expression in both CIN and SCC cases. Furthermore, angiotensin II type 1 receptor was present in all AP-A-positive SCCs. These results indicate that AP-A is upregulated as the lesion progresses toward carcinoma in the cervical epithelium, and suggest that AP-A may play a regulatory role in neoplastic transformation and disease progression in cervical neoplasms and may serve as a potential tumor marker during cervical neoplasia development.
High Percentage of False-Positive Results of Cytokeratin 19 RT-PCR in Blood: A Model for the Analysis of Illegitimate Gene Expression
Authors: Ko Yon , Grünewald Elisabeth , Totzke Gudrun , Klinz Michael , Fronhoffs Stefan , Gouni-Berthold Ioanna , Sachinidis Agapios , Vetter Hans
Published: April 2003

Cytokeratin 19 (CK19) RT-PCR is widely used in order to detect circulating tumor cells in peripheral blood and bone marrow. However, increasing amounts of information support the fact that it is also associated with a high percentage of false-positive results. In our study, we not only managed to demonstrate the significant limitations of this method, but were also able to clarify the reasons behind these limitations. We developed a completely novel RT-PCR for CK19 and sequenced an intron at nucleotide (nt) 980 of the CK19 mRNA to exclude DNA contamination. Tumor dilution experiments were performed in order to analyze the specificity and sensitivity of the method. Control experiments using the blood of healthy donors were performed. Tumor cell dilution experiments gave a detection limit of one tumor cell. If tumor cells were mixed with an equal volume of pure mononuclear cells, the detection limit was 1 tumor cell in 105 mononuclear cells. RT-PCR of mononuclear cells from healthy blood donors gave false-positive results in 29% of the cases. We conclude that a significant decrease in the sensitivity of CK19 RT-PCR occurs if it is performed in blood cells and that the illegitimate CK19 gene expression in normal cells can lead to false-positive results. These limitations have to be taken into account if RT-PCR is to be used for the detection of tumor cells either in blood or in bone marrow in clinical practice.
Weekly 24-Hour Infusion of High-Dose 5-Fluorouracil plus Folinic Acid in Combination with Mitomycin C for the Treatment of Advanced Gastric Cancer
Authors: Kretzschmar Albrecht , Reichardt Peter , Thuss-Patience Peter C. , Hohenberger Peter , Benter Thomas , Dörken Bernd , Köhne Claus-Henning
Published: April 2003

Purpose: This study was performed to investigate the activity and safety of high dose 5-fluorouracil (5-FU) given as a weekly 24-hour infusion in combination with folinic acid plus mitomycin C in patients with advanced gastric cancer. Patients and Methods: Chemonaive patients with locally advanced inoperable, recurrent or metastatic gastric cancer were treated with 15 mg/m2 i.v. mitomycin C as bolus on day 1 of a 7-week cycle followed by a 2-hour infusion of folinic acid (500 mg/m2) and a 24-hour infusion of 5-FU (2,600 mg/m2) given on days 1, 8, 15, 22, 29, and 36 as outpatient treatment. Results: Thirty evaluable patients (median age 58 years and median ECOG performance status 1) received 1–4 cycles (median 3). 53% of the patients had liver metastases. Treatment-related toxicity was low with 10% of patients experiencing diarrhea ≥grade 3, 3% mucositis grade 3 and 3% nausea grade 3 (CTC). Hematological toxicity was mild with 13% thrombopenia grade 3 and no leukopenia grade 4. Eleven patients achieved a partial remission (major response rate 37%; 95% confidence interval 22–53%). Median time to progression was 5 months and median overall survival time was 7 months. Conclusion: This regimen is a well-tolerated outpatient treatment for patients with advanced gastric cancer with efficacy being comparable to other chemotherapy protocols.
bcl-2 Expression in Cholangiocellular Carcinoma Is Inversely Correlated with Biologically Aggressive Phenotypes
Authors: Ito Yasuhiro , Takeda Tsutomu , Sasaki Yo , Sakon Masato , Monden Morito , Yamada Terumasa , Ishiguro Shingo , Imaoka Shingi , Tsujimoto Masahiko , Matsuura Nariaki
Published: April 2003

bcl-2 is known to play a crucial role in modulating carcinoma progression as well as in inhibiting apoptosis. However, its expression and clinical significance for cholangiocellular carcinoma (CCC) remains unclear. In the present study, we immunohistochemically investigated bcl-2 expression in 41 CCC. Thirteen cases (31.7%) were classified as bcl-2 positive, because more than 10% of the carcinoma cells expressed bcl-2. The expression of bcl-2 was inversely related to lymph node metastasis, vascular invasion, perineural invasion, the Ki-67 labeling index, aberrant p53 expression and the incidence of apoptotic cells. Furthermore, well or moderately differentiated carcinoma more frequently expressed bcl-2. These results suggest that downregulation of bcl-2 expression is strongly linked to highly biologically aggressive phenotypes of CCC.
Cytoplasmic Beta-Catenin Accumulation as a Predictor of Hematogenous Metastasis in Human Colorectal Cancer
Authors: Maruyama Keiji , Ochiai Atsushi , Akimoto Shingo , Nakamura Satoshi , Baba Shozo , Moriya Yoshihiro , Hirohashi Setsuo
Published: April 2003

