bluuebunny/crossref_metadata_2025 huggingface dataset:
The Synthesis by Fine-Needle Aspiration Biopsy Cultures of IL-7, IL-16 and IL-18 Is Significantly Associated with Acute Rejection in Kidney Transplants
Authors: de Oliveira José Gerardo Gonçalves , Xavier Paula Dias Pinto , Sampaio Susana Moreira , Tavares Isabel Salomé , Mendes Armando Augusto
Published: April 2003

Background: T-cell activation, the key event in the development of acute allograft rejection, depends on co-stimulatory signals delivered by antigen-presenting cells (APC). APC-derived cytokines may provide co-stimulation and modulate alloimmune reaction. We have studied cytokine synthesis by fine-needle aspiration biopsy (FNAB) culture and we found significant differences for interleukin (IL)-2, IL-6, IL-10, M-CSF and IL-1ra on comparing acute rejection versus stable kidney transplant patients. We report our findings on FNAB cultures synthesis of IL-7, IL-15, IL-16, IL-17, IL-18 and RANTES (regulated upon activation, normal T-cell expressed and secreted), all potential modulators of anti-graft reaction. Patients and Methods: Kidney transplants (KTX) treated with CsA-AZA-Pred from the beginning, were divided into four groups. Group I: day 7 post-KTX, stable; II: day 7 post-KTX, 6.5 ± 5.5 days before acute rejection; III: first day of acute rejection; IV: day 14 post-KTX, stable. Patients from I and IV remained rejection-free for the first 6 months, at least. All rejection episodes were confirmed by classical core renal biopsy. FNAB samples were cultured according to our published methodology and culture supernatants were collected at 48 h and analysed by ELISA for IL-7, IL-15, IL-16, IL-17, IL-18 and RANTES. Results: Group III synthesized significantly higher amounts of IL-7, IL-16 and IL-18 than stable patients (groups I and IV). RANTES production did not show significant differences among the four groups. We did not find any trace of IL-15. Conclusions: IL-18 may play the activation role that has been attributed to IL-12 which previously, we did not find to correlate significantly with acute rejection in KTX. IL-16 seems to play an activation role rather than an inhibition of anti-graft reaction. We confirm that RANTES is not significantly associated with acute rejection in KTX.
An Oral Adsorbent Downregulates Renal Expression of Genes That Promote Interstitial Inflammation and Fibrosis in Diabetic Rats
Authors: Aoyama Isao , Shimokata Kaoru , Niwa Toshimitsu
Published: April 2003

Background/Aims: An oral adsorbent, AST-120, removes uremic toxins such as indoxyl sulfate, and delays the progression of renal failure. This study was designed to investigate the effects of AST-120 on the molecular basis of interstitial inflammation and fibrosis, using Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of non-insulin-dependent diabetes mellitus. Methods: Four weeks after unilateral nephrectomy, the uninephrectomized OLETF (1/2NxOLETF) rats were divided into two groups: AST-120-administered and control 1/2NxOLETF rats. After the administration of AST-120 for 48 weeks, we examined the effects of AST-120 on renal functional, pathological, and gene expressional changes. Results: The administration of AST-120 to the 1/2NxOLETF rats attenuated the progression of renal dysfunction, proteinuria, glomerular sclerosis, tubular injury, and interstitial inflammation and fibrosis. AST-120 significantly reduced renal expression of intercellular adhesion molecule (ICAM)-1, osteopontin, monocyte chemotactic protein (MCP)-1, and transforming growth factor (TGF)-β1, as well as clusterin. All the five molecules were expressed mainly in tubular cells. AST-120 also decreased serum and urinary levels of indoxyl sulfate and the overload of indoxyl sulfate in tubular cells. Conclusion: AST-120 ameliorates tubulointerstitial injury by reducing renal expression of ICAM-1, osteopontin, MCP-1, TGF-β1 and clusterin in 1/2NxOLETF rats.
The Herbal Medicine Sairei-to Inhibits Proliferation of Rat Mesangial Cells
Authors: Awazu Midori , Fujita Hisayo , Omori Sayu , Hida Mariko
Published: April 2003

Background: The herbal medicine Sairei-to is efficacious in renal diseases where mesangial proliferation is a key event. We examined whether Sairei-to inhibits proliferation of cultured rat mesangial cells and investigated its mechanism of action. Methods: The effect of Sairei-to on [3H]-thymidine incorporation stimulated by serum was assessed. Cell cycle was analyzed by flowcytometry. Extracellular signal-regulated kinase (ERK) activity was determined by immunecomplex kinase assay. Tyrosine phosphorylation of cellular proteins, and phosphorylation of ERK and Raf-1 were analyzed by immunoblot. Cyclic AMP was measured by radioimmunoassay. Results: Incubation of mesangial cells for 18 h with water-soluble but not insoluble fraction of Sairei-to inhibited serum-stimulated [3H]-thymidine incorporation. In subsequent experiments, water-soluble fraction, at a dose required for a half-maximal response (2 mg/ml), was used. Sairei-to inhibited S-phase entry stimulated by serum. Serum-induced tyrosine phosphorylation of p44 and p42 ERK was inhibited by Sairei-to, but that of other cellular proteins was not affected. Suppression of serum-stimulated ERK activation by Sairei-to was confirmed by immunecomplex kinase assay. Activation of Raf-1, an upstream activator of ERK, was also attenuated by Sairei-to. Incubation of cells with Sairei-to significantly increased the generation of cAMP. Conclusions: Sairei-to inhibits serum-induced DNA synthesis of rat mesangial cells by suppressing Raf-1/ERK cascade probably via cAMP.
Lack of Reported Mutations in a Japanese Case of Toxic Multinodular Goiter
Authors: Hanamitsu Masakazu , Takeuchi Eiji , Kitanishi Tsuyoshi , Sakurai Hironori , Tanaka Hiroshi , Kitano Hiroya
Published: April 2003