The membranous, cytoplasmic and nuclear levels of beta-catenin were evaluated immunohistochemically in archival tissue specimens from 96 Japanese patients with primary colorectal carcinoma who had undergone surgery. The relationships between beta-catenin and clinicopathological variables were analyzed statistically. Reduced beta-catenin immunoreactivity in the cell membranes of cancer cells was found in 70% of the tumors, and cytoplasmic and nuclear accumulation of beta-catenin were found in 68 and 66% of tumors, respectively. Significant correlations between cytoplasmic beta-catenin accumulation and the depth of invasion, venous invasion and focal dedifferentiation were observed. Cytoplasmic beta-catenin accumulation was also found to be a useful predictor of hematogenous metastasis (hazard ratio = 8.94, p = 0.054), though neither a reduced cell membrane level nor nuclear accumulation of beta-catenin correlated with metastasis.
Relationship of Cosmetic Disfigurement to the Severity of Posttraumatic Stress Disorder in Burn Injury or Digital Amputation
Authors: Fukunishi Isao
Published: April 2003

Background: The purpose of this study was to examine the relationships of physical factors including physical functioning and cosmesis to posttraumatic stress disorder (PTSD) symptoms in patients with burn injury and in patients with digital amputation. Methods: Subjects were 56 patients with burn injury and 26 patients with digital amputation. In addition to assessments of physical factors, psychiatric interviews were administered to examine mental disorders including PTSD and major depression. Results: The prevalence rates of PTSD and major depression were 33.9 and 7.1% in burn-injured patients and 18.5 and 7.4% in patients with digital amputation respectively. Multivariate analysis of variance (MANOVA) revealed that, regardless of the severity of burn injury such as percentage of total body surface burned, female victims with cosmetic disfigurement (i.e., facial burn) exhibited PTSD symptoms, in particular PTSD symptoms of avoidance and emotional numbing. For subjects with digital amputation, MANOVA indicated that, regardless of the degree of physical functioning after replantation, female victims with cosmetic disfigurement exhibited PTSD symptoms. Discussion: These findings suggest that, in female victims with burn injury and/or digital amputation, the degree of cosmetic disfigurement is related to the manifestation of PTSD symptoms of avoidance and emotional numbing.
Iron-Manganese Interactions in the Evolution of Iron Deficiency
Authors: Rodríguez-Matas M.C. , Campos M.S. , López-Aliaga I. , Gómez-Ayala A.E. , Lisbona F.
Published: April 2003

This article examines the evolution of nutritional iron deficiency and the possible interactions with other minerals, such as manganese, in control and iron-deficient rats. The evolution of iron deficiency was studied at 0, 10, 20, 30 and 40 days of providing the animals with an iron-free diet (diet 0). It was found that the critical period in the development of nutritional iron deficiency occurs after 30–40 days without iron, at which moment the organism is unable to maintain hemoglobin levels without endangering the iron-dependent enzymatic groups which, in turn, are essential for life. It was also demonstrated that in a situation of iron deficiency, there occurs a greater absorption of manganese. It should be noted that this greater absorption of manganese is not reflected in the concentration of the mineral in the organs. Therefore, it is evident that the interactions of iron with manganese take place at the digestive level with no apparent consequences being observed at the metabolic level.
Study Design of a TotalReference Diet for a Population inNorthern Italy
Authors: Ciappellano S. , Roggi C. , Baggio C. , Lanza M.P. , Erba D. , Maccarini L. , Brighenti F. , Testolin G.
Published: April 2003

A market based of 91 food items was purchased in Northern Italy, based on a list taken from a food survey previously conducted in the same area. The food items from the survey were grouped into 14 categories. Food samples were collected, homogenized, and frozen for the analysis of both the nutrient content and the levels of mineral contaminants. The study design and decision processes behind the choice of type and quantity of each food are explained. The relative quantities of each food group were compared with those from two similar studies. Finally, energy, nutrients, and mineral contaminants obtained by direct analysis were compared with the calculations given on the food composition tables. The comparison between the analyzed and calculated data only showed marked differences in phosphorus, sodium, potassium, and copper intakes.
Olive Oil Supplementation in Healthy Adults: Effects in Cell Membrane Fatty Acid Composition and Platelet Function
Authors: Vicario Isabel M. , Malkova Dala , Lund Elizabeth K. , Johnson Ian T.
Published: April 2003

Ten healthy volunteers were given a daily supplement of 30 g olive oil for 6 weeks in order to evaluate how it would affect cell membrane composition and ultimately platelet function. Fasting blood and cheek cell samples were taken before commencing the study, after 21 and 42 days of supplementation and also at 30 days after finishing the supplement (washout). C18:1n-9 was significantly increased (p < 0.01) in platelet and cheek cell phospholipids. Erythrocytes were not good markers for C18:1n-9 intake and no significant change was found in this tissue. There was a small nonsignificant decrease in platelet phospholipid 20:4n-6 after the supplementation, in accordance with previously published results. C18:1n-9 did not persist in platelet membranes after the volunteers stopped consuming the olive oil supplement, but in erythrocytes a significant increase (p < 0.05) was found after the washout period. None of these changes in fatty acid composition in the different tissues were related to significant changes in serum cholesterol-related variables or in clotting factors or adenosine diphosphate-induced platelet aggregation.
Hepatic Glycogen and Lactate Handling in Dietary Obese Rats
Authors: Lladó Isabel , Palou Andreu , Pons Antoni
Published: April 2003

Hepatic balances for glucose and its precursor, lactate, were calculated by measuring hepatic blood flows and the arteriovenous differences of these metabolites in 2 groups of overweight rats: cafeteria diet-fed rats and post-cafeteria rats. Obese rats show abnormal hepatic glycogen handling, since they do not mobilize all hepatic glycogen stores after 24-hour starvation, in a situation in which a lower rate of hepatic glucose output and a higher capacity for lactate uptake are attained. The important decrease (about 50%) in the hepatic blood flows observed in post-cafeteria rats versus control rats was similar to that caused by 24-hour starvation in control animals, suggesting that after withdrawal of the cafeteria diet, the liver blood flow of the post-cafeteria rats was adapted to the low-food intake in order to make better use of the energy consumed. The results also suggest an increased efficiency of hepatic lactate uptake in post-cafeteria rats.
Genistein-Induced Changes in Lipid Metabolism of Ovariectomized Rats
Authors: Nogowski Leszek , Maćkowiak Paweł , Kandulska Katarzyna , Szkudelski Tomasz , Nowak Krzysztof W.
Published: April 2003

The effect of the isoflavone, genistein, on the lipid metabolism of ovariectomized rats was studied. Three types of experiments were performed. In the first one, the rats were fed diets supplemented with 0.01 or 0.1% of genistein for 14 days. In the second and third experiments, the direct effect of genistein on the liver and fat tissue were measured respectively by means of liver perfusion or incubation of isolated adipocytes with the isoflavone. Genistein in food significantly decreased blood serum and muscle triglyceride concentrations and increased the level of free fatty acids in serum. Serum free cholesterol was diminished and liver cholesterol was enhanced after genistein ingestion. When genistein acted directly on the liver during perfusion, a smaller incorporation of 14C-glucose into lipids was observed, and in parallel a greater output of free fatty acids into the medium was noticed. These changes were accompanied by diminution of the liver triglyceride contents. Genistein, acting on the adipocytes strongly depressed both basal and insulin-induced lipid synthesis, when glucose was used as a substrate. The effect of the isoflavone alone on the lipolysis in the adipocytes was negligible. However, it intensified lipolysis induced by epinephrine. The results obtained let us conclude that genistein in food can reduce the fattening processes in ovariectomized rats. This effect of genistein may be attributed, at least in part, to its direct influence on lipid metabolism in the liver and adipose tissue.
Hormonal, Lifestyle, and Dietary Factors in Relation to Leptin among Elderly Men
Authors: Lagiou Pagona , Signorello Lisa B. , Mantzoros Christos S. , Trichopoulos Dimitrios , Hsieh Chung-cheng , Trichopoulou Antonia
Published: April 2003

Background: Leptin, the adipocyte-secreted protein product of the ob gene, has been strongly linked to obesity and is believed to play a role in the regulation of the reproductive system. This study examines the potential influence of lifestyle and dietary factors, as well as of other hormones, on serum levels of leptin. Methods: The authors studied a population of 48 healthy elderly Greek men. Sera from these men were analyzed for leptin, several steroid hormones, sex hormone-binding globulin, and insulin-like growth factor 1. The authors also utilized data from food frequency questionnaires and information on demographic, anthropometric, and lifestyle (cigarette smoking, alcohol and coffee drinking) factors. Results: Using linear regression modeling, serum leptin levels were inversely associated with testosterone and positively associated with estradiol and dehydroepiandrosterone sulfate, after adjustment for the other hormones and body mass index (BMI). Leptin levels in men with a BMI >30 kg/m2 were 170% higher than in men with a BMI <27 kg/m2 (95% CI 63– 346%). Height was also positively associated with leptin, independent of BMI. No notable relationships were observed between leptin, on the one hand, and smoking, alcohol drinking, coffee drinking, or total energy intake, on the other. When total energy intake was separated into its three major components (carbohydrate, fat, and protein), it appeared that fat intake may have an isocalorically differential effect on serum leptin levels; one marginal quintile increase in fat intake corresponded to an 11% increase in leptin (95% CI 0–24%). Conclusion: Serum levels of leptin may be influenced by other endocrine factors, especially testosterone and estradiol, and may be positively associated with excess fat intake independently of obesity.
Effect of Dietary Fats Differing in Degree of Unsaturation on Gene Expression in Rat Adipose Tissue
Authors: Takahashi Yoko , Ide Takashi
Published: April 2003

To test the possibility that the type of dietary fat affects the expression of proteins involved in adipose tissue metabolism, levels of mRNA for lipoprotein lipase, leptin, glucose transporter 4, and uncoupling protein in adipose tissues were compared among rats fed a low-fat diet (2% safflower oil), and high-fat diets containing 20% saturated fat (palm oil) or unsaturated fat rich in linoleic acid (safflower oil) for 3 weeks. High-fat diets decreased the lipoprotein lipase mRNA level in epididymal but not in perirenal white adipose tissue, but increased it in brown adipose tissue. Leptin gene expression in perirenal white adipose tissue was significantly higher in rats fed high-fat diets than in those fed a low-fat diet. High-fat diets failed, however, to alter this parameter in epididymal white adipose tissue and interscapular brown adipose tissue. mRNA levels of glucose transporter 4, both in epididymal and perirenal white adipose tissues, were lower in rats fed high-fat diets than in those fed a low-fat diet. Uncoupling protein gene expression in interscapular brown adipose tissue was 2–3 times higher in rats fed high-fat diets than in those fed a low-fat diet. The abundance of mRNAs for lipoprotein lipase, leptin, glucose transporter 4 and uncoupling protein was, however, comparable between rats fed diets high in safflower and palm oil. We concluded that the high-fat diet influences gene expression of adipose tissue in a site-specific manner. The difference in the degree of unsaturation of dietary fats is rather irrelevant in modifying the level of mRNAs for proteins related to energy metabolism and expenditure in adipose tissue.
Alpha-Tocopherol Concentration in Fetal and Maternal Tissues of Pregnant Rats Supplemented with Alpha-Tocopherol
Authors: Viana M. , Barbas C. , Castro M. , Herrera E. , Bonet B.
Published: April 2003