We describe a toxic multinodular goiter that was subjected to genomic sequencing of the thyroid-stimulating hormone receptor and the α-subunit of the stimulatory guanine nucleotide-binding protein. No mutation was detected in either gene. While frequent occurrence of thyroid-stimulating hormone receptor gene mutations in toxic multinodular goiters has been reported in areas such as part of Europe with a relatively high prevalence of iodine deficiency, toxic multinodular goiters in areas with an abundance of dietary iodine such as Japan seem unlikely to involve mutations of this gene.
Induction of Human Macrophage Vascular Endothelial Growth Factor and Intercellular Adhesion Molecule-1 by Ureaplasma urealyticum and Downregulation by Steroids
Authors: Li Ying-Hua , Brauner Annelie , Skov Jensen Jørgen , Tullus Kjell
Published: April 2003

Chronic lung disease (CLD) remains a major cause of morbidity for the prematurely born infant. The pathogenesis of CLD is complex and has not been defined entirely. Infection and lung inflammatory events have been thought to play a key role in the development of CLD. However, the contribution of Ureaplasma urealyticum to the development of CLD is debated and steroids produce some improvement in neonates with this disease. The aim of this study was to investigate if U. urealyticum could stimulate macrophages to produce vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) in vitro, which are potentially associated with both early and later pathological changes in the lung during the development of CLD. In addition, the impact of dexamethasone and budesonide on these processes was examined. We found that U. urealyticum antigen (≧4 × 107 color-changing units/ml) stimulated human macrophages (phorbol 12-myristate 13-acetate-differentiated THP-1 cell line) to produce VEGF and soluble ICAM-1 in a dose-dependent manner (p < 0.05) measured by ELISA. Likewise, cell surface ICAM-1 (CD54) measured by flow cytometry was increased after stimulation with U. urealyticum. This effect was attenuated by budesonide and dexamethasone (p < 0.05). The mRNA expressions of VEGF and ICAM-1 detected by a semi-quantitative reverse transcriptase polymerase chain reaction were also induced in response to U. urealyticum and inhibited by the steroids (p < 0.05). The expression of ICAM-1 was reduced by 85.5% when the TNF-α production was neutralized with an anti-TNF-α antibody. Our findings imply that U. urealyticum might be involved in the development of CLD of prematurity.
The Opinions, Expectations and Experiences of Women with a Family History of Breast Cancer Who Consult Their GP and Are Referred to Secondary Care
Authors: Andermann Anne A.J. , Watson Eila K. , Lucassen Anneke M. , Austoker Joan
Published: April 2003

Objectives: The purpose of this work was to explore the views, expectations and experiences of the increasing number of women with a family history of breast cancer who present to their GP and are referred to secondary care. Methods: A prospective descriptive study was carried out with 193 women referred by their GP regarding a family history of breast cancer to a genetics clinic or breast clinic in Oxfordshire and Northamptonshire over a one-year period. Results: Women who presented to primary care about a family history of breast cancer wanted their GP to provide them with information (90%) and to discuss their risks of developing breast cancer (87%). Women often had unrealistic expectations of what they might expect from a referral to secondary care, especially with regards to being offered genetic testing. Within 1 month of attending the secondary care appointment, 11% of women had returned to see their GP regarding their family history and what had happened at the specialist clinic. Conclusions: Women want information and the opportunity to discuss their breast cancer family history concerns in a primary care setting. For women who are referred, information provision in primary care is important to ensure realistic expectations of the secondary care visit and to provide ongoing reassurance and support throughout the often lengthy referral process. For women who are not referred, information provision in primary care is even more important, as this may be their only source of information and advice.
Manganese Deposition in Basal Ganglia due to Perioperative Parenteral Nutrition following Gastrointestinal Surgeries
Authors: Iwase Kazuhiro , Higaki Jun , Mikata Shoki , Tanaka Yasushi , Kondoh Haruhiko , Yoshikawa Masato , Hori Shinichi , Kamiike Wataru
Published: April 2003

Background/Aims: Serial changes in blood manganese (Mn) levels and brain MRI examinations following perioperative parenteral nutrition (PN) were investigated. Methods:  Six cases undergoing pancreatoduodenectomy (PD), 4 cases undergoing thoracic esophagectomy (TE), 18 cases undergoing total gastrectomy (TG) and 20 cases undergoing colorectal surgeries (CR) with daily administration of 20 µmol of Mn per day were studied. Cases undergoing PD, TE, TG or CR without Mn administration served as controls.  Results: Hyperintense lesions in the basal ganglia on T1-weighted MRI and elevated blood Mn levels were recognized after PN in 4 of 6 cases in the PD group, in 3 of 4 cases in the TE group, in 1 of 18 cases in the TG group and in 2 of 20 cases in the CR group. No abnormalities were recognized in the control groups.  Conclusion: The possible Mn deposition in the basal ganglia caused by perioperative PN should be especially noted in cases undergoing PD or TE.
Preparation and Characterization of Silverfish (Lepisma saccharina) Extract and Identification of Allergenic Components
Authors: Barletta B. , Puggioni E.M.R. , Afferni C. , Butteroni C. , Iacovacci P. , Tinghino R. , Ariano R. , Panzani R.C. , Di Felice G. , Pini C.
Published: April 2003

Background: Airborne insect antigens represent important aeroallergens which have been widely investigated. Although it has been demonstrated that house dust contains significant silverfish (Lepisma saccharina) levels, none of the extracts obtained so far has been extensively characterized. Thus, we have prepared and characterized a silverfish extract and investigated its IgE-reactive components by testing the reactivity of sera from patients allergic to inhalant insect allergens. Methods: The extract from silverfish insect bodies was prepared by homogenizing frozen silverfish in Tris-HCl buffer. The soluble material (Sup) was filtered and the insoluble material (Ppt) was resuspended in 100 mM Tris pH 10.6. The two fractions were characterized by biochemical and immunochemical methods. IgE reactivity was investigated on both fractions before and after periodate treatment. Results: Protein content and total carbohydrates was 2 and 3% w/w for Sup and 1 and 0.3% w/w for Ppt. The SDS-PAGE profile of the two fractions showed a different pattern in the MW range of 5–175 kD. Sup and Ppt, probed with allergic sera, showed a complex pattern of IgE reactivity. When periodate-treated fractions were tested, IgE reactivity was either completely abrogated, reduced or not affected, depending on the allergic serum employed. Conclusions: The results obtained indicate that the classic aqueous-extraction procedures that have been used up to now for other insects might not be completely satisfactory, since several allergenic components are not soluble at the normally used pH. We developed a dedicated extraction procedure allowing the detection of a certain degree of reactivity in sera negative to allergens extracted following classic procedures.
Murine AIDS Induces Viremia and Functional and Phenotypic Alterations in Blood Cells
Authors: Hügin Ambros W. , Wirth Susanne
Published: April 2003

Background: Murine acquired immunodeficiency syndrome (MAIDS) is characterized by generalized lymphoproliferation and progressive immunodeficiency. It is induced by a mixture of two replication-competent murine leukemia viruses (MuLV) and a disease-causing, replication-incompetent defective MuLV. Infection leads to specific phenotypic and functional alterations of lymphocytes in lymphoid organs. Methods: We analyzed phenotypic, virological and functional parameters in the blood of mice infected with MAIDS virus. Results: Disease progression correlated with increasing viremia, a loss of mitogen responsiveness of T lymphocytes, and the appearance of CD4+ Thy1– T lymphocytes. At >9 weeks after infection, the distribution of leukocyte cell populations became very heterogeneous, and late-stage leukemic events were observed in 5 of 23 mice. Conclusions: Virus titers, mitogen responsiveness and the presence of CD4+ Thy1– T lymphocytes can efficiently be monitored in the blood and serve as diagnostic parameters to monitor disease progression. Acute leukemic events occurring at the terminal stage could be responsible for the death of at least some of the mice with MAIDS.
Rufus of Ephesus and His ‘Diseases of the Kidneys’
Authors: Eknoyan Garabed
Published: April 2003

The first book on diseases of the kidneys, titled ‘Diseases of the Kidneys and Bladder’, was written by Ruphus of Ephesus at the close of the 1st century AD. Little is known of Rufus, who seems to have attained fame and was considered an equal of Hippocrates and Galen. He was highly respected and extensively quoted by authors of Byzantine, Arabic and Middle Ages medicine. In his description of diseases of the kidneys he makes a concerted effort to correlate structure and function, and to provide a rational explanation of the altered function of the kidneys in disease. The section of his monograph ‘On Hardening of the Kidneys’ is brief, but constitutes the first description of morbid and clinical features of the end-stage kidneys. Like many of his contemporaries, Rufus wrote several monographs on selected topics and organs. That he chose diseases of the kidneys as the subject of one of his monographs makes him especially pertinent to the history of nephrology.
Effect of Mizoribine on IL-6 Release by Peripheral Blood Mononuclear Cells
Authors: Kaneko Kazunari , Nagaoka Rieko , Ohtomo Yoshiyuki , Shimizu Toshiaki , Yamashiro Yuichiro
Published: April 2003

Background/Aim: A novel immunosuppressant, mizoribine (MZB), has recently been reported to be effective in the treatment of IgA nephropathy (IgAN), although its mechanism of action remains unknown. This study was conducted to investigate whether the efficacy of MZB on IgAN is exerted by suppression of interleukin-6 (IL-6) release. Methods: Peripheral blood mononuclear cells (PBMC) were collected from 4 children with IgAN (median age 13.0 years) and 4 control children (median age 5.2 years). PBMC were cultured with medium alone or medium with lipopolysaccharide (LPS), and then incubated with LPS and MZB. Culture supernatants were assayed for lL-6. Results: IL-6 release was increased by LPS in all subjects. Although the median value was higher in IgAN patients (median increase in IL-6 release 1,298.1%) than in controls (median 489.2%), statistical significance was not reached (p > 0.05). 10 mg/ml of MZB suppressed the release of IL-6 in both IgAN patients (median decrease in IL-6 release 39.3%) and controls (median 43.2%), with statistical significance (p < 0.05 and p < 0.01, respectively). Conclusion: This study suggests that MZB could suppress IL-6 release in vitro and thus may exert its efficacy on IgAN.
Central Antinociceptive Activity of Acetylsalicylic Acid Is Modulated by Brain Serotonin Receptor Subtypes
Authors: Sandrini Maurizio , Vitale Giovanni , Pini Luigi Alberto
Published: April 2003