We wanted to determine whether alpha-tocopherol supplementation to pregnant rats could increase the concentration of alpha-tocopherol in maternal and fetal plasma and tissues. Pregnant rats were treated with alpha-tocopherol on days 18 and 19 gestation and studied at day 20. A control group was studied in parallel. Treatment of pregnant rats with alpha-tocopherol increased its concentration in maternal and fetal plasma, in all maternal plasma lipoprotein fractions, in maternal and fetal liver and in the placenta. The fetal and maternal concentration of alpha-tocopherol were positively correlated.
Patterns of Past Alcohol Consumption in the EPIC-Germany Cohorts
Authors: Klipstein-Grobusch K. , Becker N. , Kroke A. , Boeing H.
Published: April 2003

Information on life-long history of alcohol consumption might be more relevant to chronic diseases than current intake. The aim of this study was to describe past alcohol intake and consumption patterns in the EPIC-Germany cohorts, by sex and age, from 1949 to 1998. Past daily consumption of alcoholic beverages – beer, wine, and spirits – was assessed through a lifestyle questionnaire administered to 27,099 subjects of the EPIC-Potsdam and 25,449 subjects of the EPIC-Heidelberg cohort. Recruitment of the cohorts concentrated on men aged 40–64 and on women aged 35–64. For each alcoholic beverage, the consumption at ages 20, 30, and 40 was asked. The data were used to calculate previous mean consumption in 10-year intervals from 1949 to 1998. Alcohol intake was observed to be higher in the Heidelberg than in the Potsdam cohort. Differences between cohorts were most marked for wine consumption which was considerably higher in the Heidelberg cohort. Men consumed approximately 3 times the amount of alcohol of women. Men preferred to drink beer, women preferred to drink wine. For the Potsdam cohort, alcohol intake was observed to increase since 1949. For the Heidelberg cohort, a recent decrease in alcohol intake in males and females of 30 and 40 years of age was noted. The data indicate that collection of alcohol consumption data at various discrete points in time is essential to depict life-long history of alcohol consumption.
Australian Food Sources and Intakes of Omega–6 and Omega–3 Polyunsaturated Fatty Acids
Authors: Ollis Tennille E. , Meyer Barbara J. , Howe Peter R.C.
Published: April 2003

Background/Aims: Both ω–6 and ω–3 polyunsaturated fatty acids (PUFAs) are recognised as essential nutrients in the human diet, yet we have little information on the extent to which different food sources contribute to their intake. The aim of the present study was to ascertain the daily intakes and food sources of ω–6 and ω–3 PUFAs in our local community. Methods: Three-day food records were obtained from 83 healthy adults living in the Illawarra region of New South Wales. The PUFA composition of the foods which they consumed was derived from food composition tables and recently published food analysis data. Results: Polyunsaturated margarine, nuts/seeds, bread, snacks/desserts and takeaway foods were important sources of ω–6 PUFAs, while canola oil and margarine, takeaway foods, snacks/desserts and bread were sources of α-linolenic acid (LNA), an ω–3 PUFA. As expected, fish was the main source of the very long chain (VLC) ω–3 PUFAs, i.e. eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA), to which significant health benefits are attributed. An unexpected finding, however, was that, due to the large amount eaten, meat was also a major contributor (29%) to the dietary intake of VLC ω–3 PUFAs. Median intakes of ω–6 and ω–3 PUFAs were 9.9 and 1.2 g/day, respectively, resulting in a dietary ω–6:ω–3 ratio of 8:1. The median intake of VLC ω–3 PUFA was 0.18 g/day. Conclusion: We have identified food sources and intakes of PUFAs for an Australian subpopulation differentiating between ω–6 and ω–3 PUFAs. Whilst canola and fish were the primary sources of LNA and VLC ω–3 PUFAs respectively, we found that meat made a significant contribution to VLC ω–3 PUFA intake.
Nutrient Intake and Growth of Preschool Children from Different Socioeconomic Regions in the City of Oaxaca, México
Authors: Wyatt C. Jane , Triana Tejas M.A.
Published: April 2003