Male Wistar rats were treated with ondansetron (1 and 2 mg/kg s.c.), ketanserin (0.2, 1 and 5 mg/kg s.c.) or NAN-190 (1, 3 and 5 mg/kg i.p.) 15 min before acetylsalicylic acid (ASA, 400 mg/kg i.p.), and 30 min thereafter the pain threshold was evaluated. The antinociceptive activity of ASA in the hot-plate test was variously affected by ondansetron, ketanserin and NAN-190: at the highest dose (2 mg/kg s.c.) ondansetron abolished it while ketanserin (5 mg/kg s.c.) significantly reduced it, and NAN-190 (1–5 mg/kg) did not significantly modify the effect of ASA. Binding experiments indicate that both ondansetron and ketanserin completely prevented the decrease in the maximum number of 5-HT2 receptors (Bmax) provoked by ASA. These data indicate that the central antinociceptive activity of ASA is modulated in a different manner by serotonin receptor antagonists, and that 5-HT2 and 5-HT3 receptors may exert a pivotal role in nociception, alone or in association.
The Expression of Oncoproteins in Transitional Cell Carcinoma: Its Correlation with Pathological Behavior, Cell Cycle and Drug Resistance
Authors: Yu Dah-Shyong , Chang Sun-Yran
Published: April 2003

Objective: To investigate the relationship of oncoproteins with histological grade, tumor stage, cell cycle and multidrug resistance (MDR) in bladder cancer. Methods: The expression of various oncoproteins (p21, EGFR1, erbB-2, c-jun, c-myc, bcl-2, Bax) and suppressor gene products (WT-1, RB gene, p53) was studied in normal urothelium, transitional cell carcinoma (TCC) cell lines and their MDR sublines by using specific antibodies and an indirect immunofluorescence flow-cytometric method. Results: The total increased rate of measured oncoproteins in TCC cell lines was 62.7%. There was no difference in the expression rate of oncoproteins between low-grade/stage TCC cell lines and high-grade/stage TCC cell lines. All of these TCC cell lines have aneuploidy and increased proliferative activity in the cell cycle, but a correlation with oncoprotein expression was not seen. They had a low expression rate of c-myc, Bax and RB gene when compared to normal urothelium. On the contrary, the expressions of p21, EGFR1, erbB-2, bcl-2, WT-1 and p53 oncoproteins were significantly higher than in normal urothelium (p < 0.05). A long-term cultured MDR subline of TCC8702 (TCC8702/ADR1000) demonstrated a generally decreasing expression of oncoproteins in addition to p53. Conclusions: The p21, EGFR1, erbB-2, bcl-2, WT-1 and p53 oncoproteins were increased in TCC cells compared to normal urothelium. Oncoprotein expression is related to tumorigenesis of TCC cells, but no correlation was seen between the incidence and tumor differentiation and cell cycle. These oncoproteins decreased gradually in the process of generation of MDR in addition to p53. It indicates that the p53 oncogene is closely related to the acquired MDR of TCC cells.
Immunohistochemical Study of bcl-2, p53 and Ki-67 Expressions in Collecting Duct Carcinoma of the Kidney
Authors: Suzuki Kazumi , Tokue Akihiko
Published: April 2003

Objectives: This study was designed to examine the expressions of bcl-2, p53 and Ki-67 antigen in collecting duct carcinoma (CDC) of the kidney by an immunohistochemical method. Methods: The diagnosis of CDC was based on the criteria proposed by Srigley and Eble. The clinical courses of 5 CDC cases examined in this study suggested that 3 cases were low grade and 2 cases high grade. The expressions of bcl-2, p53 and Ki-67 antigen were evaluated in paraffin-embedded surgical specimens using anti-bcl-2 and anti-p53 antibodies and Ki-67 antigen, respectively. Results: The expression of bcl-2 was recognized in 3 of 5 cases (60%), p53 expression also in 3 of 5 cases (60%). The Ki-67 labeling index was 7.46 ± 7.40 (mean ± SD). Conclusions: It was suggested that there were two clinical types in CDC; the expression of bcl-2 did not correlate with the CDC patients’ clinical courses and the cellular proliferation, and p53 expression was recognized in the CDC patients with highly cellular proliferation.
Retroperitoneal Schwannoma Extending into the Intravertebral Foramen
Authors: Tsukigi Masaaki , Kubota Yoko , Iijima Yoshiaki , Yaguchi Hiromasa , Tateno Tadashi , Suzuki Tasuhiro , Sasagawa Isoji , Nakada Teruhiro
Published: April 2003

A 35-year-old Japanese man first visited the hospital for episodes of numbness in the right medial femoral region and loss of muscular strength in the right thigh. A CT scan of the abdomen showed a 10 × 9-cm well-circumscribed in homogeneous multilayered mass, in contact with the lumbar vertebrae. MRI demonstrated a hypodense and hyperdense mixed mass. Tumor extension into the L2/L3 intravertebral foramen was shown. To avoid spinal cord damage, we chose enucleation of the tumor in the intravertebral foramen. A follow-up CT after 1 year showed no evidence of a recurrent mass. In conclusion, we advocate the nerve-sparing operation in cases like that of our patient.
Variants of Renal Angiomyolipoma Closely Simulating Renal Cell Carcinoma: Difficulties in the Histological Diagnosis
Authors: Bernardini S. , Chabannes E. , Algros M.P. , Billerey C. , Bittard H.
Published: April 2003

Renal angiomyolipoma is considered to be a benign renal tumor composed of atypical blood vessels, smooth muscles and fat cells. We report 2 cases of unilateral renal angiomyolipoma. In both cases, our preoperative diagnosis was renal cell carcinoma, because no low density area compatible with fat tissue was noted in the tumors on radiographic evaluation. Through histological examination, both tumors proved to be angiomyolipomas mainly composed of epithelioid cells in 1 case, and spindle-shaped smooth muscle cells mimicking a leiomyoma in the other case. Both patients are well showing no evidence of metastases 16 and 14 months after nephrectomy, respectively.
Lisofylline and Lysophospholipids Ameliorate Experimental Colitis in Rats
Authors: Sturm Andreas , Zeeh Jörg , Sudermann Thomas , Rath Heiko , Gerken Guido , Dignass Axel U.
Published: April 2003