Dietary intake and anthropometric measurements were determined in 124 preschool children, aged 4–6 years, living in the city of Oaxaca, México. The children were classified by socioeconomic status, depending upon their living conditions and family income. A composite diet representing the typical diet according to socioeconomic group was formulated and chemically evaluated. Corn tortillas and beans were the primary protein and energy sources for the children of this study. The inclusion of dairy products, animal products, and fruits and vegetables was not common. The children in the low-income group, which represents the majority of the children of this area, received only 63% of the recommended intake. Also for the low-income group, protein and iron recommendations were met but by plant-based sources. Protein contributed 10% of the energy, 78% were from carbohydrates and 12% from fat. Calcium intake was low, meeting only 34% of the recommendation and zinc intake was 51%. Fiber intake was very high, coming primarily from beans and tortillas. In the low- income group, Z scores for height and age were –1.60 for boys and –1.75 for girls. Weight-for-age Z scores were –0.90 and –0.97 for boys and girls, respectively. The weight-for-height Z scores for this group were 0.33 and 0.12 for boys and girls, respectively. Although energy needs were not met, extreme stunting was not detected.
Plasma Copper Concentration as Marker of Copper Intake from Food
Authors: König Jürgen S. , Elmadfa Ibrahim
Published: April 2003

Copper concentration in blood plasma is used mainly as an indicator for alimentary copper supply. This has some limitations because copper concentration in plasma fluctuates with age, exercise and health status and does not increase after a meal nor decrease during short-term fasting. The Austrian Study on Nutritional Status (ASNS) provides data on nutrient intake and corresponding plasma concentrations, permitting to evaluate the suitability of copper plasma concentration as a marker of copper intake. Copper intake and intake of relevant nutrients and food groups were evaluated from 7-day weighed food records from 2,400 preschool and schoolchildren between 4 and 19 years of age. Blood samples were collected from a subgroup of 1,400 of these children. The copper concentration in plasma was measured by graphite furnace atomic absorption spectrometry. Correlations between plasma concentrations and intake of nutrients and food groups were calculated using a stepwise linear regression model. The results showed that the determination of copper plasma concentrations are inadequate to predict copper intake from dietary records. A better indicator for copper supply may be the evaluation of those food items, which are the predominant sources of copper intake at the population level. The highest influence on copper plasma concentration was found for the intake of meat, representing not only the most important food group for copper supply but also the most important food group for fat and protein supply. The individual copper status can only be estimated accurately when information on characteristic enzyme activities under control of additional factors of influence or even body stores of copper are available.
Vitamin A Deficiency in Mice Enhances the Colonic Level of Purine Enzyme Activity
Authors: Al-Awadi Farida M. , Karam Sherif M. , Khan Islam
Published: April 2003

Background: Vitamin A is an important nutritional factor that regulates normal growth and functions of epithelial cells of the gastrointestinal tract. Objective: The objective of this study was to examine the role of vitamin A on the histological and biochemical changes in the colon of mice. Methods: To address this issue, vitamin A deficiency (VAD) was developed in mice by placing them on a VAD diet from weaning up to 120–170 days. Infiltration of inflammatory cells in the colon was determined histologically. Activities of adenosine deaminase, adenylate deaminase, purine nucleoside phosphorylase and myeloperoxidase were determined. Results: VAD in mice induced a significant increase in the number of mast cells per 100 crypts. There was also an abundance of other connective tissue cells such as plasma cells, lymphocytes and neutrophils around the crypts in the lamina propria. The colonic activity of adenosine deaminase and adenylate deaminase was increased due to VAD, whereas purine nucleoside phosphorylase activity remained unchanged. Immunohistochemical analysis showed an increased expression of adenosine deaminase in VAD mice colon. The increase in myeloperoxidase activity was not statistically significant. Conclusions: VAD causes upregulation of purine enzyme, which together with an increased number of inflammatory cells might exacerbate colonic injuries in VAD condition.
Lysosomal Enzymuria in Protein Energy Malnutrition
Authors: Yazzie Delvin , Dasgupta Amitava , Okolo Angela , Glew Robert H.
Published: April 2003

Protein energy malnutrition (PEM) is common in underprivileged populations in many parts of the world and results from diets deficient in protein (kwashiorkor) or protein and calories (marasmus). The literature documents renal tubular abnormalities in children with PEM. In PEM the reabsorption of amino acids and phosphate is defective. In many kidney disorders in which renal tubular function is impaired (e.g., diabetes, preeclampsia, nephrotic syndrome, sickle cell anemia), lysosomal enzymuria ensues. We compared the urinary excretion of the following five lysosomal enzymes in 31 Nigerian children with marasmus, kwashiorkor, or marasmic-kwashiorkor: β-hexosaminidase, α-galactosidase, β-galactosidase, β-glucuronidase, and α-mannosidase. All of the protein energy malnourished children and the 18 age- and gender-matched controls were from the city of Jos, located in central Nigeria. In the severely malnourished children, the urine levels of all five lysosomal enzymes (expressed as units of enzyme activity per mg creatinine) were markedly increased. The greatest increases were seen with β-hexosaminidase (16-fold) and β-glucuronidase (14-fold). Routine clinical analyses also revealed that, relative to the control population, the sera of the 14 most severely malnourished patients contained 2- to 5-fold more vitamin B12 and markedly reduced levels (15%, p < 0.00001) of calcium. These data are significant in that they document lysosomal enzymuria in Nigerian children with severe PEM and point to the potential diagnostic utility of the urinary β-galactosidase determination for assessing renal function in children with this disorder.
Effect of Ramadan Fasting on Moslem Kidney Transplant Recipients
Authors: Abdalla Abdallah H. , Shaheen Faisal A. , Rassoul Zalmai , Owda Ali K. , Popovich William F. , Mousa Dujanah H. , Al-Hawas Fahad , Al-Sulaiman Mohammed H. , Al-Khader Abdullah A.
Published: April 2003

This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300 mmol/l, were included in this study. The mean posttransplant period was 2.0 (range 0.6–6.3) years. Urinary and serum biochemical parameters, ciclosporin A level, and hematocrit were checked weekly, during Ramadan as well as 1 week before and after. Statistical analysis showed no significant changes in all parameters before, during, and after Ramadan. In conclusion, our findings indicate that fasting during the month of Ramadan does not seem to be associated with any significant adverse effects in kidney transplant recipients with normal or impaired graft function and suggest that it is safe for those patients to fast during Ramadan after 1 year of renal transplantation.
Spiral Computed Tomographic Angiography – A New Technique for Evaluation of Vascular Access in Hemodialysis Patients
Authors: Lin Yao-Ping , Wu Mei-Han , Ng Yee-Yung , Lee Rheun-Cheun , Liou Jy-Kang , Yang Wu-Chang , Wang Jia-Hwang , Teng Michael M.H. , Huang Tung-Po
Published: April 2003

Spiral computed tomographic angiography (CTA), a new noninvasive imaging technique, was used to study 10 arteriovenous fistulas (AVF) in 9 hemodialysis patients. Digital subtraction angiography (DSA) was also performed as a gold standard for comparison. AVF stenosis was graded by a four-point scale: grade 0, well patency of supplying artery, anastomosis and drainage vein; grade 1, <50% stenosis; grade 2, 50–70% stenosis; grade 3, 70–99% stenosis, and grade 4, total occlusion. We found CTA correlated closely to DSA in detecting both stenosis and dilatation of AVF and it spared all the shortcomings of DSA. CTA has the potential to be alternative for imaging of dialysis fistulas. Further studies will be performed to specify the role of CTA images in the assessment of the hemodialysis vascular access.
Intraventricular and Brachial Artery Thrombosis in Nephrotic Syndrome
Authors: Malik Ghulam H. , Al-Wakeel Jamal S. , Al-Mohaya Suleiman , Wasfy Ibrahim , Kechrid Mohammad S. , El-Gamal Hazem H.
Published: April 2003

A 23-year-old Saudi female presented with nephrotic syndrome. On renal biopsy she had primary focal and segmental glomerulosclerosis which was resistant to steroids. Two years later she presented with absent left arm pulses and on investigation a diagnosis of left ventricular thrombosis and thromboembolism of left brachial artery was made. Low antithrombin III, high fibrinogen levels and diuretic therapy were the possible causative factors for hypercoagulable state. On anticoagulation therapy initiated with heparin and continued with warfarin for 8 weeks there was complete dissolution of intraventricular and improvement of left brachial artery thrombosis. An early diagnosis and treatment of this potentially serious complication of nephrotic syndrome are stressed.
Eicosapentaenoic Acid Inhibits Mitogen-Induced Endothelin-1 Production and DNA Synthesis in Cultured Bovine Mesangial Cells
Authors: Nitta Kosaku , Uchida Keiko , Tsutsui Takaaki , Honda Kazuho , Kawashima Akira , Yumura Wako , Nihei Hiroshi
Published: April 2003

The present study was designed to examine whether eicosapentaenoic acid (EPA) inhibits the production of basal or stimulated endothelin (ET)-1 by platelet-derived growth factor (PDGF)-BB or epidermal growth factor (EGF), and DNA synthesis in cultured bovine mesangial cells. PDGF-BB and EGF stimulated ET-1 secretion in a dose-dependent fashion in these cells. EPA (10–100 µM) exhibited dose-related inhibition of PDGF-BB- and EGF-stimulated ET-1 secretion. EPA had no inhibitory effects on basal ET-1 secretion in these cells. Moreover, 50 µM EPA significantly attenuated PDGF-BB- and EGF-stimulated [3H]thymidine incorporation into mesangial cells. Receptor-binding experiments showed that EPA competitively inhibited 125I-PDGF-BB or 125I-EGF binding to mesangial cell surface receptors. Scatchard analysis for PDGF-BB receptor or EGF receptor revealed a linear regression fit and one binding site. Pretreatment with 50 µM EPA suppressed the number of maximum binding sites, but did not affect the Kd values. These results indicate that EPA potentially inhibits mesangial cell ET-1 production, when stimulated by PDGF-BB or EGF. This inhibitory effect of EPA could be related to the attenuation of mesangial cell proliferation via inhibition of the binding of PDGF-BB or EGF to their receptors due to alteration of the physicochemical characteristics of the cell membrane.
Does the Choice of Renal Replacement Therapy Adversely Affect the Hypercoagulability Associated with Renal Disease?
Authors: Assouad Mario , Eknoyan Garabed
Published: April 2003