Background: Intestinal inflammatory processes initiate a chain reaction in which membrane-bound lipids generate eicosanoids and phospholipids. Bioactive lipid mediators play a pivotal role in the pathogenesis of intestinal inflammation and colonic mucosa from patients with inflammatory bowel disease contains high levels of phospholipids. Therefore, we investigated the effects of lysophosphatidic acid and lysophosphatidylethanolamine, two natural occurring phospholipids and lisofylline, which decreases lipid peroxidation, in an in-vivo model of intestinal inflammation. Methods: Colitis was induced by rectal administration of ethanol and trinitrobenzene sulfonic acid in rats. Rats were treated once daily with either lysophosphatidic acid or lysophosphatidylethanolamine rectally or twice daily intraperitoneally with lisofylline following induction of colitis. Rats were sacrificed after 7 days and the effect of lysophosphatidic acid, lysophosphatidylethanolamine, and lisofylline on colonic damage and inflammation were assessed using standardized macroscopical and histological injury scores. Results: Treatment with lysophosphatidic acid, lysophosphatidylethanolamine, and lisofylline significantly reduced the degree of inflammation and necrosis in the distal colon compared to control rats. In addition, the weight loss was significantly less in the treatment groups compared to controls. Histological studies revealed a significant reduction of epithelial damage and colonic inflammation. Conclusion: The administration of anti-inflammatory lysophospholipids and suppression of proinflammatory lipid metabolites by lisofylline may provide new approaches to ameliorate intestinal inflammation.
Effects of Amidated Gastrin and Glycine-Extended Gastrin on Cell Proliferation and Crypt Fission in Parenterally and Orally Fed Rats
Authors: FitzGerald Anthony J. , Ghatei Mohammad A. , Mandir Nikki , Bloom Steven R. , Iversen Leslie , Goodlad Robert A.
Published: April 2003

Background/Aims: It has been suggested that processing variants of gastrin, such as glycine-extended gastrin (G17-Gly), are enterotrophic to the colon. Methods: Cell proliferation and crypt branching were studied in total parenteral nutrition (TPN) and orally fed rats after infusion of G17-Gly or gastrin-17. Results: Gastrin produced an increase in the weight of the stomach and small intestine and a marked proliferative action on the proximal small intestine, which diminished distally. No proliferative effects of gastrin were seen in the colon. G17-Gly was associated with a small, but significant, increase in colonic weight but had little effect on cell proliferation, except in the gastric fundus. In the distal colon, G17-Gly was associated with a significant decrease in proliferation. Neither agent affected crypt branching in the small intestine or colon, but both proliferation and branching were significantly decreased by TPN. Conclusion: Gastrin was trophic to the stomach and the proximal small intestine but not the colon. G17-Gly had only modest proliferative actions on the intestinal epithelium in this study.
Josephus Andreas Jacobus Plenck – A Forerunner of Modern Diuretic Therapy
Authors: De Santo Natale Gaspare , Aliotta Antonio , De Santo Rosa Maria , Aliotta Giovanni
Published: April 2003

Joseph Andreas Jacobus Plenck was born in 1735 in Vienna where he studied surgery with Johan Christian Retter. At age 35 he was appointed Professor of Surgery and Obstetrics by Maria Theresia. Subsequently he became professor and life long secretary of the Medical Military Academy know as the Josephinum where he worked up to 1807. He was one of the most brilliant scientific writers of his time. Here we analyze his medical treatise, Icones Plantarum Medicinalium secundum systema Lynnaei cum enumeratione virium et usus medici, chirurgici et diaetetici, published in folio in Latin and German. This is a therapy based on plants in which the author discusses the medical use of 758 plants. This article is centered on 111 plants with diuretic properties which still appear in many pharmacopoeias.
Importance of Serum Ferritin Levels in Patients with Renal Failure
Authors: Gülçelik Neşe E. , Kayataş Mansur
Published: April 2003

Study results on acute phase reactants of renal failure patients are controversial. In this study, we enrolled 39 patients and divided them into 2 groups: acute renal failure (ARF), and chronic renal failure (CRF) patients. As opposed to CRF patients, the patients with ARF had higher serum ferritin levels that were independent of anemia parameters and other acute phase reactants.
MCP-1 and RANTES Are Expressed in Renal Cortex of Rats Chronically Treated with Nitric Oxide Synthase Inhibitor
Authors: Kashiwagi Minoru , Masutani Kohsuke , Shinozaki Michiya , Hirakata Hideki
Published: April 2003

Long-term inhibition of nitric oxide synthase (NOS) in rats is known to cause systemic hypertension and renal parenchymal injury. We have previously reported that activation of intra-renal renin-angiotensin system was a major contributing factor for renal injury in chronically NOS-inhibited rats. Massive interstitial infiltration of monocytes/macrophages (M/M) was characteristically seen in this model. The present study was performed to elucidate the role of chemokines, RANTES and MCP-1, in promoting M/M recruitment into the renal cortex. The number of infiltrating ED-1-positive cells was examined in association with the level of expression of RANTES and MCP1 mRNAs in the renal cortex of rats treated orally for 12 weeks with L-NAME. Compared to controls rats, the number of infiltrating ED-1-positive cells was significantly higher in L-NAME-treated rats. The mRNA expressions of both RANTES and MCP-1 were significantly higher in L-NAME-treated rats than the control. In L-NAME-treated rats, the high number of ED-1-positive cells and increased expression of both RANTES and MCP-1 were suppressed by ACE inhibitor, but not by hydralazine. In contrast, neither ED-1 counts nor RANTES mRNA expression were affected by angiotensin (Ang) II type 1 receptor antagonist. These results suggest the likely involvement of RANTES and MCP-1 in the recruitment of M/M into the renal cortex of rats with chronic NOS inhibition. Furthermore, it is also indicated that Ang II stimulates MCP-1 expression via Ang II type 1 receptor, whereas RANTES expression is mediated via Ang II type 2 receptor.
Blood Sugar Control Reverses the Increase in Urinary Excretion of Prostaglandin D Synthase in Diabetic Patients
Authors: Hamano Kumiko , Totsuka Yasuo , Ajima Miho , Gomi Tomoko , Ikeda Toshio , Hirawa Nobuhito , Eguchi Yutaka , Yamakado Minoru , Takagi Masao , Nakajima Hiroshi , Oda Hiroshi , Seiki Kousuke , Eguchi Naomi , Urade Yoshihiro , Uehara Yoshio
Published: April 2003