Both a bleeding diathesis and a tendency to hypercoagulability occur in the course of renal disease. More common and consistent in occurrence during the progression of renal failure to end-stage renal disease is the hemostatic defect. The principal cause of this abnormality is the uremic state and, as a rule, it is reversible following the institution of adequate renal replacement therapy and correction of the anemia with epoietin. By contrast, the tendency to hypercoagulability is usually encountered in patients with the nephrotic syndrome and shows a correlation to the degree of hypoalbuminemia, being more evident at serum albumin levels of < 2 g/dl. Although the coagulopathy is complex in pathogenesis, a defect in the fibrinolytic process plays a critical role in its development. A tendency to pro-thrombosis due to abnormal fibrinolysis has been identified also in patients on renal replacement therapy with continuous ambulatory peritoneal dialysis (CAPD). The observed coagulation abnormalities resemble those of the nephrotic syndrome. Although its etiology remains undefined, a role for the albumin losses in the peritoneal dialysate has been implicated in the prothrombotic state that occurs in some CAPD patients.
Predicting Hemodialysis Access Failure with Color Flow Doppler Ultrasound
Authors: Bay William H. , Henry Mitchell L. , Lazarus J. Michael , Lew Nancy L. , Ling Jie , Lowrie Edmund G.
Published: April 2003

Color flow doppler ultrasound examination of the hemodialysis access was conducted in 2,792 hemodialysis patients to evaluate its value in predicting hemodialysis access failure. After baseline assessment of vascular access function with clinical and laboratory tests including color flow doppler evaluation these patients were followed for a minimal of 6 months or until graft failure occurred (defined as surgery or angioplasty intervention, or graft loss). The patient demographics and vascular accesses were typical of a standard hemodialysis patient population. On the day of the color flow doppler examination systolic and diastolic blood pressure, hematocrit, urea reduction ratio, dialysis blood flow, venous line pressure at a dialysis blood flow of 250 ml/min, and access recirculation rate were measured. At the conclusion of the study 23.5% of the patients had access failure. Case mix predictors for access failure were determined using the Cox Model. Case mix predictors of access failure were race, non-white was higher than white (p < 0.005), younger accesses had a higher risk than older accesses (p < 0.025), accesses with prior thrombosis had a higher risk of failure (p = 0.042), polytetrafluoroethylene (PTFE) grafts had a higher risk than native vein fistulae (p < 0.05), loop PTFE grafts had a higher risk than straight PTFE grafts (p < 0.025), and upper arm accesses had a higher risk than forearm accesses (p = 0.033). Most significant, however, was decreased access blood flow as measured by color flow doppler (p < 0.0001). The relative risk of graft failure increased 40% when the blood flow in the graft decreased to less than 500 ml/min and the relative risk doubled when the blood flow was less than 300 ml/min. This study has shown that color flow doppler evaluation, quantifying blood flow in a prosthetic graft, can identify those grafts at risk for failure. In contrast, color doppler volume flow in native AV fistulae could not predict fistula survival. This technique is noninvasive, painless, portable, and reproducible. We believe that preemptory repair of an anatomical abnormality in vascular access grafts with decreased blood flow may decrease patient inconvenience, associated morbidity, and associated costs.
Duodenal Obstruction in Polycystic Kidney Disease
Authors: Fried Linda F. , Palevsky Paul M. , Johnston James R.
Published: April 2003

Polycystic kidney disease in a common inherited disorder accounting for 8–10% of cases of end-stage renal disease. The enlarged kidneys often produce pain and hematuria but rarely obstruction of surrounding organs. We report a case of autosomal dominant polycystic kidney disease producing symptomatic duodenal obstruction and malnutrition. Duodenal obstruction should be considered in the differential diagnosis of a patient with polycystic kidney disease and intermittent or persistent nausea and vomiting.
Brown Tumor in Association with Secondary Hyperparathyroidism
Authors: Balon Breda Pečovnik , Kavalar Rajko
Published: April 2003

Since 1993, our 34-year-old female patient was on replacement treatment with hemodialysis for terminal renal failure due to hypertensive nephropathy. She developed severe secondary hyperparathyroidism. In 1996, she presented with a brown tumor, localized in the region of the left maxillary sinus and at its front. The patient did not take phosphate binders and treatment with vitamin D was not possible due to the increased Ca × P product. She had no difficulties, so she did not desire a surgical parathyroidectomy. As she had trouble breathing through the nose, and because of the facial deformity due to the brown tumor, she decided to have the tumor removed surgically.
Prolonged Asymptomatic Dense Deposit Disease in Chinese
Authors: Mao Tsui-Lien , Wu Kwan-Dun , Yang Yu , Hsu Hey-Chi
Published: April 2003

Dense deposit disease (DDD) is a less common form of membranoproliferative glomerulonephritis (MPGN). The disease occurs predominantly in children and young adults and the prognosis is variable. DDD varies considerably in incidence among different populations and has not been reported in Chinese. Herein we reported 2 cases of DDD in young Chinese girls in Taiwan. Although 1 case (case 2) had mild hypertension, both patients had asymptomatic proteinuria and ran a benign course of 8 and 14 years, respectively. The histological features of case 1 resembled membranous glomerulonephritis (MGN) on hematoxylin-eosin stain, but revealed DDD on periodic acid Schiff and chromotrope-2R silver methenamine stains. Whereas case 2 showed focal MPGN on light miscroscopy, she had a fine granular immunofluorescence pattern resembling MGN. Characteristic intramembranous dense deposits were demonstrated by electron microscopy in the basement membranes of the glomeruli, Bowman’s capsules and the renal tubules. Both patients were followed closely, and had stable normal renal function 1 year after renal biopsy.
A Cluster of Bloodstream Infections and Pyrogenic Reactions among Hemodialysis Patients Traced to Dialysis Machine Waste-Handling Option Units
Authors: Jochimsen Elise M. , Frenette Charles , Delorme Monique , Arduino Matthew , Aguero Sonia , Carson Loretta , Ismaïl Johanne , Lapierre Stephen , Czyziw Elizabeth , Tokars Jerome I. , Jarvis William R.
Published: April 2003