Background/Aims: We investigated basal levels of serum and urinary lipocalin-type prostaglandin D synthase/β-trace (L-PGDS) in type-2 diabetic patients and explored whether glycemic control affects L-PGDS status in another 55 diabetic inpatients with normoalbuminuria. Methods: Fifty-five type-2 diabetic outpatients (HbA1c, 9.14 ± 0.20%; creatinine (Cr), 85.1 ± 2.4 µmol/l), and 55 age-matched healthy control subjects were recruited. Serum and urinary levels of L-PGDS were determined with respect to the stage of diabetic nephropathy. The L-PGDS was localized by immunohistochemistry. Results: The urinary L-PGDS index increased in diabetic patients, compared with the controls (234.8 ± 27.4 vs. 73.8 ± 7.8 µg/mmol Cr, p < 0.001). Even in normoalbuminuric patients as well as in microalbuminuric patients, urinary L-PGDS indexes were higher than the controls (166.0 ± 21.1, p < 0.0001 and 338.6 ± 62.5 µg/mmol Cr, p < 0.0001, respectively), although the serum L-PGDS level was equal to that in the control subjects. Multiple regression analysis revealed that the urinary L-PGDS index was predicted solely by glucose levels and type-IV collagen index, whereas the serum L-PGDS was determined mainly by age and serum Cr. Glycemic control reduced the urinary L-PGDS index towards the normal range in diabetic patients with normoalbuminuria (172.3 ± 6.6 vs. 118.1 ± 2.6 (SE) µg/mmol Cr, p < 0.0001). Immunohistochemistry showed that L-PGDS was uniquely present in the renal tubules in diabetes while in nondiabetics, L-PGDS occurred solely in the peritubular interstitium, not in the tubular cells. Conclusion: Inadequate glycemic control is responsible for urinary L-PGDS excretion in the diabetic patients. Urinary L-PGDS is useful to predict subclinical renal injury associated with type-2 diabetes.
Communication of Agonist-Induced Electrical Responses along ‘Capillaries’ in vitro Can Be Modulated by Lipopolysaccharide, but Not Nitric Oxide
Authors: Lidington Darcy , Ouellette Yves , Tyml Karel
Published: April 2003

Communication of agonist-induced membrane potential changes along blood vessels has been proposed to contribute to the coordination of microvascular function. Factors mediating septic shock may compromise this coordination. Using electrophysiology in a simplified in vitro model of endothelial cells grown as capillary-like structures, we aimed to determine (i) the effect of lipopolysaccharide (LPS) on endothelial cell membrane potential responses to ATP and KCl and (ii) the effect of LPS and nitric oxide (NO) on cell-to-cell communication. Treatment of ‘capillaries’ with LPS (10 µg/ml for 1 h) did not affect local responsiveness to ATP or KCl, but reduced cell communication by a tyrosine-kinase-dependent mechanism. Treatment of ‘capillaries’ with the NO donor DETA (100 µM) or the NO synthase inhibitor L-NAME (100 µM) had no effect on cell communication or the response to LPS. Endogenous NO production, stimulated by LPS + interferon-γ (100 U/ml) treatment, also had no effect on cell communication beyond that of LPS alone. We conclude that LPS, but not NO, can modulate conduction of agonist-induced electrical responses along endothelial capillary-like structures in vitro.
Weight in the Balance
Authors: Altman Jennifer
Published: April 2003

The adage ‘we are what we eat’ is taking on a new meaning in our well-fed and increasingly sedentary culture, as many of us convert much of our excess food into body fat; in the USA, 60% of the population is now considered to be overweight. Obesity brings with it an increased risk of developing type II diabetes, hypertension and heart disease, so the mechanisms that control food intake and body weight are of considerable importance for public health and clinical medicine. The mass of body fat is now known to be regulated by several hormones and neuropeptides. Two of these, the circulating peptide hormones leptin and ghrelin have actions that include reciprocal effects on appetite-regulating neurons in the hypothalamus. This article reviews data discussed at a recent meeting1, where an overview of recent developments in research into leptin and ghrelin was presented. Topics covered are the roles of leptin and ghrelin in the regulation of food intake and energy production; the integration of food intake with other energy-regulated processes, such as growth, sexual maturation and reproduction, sleep and the immune response; and pathological conditions, ranging from diabetes to psychiatric disorders.1 This report summarizes conclusions of the meeting ‘Brain Somatic Cross-Talk and the Central Metabolism’ held in Paris on January 28, 2002.
Massive Bleeding from Dieulafoy’s Lesion of the Small Intestine in a Child – Therapy for the Bleeding from Gastrointestinal Tract Out of Endoscopic Observation
Authors: Owaki Tetsuhiro , Kusano Chikara , Ojiro Masataka , Aikou Takashi
Published: April 2003

Dieulafoy’s lesion is recognized as a submucosal artery associated with a minute mucosal defect and a rare cause of severe gastrointestinal hemorrhage. Especially, that of distal jejunum or ileum is extraordinarily rare. It is very difficult to detect the lesion in these parts. We experienced massive bleeding from Dieulafoy’s lesion of the distal jejunum in a 12-year-old girl. Preoperative angiography and intraoperative palpation detected the point of bleeding. She was rescued by partial jejunectomy. Compiled reports suggested that careful palpation was useful for detection of the location of the bleeding point, which was enhanced as vascular dilatation by the angiogram, during the operation comparatively.
Sigmoidoscopy-Assisted Colostomy – An Adapted Trephine Stoma Formation
Authors: Beilman Greg J. , Jonson Gary M.
Published: April 2003

Background/Aim: The purpose of this article was to report an adapted colostomy procedure that can be used on patients with multiple morbidities requiring fecal diversion. Methods: An adapted colostomy was performed on a patient needing fecal diversion who had multiple surgical and medical complications. Results: Thirteen weeks after colostomy placement, the patient’s colostomy functioned well and was viable throughout his course without related complications. Conclusion: The method of sigmoidoscopy-assisted colostomy described here can be beneficial to the complicated patient needing fecal diversion but unable to tolerate a laparotomy or laparoscopy.
Myelotomy through the Years
Authors: Gildenberg Philip L.
Published: April 2003

Although myelotomy was first designed to treat somatic pain by interruption of the decussating fibers of the spinothalamic tract, it was soon recognized that pain relief may be obtained in a wider distribution than the dermatomes represented by the interrupted nerves. In 1970, Hitchcock described relief of pain throughout the body by stereotactic production of a single lesion in the middle of the spinal cord at the cervico-medullary junction, a procedure named extra-lemniscal myelotomy by Schvarcz several years later. This led me to the observation reported in 1984 that pelvic pain might be controlled by a non-stereotactic lesion at the thoraco-lumbar area, which appeared to be particularly effective against visceral pain of cancer, in a procedure termed limited myelotomy. In 2000, Kim recognized that thoracic pain might be treated by a similar lesion in the high thoracic area, and termed his procedure thoracic dorsal column midline myelotomy. Up to that time, all authors had considered that pain relief was the result of interruption of a multi-synaptic pathway just dorsal to or within the central canal, which had not yet been defined. However, Willis identified a new pathway in the ventromedial dorsal columns in the post mortem spinal cord provided to him by my coauthor, which he further documented by animal physiologic studies. Nauta, at that same institution, reintroduced limited myelotomy based on those anatomical findings, naming the procedure punctate myelotomy. It must be recognized that all of these procedures have involved interruption of the same pathway, even before it was defined anatomically, and all authors provided similar observations about relief of particularly visceral pain.
Basic Science and Epilepsy: Experimental Epilepsy Surgery
Authors: Tanaka Tatsuya , Hashizume Kiyotaka , Sawamura Atsushi , Yoshida Katsunari , Tsuda Hiroshige , Hodozuka Akira , Nakai Hirofumi
Published: April 2003

Epilepsy surgery, as is employed for the management of intractable seizures, was performed in animals harboring a seizure focus induced by a local application of kainic acid (KA). Amygdalo-hippocampectomy failed to stop spontaneous seizures in the contralateral hippocampus. Callosotomy inhibited seizure propagation to the contralateral sensori-motor cortex. However, epileptic activity ipsilateral to the focus, including subcortical structures, persisted even after the callosotomy. Multiple subpial transection (MST) around the epileptic cortical focus suppressed the seizure activity of the cortex. However, seizure propagations in subcortical structures remained, even after MST. Niferacetam (a new nootropic agent) was tested in these models, and its promising effect on the intractable extratemporal epilepsy is reported.
The Use of Birth Defect Registries for Etiological Research: A Review
Authors: Reefhuis Jennita , de Jong-van den Berg Lolkje T.W. , Cornel Martina C.
Published: April 2003

Background: Birth defect registries are often used for etiological research. Either as hypotheses-generating studies, or studies directed at one specific association between a risk factor and a birth defect in order to confirm or refute possible associations. Methods: A literature search in Medline was performed looking for studies using birth defect registries for studying different risk factors. Results: A brief summary of study design for etiological research with registration data is given. Subsequently, the different studies performed are discussed according to the risk factors investigated. Different aspects of the studies are listed and discussed. For each of the risk factors, the usefulness of birth defect registries to study the specific risk factor is discussed. Registries are dependent on the factors that are included in the registry or recorded in different databases. Most studies have looked at risk factors with readily available data, such as maternal age, illnesses and drugs. There is also wide use of other registers with exposure data on, for example, the environment. Conclusions: Birth defect registries have been used in the evaluation of many possible risk factors for birth defects. They have also been used in rebutting alarms in the media on possible clusters and risk factors.
Antiepileptic Drugs in Pregnancy: Options for the Prevention of Congenital Abnormalities
Authors: ten Berg K. , Lindhout D.
Published: April 2003

Maternal antiepileptic drug use during pregnancy is associated with an increased prevalence of congenital malformations in the offspring. This article describes the commonly known teratogenic effects of antiepileptic drugs. Options for primary and secondary prevention are discussed.
Clonal Analysis of Esophageal Squamous Cell Carcinoma with Intraepithelial Components
Authors: Tamura Hiroki , Sugihara Hiroyuki , Bamba Masamichi , Tani Tohru , Hosokawa Masao , Kodama Masashi , Hattori Takanori
Published: April 2003