From June 17 through November 15, 1995, ten episodes of Enterobacter cloacae bloodstream infection and three pyrogenic reactions occurred in patients at a hospital-based hemodialysis center. In a case-control study limited to events occurring during October 1–31, 1995, seven dialysis sessions resulting in E. cloacae bacteremia or pyrogenic reaction without bacteremia were compared with 241 randomly selected control sessions. Dialysis machines were examined, dialysis fluid and equipment were cultured, and E. cloacae isolates were genotyped by pulsed-field gel electrophoresis. Each dialysis machine had a waste-handling option (WHO) through which dialyzer-priming fluid was discarded before each dialysis session; in 7 of 11 machines, one-way check valves designed to prevent backflow from the WHO into patient bloodlines were dysfunctional. In the case-control study, case sessions were more frequent when machines with ≥1 dysfunctional check valves were used. E. cloacae with identical pulsed-field gel electrophoresis patterns were isolated from case patients, dialysis fluid, station drains, and WHO units. Our investigation shows that bloodstream infections and pyrogenic reactions were caused by backflow from contaminated dialysis machine WHO units into patient bloodlines. The outbreak was terminated when WHO use was discontinued, check valves were replaced, and dialysis machine disinfection was enhanced.
Hypertension Due to Coexisting Pheochromocytoma and Aldosterone-Producing Adrenal Cortical Adenoma
Authors: Miyazawa Katsuhito , Kigoshi Toshikazu , Nakano Shigeru , Kobayashi Yuichi , Suzuki Koji , Tsugawa Ryuzo , Uchida Kenzo
Published: April 2003

A 49-year-old male was diagnosed as having primary aldosteronism at age 39, and he was treated with antihypertensive drugs. In 1995, a computed tomogram revealed a mass in the right adrenal gland. Radiological examinations and endocrinological data revealed the presence of a pheochromocytoma in the right and an adrenocortical tumor in the left adrenal gland. Right adrenalectomy and left partial adrenalectomy were performed. Histologically, the right adrenal mass was compatible with pheochromocytoma, and the left adrenal mass was an adrenocortical adenoma. Endocrinological data as well as blood pressure returned to normal after operation.
Extreme Hyperphosphatemia and Acute Renal Failure after a Phosphorus-Containing Bowel Regimen
Authors: Orias Marcelo , Mahnensmith Rex L. , Perazella Mark A.
Published: April 2003

Phosphate intoxication, manifested by hypocalcemic tetany and acute renal failure, may complicate bowel-cleansing preparations which contain phosphate. These preparations are commonly used to prepare patients for various gastrointestinal procedures. Often, patients who receive these regimens are at increased risk of phosphate intoxication from diseases which slow gastrointestinal transit or decrease renal excretion (renal insufficiency). We present a patient who developed oliguric acute renal failure from severe phosphate intoxication associated with a phosphate-containing bowel-cleansing regimen.
British Contributions to Renal Physiology: Of Dynasties and Diuresis
Authors: Fine Leon G.
Published: April 2003

British contributions to renal physiology trace back to the seminal contribution of William Bowman, who defined the structure of mammalian nephron and its blood supply and pointed out its likely mode of function. A series of contributions followed, which stemmed from a distinguished lineage of physiologists based at University College London and which had, as its high point, the establishment by Ernest H. Starling, in 1899, of a method for measuring oncotic pressure and the subsequent demonstration that glomerular filtration requires a hydrostatic pressure in excess of oncotic pressure in the glomerular capillaries. Arthur Cushny published a monograph on renal function in 1917 which had wide influence. The homeostasis of water and sodium chloride were the subjects of important contributions by Verney and De Wardener, respectively. Little contribution was made by British renal physiologists to the understanding of single nephron function with the emphasis being largely on integrative physiology.
A Note on the Early History of Renal Transplantation: Emerich (Imre) Ullmann
Authors: Nagy Judit
Published: April 2003

In January 1902 at the Vienna Medical Society Meeting, the surgeon Emerich Ullmann reported the first case of renal autotransplantation performed in the neck of a dog. In the same year, he presented the first xenotransplantation of the kidney (a goat with a dog’s kidney). These publications immediately had a great impact on the medical word. After his failed attempt to transplant a pig’s kidney into a young uraemic woman he stopped his research in this field in order to devote himself to other lines of surgical research. However, his idea survived him, because, nowadays, nearly 100 years later, pigs appear to be the most suitable donors for human renal xenotransplantation. Ullmann was born in Pécs, Hungary, on February 23, 1861. After a distinguished undergraduate career in 1878 his father (being also a medical doctor) sent him to study medicine at the world-famous Vienna Medical School. He graduated in 1884 and was immediately invited to the Surgical Department where Billroth worked. Next year, because of his interest in bacteriology he visited Pasteur in Paris and successfully volunteered to serve as a healthy subject to prove the effectiveness of Pasteur’s antisera against rabies. Although Ullmann did not succeed in doing a human transplantation he gave birth to the era of the organ transplantation, stimulated vascular surgery and the development of transplantation immunology.