Objective: In tumors of the upper aerodigestive tract, field carcinogenesis is a prevailing concept which suggests that such tumors are commonly of multiclonal origin. Methods: To test this possibility, we applied a PCR-based clonality assay utilizing the polymorphic locus of the human androgen receptor gene (HUMARA) in female patients with esophageal squamous cell carcinomas (SCCs). DNA was extracted from small pieces of tissues microdissected from multiple points of intraepithelial and invasive parts of each tumor and the adjacent epithelia in 12 cases. The HUMARA locus was PCR amplified with or without prior digestion with Hpa II. PCR products were analyzed by a genetic analyzer and polyacrylamide gel electrophoresis followed by silver staining. Results: In each of 8 informative cases, the pattern of X chromosome inactivation of the major cell population in each sample was common among the samples from the invasive part and among those samples, if any, from the intraepithelial part, and was concordant between the intraepithelial and invasive parts in 5 cases and discordant in 1 case. Out of the samples of adjacent epithelia, a monoclonal pattern was demonstrated in 8 basal cell hyperplasias and 3 dysplasias, of which 2 and 1, respectively, showed inactivation patterns discordant with those of the concomitant cancers. Conclusion: Esophageal SCCs may often be preceded or accompanied by multiclonal precancerous lesions, and may develop through the outgrowth of single or less commonly multiple dominant clones.
Zena and Carlotta: Transition Narratives and Early Education in the United States and Italy
Authors: Corsaro Willliam A. , Molinary Luisa , Brown Rosier Katherine
Published: April 2003

In line with recent critiques of individualistically based theories of human development, we offer a theoretical approach to childhood socialization that we refer to as interpretive reproduction. This approach stresses both the innovative and creative aspects of children''s participation in society and the fact that children both contribute to and are affected by processes of social reproduction. We apply our theoretical approach to children''s life transitions and introduce the notion of priming events. Priming events involve activities in which children, by their very participation, attend prospectively to ongoing or anticipated changes in their lives. We discuss the similarities and differences of our theoretical position with socio-cultural theories of human development, noting the importance of socio-economic and power relations that are of key importance in interpretive reproduction while they are often neglected in socio-cultural theory and research. We then present a comparative case study of an American and an Italian child''s transition from preschool to elementary school. Based on our rich set of comparative, longitudinal ethnographic data, we present interpretative narratives that situate the changes in these children''s lives by focusing on their participation in a complex web of collective experiences at the individual, interpersonal, and cultural (or societal) planes of analysis. We discuss the significance of our identification of priming events which contribute to both continuities and discontinuities in these children''s transition experiences, and how priming events are influenced by educational policies in the two countries.
A New Approach for Transseptal Catheterization in Patients Undergoing Percutaneous Balloon Mitral Valvuloplasty
Authors: Kong Xiang-Quan , Wang Lexin , Xue Yu-Zeng , Jin Yue , Kong Jing-Bo , Wang Xiao-Hua
Published: April 2003

Aims: To evaluate the safety and efficacy of a new approach for transseptal catheterization in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). Methods: One hundred and two patients with rheumatic mitral stenosis were randomized into two groups. In the study group (RA approach), an imaginary horizontal line was drawn from the top end of the tricuspid valve under anteroposterior fluoroscopic view. The intersection of the horizontal line and the right edge of the corresponding thoracic vertebra was defined as the upper border of the Fossa ovalis. The atrial septum was punctured from a point 0.5 cm below the upper border of the Fossa ovalis. In the control group (LA approach), an imaginary horizontal line was drawn between the upper and middle third of the left atrium, and the intersection of this horizontal line and the right edge of the corresponding thoracic vertebra was used as an atrial septum puncture point. Results: Atrial septum puncture succeeded in all patients in the study group and in 72.6% of the patients in the control group (p < 0.01). The average fluoroscopy times for transseptal catheterization in the study and the control groups were 2.0 ± 0.5 and 3.0 ± 1.0 min, respectively (p < 0.01). Transseptal catheterization was subsequently achieved using the RA approach in the 14 patients from the control group in whom the LA approach failed. Conclusions: The RA approach is a safe and effective means for transseptal catheterization in patients undergoing PBMV.
Burden of Late Repeat Hospitalization in Patients Undergoing Angioplasty or Bypass Surgery
Authors: Halon David A. , Rennert Hedy S. , Flugelman Moshe Y. , Jaffe Ronen , Lewis Basil S.
Published: April 2003

We investigated the incidence and determinants of early and late repeat hospitalization for cardiac causes in 378 patients following myocardial revascularization [199 coronary balloon angioplasty (PTCA), 179 coronary bypass surgery (CABG)] in a single cardiovascular center and followed for a median period of 13 years. Data were available for repeat rehospitalization in 91% and for mortality in all. Patients in the upper quartile for repeat hospitalization (≧4 rehospitalizations) were defined as having multiple repeat hospitalizations. In the PTCA cohort, the rehospitalization rate was high (48%) in the first year, partly due to restenosis and to a group of patients who underwent planned repeat angiography, and then 15–26% annually. In the surgical cohort, annual repeat hospitalization was 8–12% during the first 4 years, but increased to a level similar to that in PTCA patients (19–26%) in the second half of the follow-up period. Independent predictors of multiple (≧4) repeat hospitalizations included systemic hypertension (odds ratio 2.4, 95% CI 1.4–4.0), incomplete revascularization (odds ratio 2.0, 95% CI 1.1–3.4) and less extensive (<3 vessels) disease at the time of the index procedure (odds ratio 2.0, 95% CI 1.1–3.4). Predictors of repeat hospitalization were different from those of mortality (diabetes mellitus, 3-vessel disease). Late repeat hospitalizations after myocardial revascularization impose a considerable burden on the patient and the health care system, and represent an issue which should be better addressed.