bluuebunny/crossref_metadata_2025 huggingface dataset:
Histiocytic Disorders with Spontaneous Regression in Infancy
Authors: Jang Kyoung‐Ae , Ahn Se‐Jin , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung
Published: March 2003

Abstract: The histiocytic disorders are uncommon, have a wide spectrum, and are poorly understood. We describe seven cases developing in infancy, seen during a period of 9 years at Asan Medical Center, Seoul, Korea. Clinically the patients had multiple papules over the face, trunk, and extremities that developed at birth or during infancy. Histopathologic examinations revealed an infiltrate of many histiocytic cells in the upper dermis with or without epidermotropism. Four cases were classified as congenital self‐healing reticulohistiocytosis in that the histiocytes were identified as Langerhans cells by positive immunohistochemical staining for S‐100 protein, ultrastructural studies showing many Birbeck granules, and spontaneous regression of the lesions within 1–4 months. One infant with a solitary lesion on the forehead was diagnosed as solitary, congenital, indeterminate cell histiocytoma because the histiocytic cells were S‐100 protein positive, but meticulous ultrastructural studies did not detect Birbeck granules. The lesion was removed by shave excision. Two cases were classified as generalized eruptive histiocytoma. The histiocytic cells were S‐100 protein negative and ultrastructurally Birbeck granules were absent. In one patient, eyeball‐ or popcornlike lysosomal structures were seen. The lesions regressed completely.
Accessory Tragus: Report of Two Cases and Review of the Literature
Authors: Jansen Thomas , Romiti Ricardo , Altmeyer Peter
Published: March 2003

Abstract:Accessory tragus is a fairly common congenital malformation of the external ear. In the vast majority of cases it is an isolated developmental defect not associated with other abnormalities. However, the remote possibility exists that it could be associated with other abnormalities of the first and second branchial arch. Accessory tragus is a consistent feature of the oculoauriculovertebral syndrome (Goldenhar syndrome). When correctly identified, surgical excision of accessory tragus is quite simple and rarely results in any complications.
Disfiguring Draining Sinus Tracts in a Female Acne Patient
Authors: Jansen Thomas , Romiti Ricardo , Plewig Gerd , Altmeyer Peter
Published: March 2003

Abstract: A 17‐year‐old girl with a 9‐month history of papulopustular acne developed disfiguring, highly inflammatory, fluctuant nodules in both nasolabial folds within 2 months. Periodically she experienced discharge of pus and blood from these lesions. A diagnosis of disfiguring draining sinus tracts associated with acne vulgaris was made. The therapeutic regimen included intralesional corticosteroid injection, systemic corticosteroids along with a macrolide antibiotic, and systemic isotretinoin to reduce the inflammatory process. Outcome was favorable, with no recurrences during the following 10 months. Draining sinus is a malevolent lesion usually seen in severe forms of acne such as acne conglobata, acne fulminans, and acne inversa. Treatment is difficult and often unsatisfactory. In many cases, excision of the lesion is necessary to provide a permanent cure.
Microsporum canis Tinea Capitis in an 8‐Month‐Old Infant Successfully Treated with 2 Weekly Pulses of Oral Itraconazole
Authors: Koumantaki E. , Georgala S. , Rallis E. , Papadavid E.
Published: March 2003

Abstract: We report an 8‐month‐old girl with tinea capitis caused by Microsporum canis which was successfully treated with two pulses of oral itraconazole 50 mg/day, each of 1 week duration with an interval of 2 weeks. M. canis tinea capitis can be a difficult therapeutic problem in an infant, as the treatment is usually long, lasting up to 4–6 weeks with griseofulvin and 6–12 weeks with terbinafine, and the desire to provide a safe systemic therapy is particularly important. With an intermittent regimen the duration of treatment with active drug can be much shorter compared to continuous therapy. We found that itraconazole pulse therapy for M. canis tinea capitis was a safe and effective treatment in an infant.
Combined Treatment with Calcipotriol Ointment and Low‐Dose Ultraviolet A1 Phototherapy in Childhood Morphea
Authors: Kreuter Alexander , Gambichler Thilo , Avermaete Annelies , Jansen Thomas , Hoffmann Matthias , Hoffmann Klaus , Altmeyer Peter , Von Kobyletzki Gregor , Bacharach‐Buhles Martina
Published: March 2003

Abstract: Various therapies for morphea have been used with limited success, including ones with potentially hazardous side effects. When morphea occurs in childhood it may lead to progressive and long‐lasting induration of the skin and subcutaneous tissue, growth retardation, and muscle atrophy. We report an open prospective study in which the efficacy of a combined treatment with calcipotriol ointment and low‐dose ultraviolet A1 (UVA1) phototherapy in childhood morphea was investigated. Nineteen children (mean age 8.5 years, range 3–13 years) with morphea were exposed to UVA1 (340–400 nm) phototherapy at a dose of 20 J/cm2 four times a week for 10 weeks. Forty phototherapy sessions resulted in a cumulative dose of 800 J/cm2 UVA1. In addition, calcipotriol ointment (0.005%) was applied twice a day. After 10 weeks, palpation and inspection showed a remarkable softening and repigmentation of formerly affected skin resulting in a highly significant (p < 0.001) decrease of the mean clinical score from 7.3 ± 0.9 at the beginning to 2.4 ± 0.9 (relative reduction 67.1%) at the end of combined therapy. Our results indicate that a combined therapy with calcipotriol ointment and low‐dose UVA1 phototherapy is highly effective in childhood morphea. Further controlled studies are necessary to investigate whether this combined therapy is superior to UVA1 phototherapy alone.
Urticaria Pigmentosa Associated with Wilms Tumor
Authors: Güler Elif , Emir Suna , Kutluk Tezer , Varan Ali , Büyükpamukçu Münevver
Published: March 2003

Urticaria pigmentosa is the most common manifestation of mastocytosis, with the majority of cases undergoing spontaneous resolution, especially in children. Several reports have documented hematologic malignancies developing in patients with urticaria pigmentosa. We present a 4.5‐year‐old boy with urticaria pigmentosa who developed Wilms tumor. To our knowledge, coexisting urticaria pigmentosa and Wilms tumor have not previously been described.
Lack of Evidence of Active Human Herpesvirus 7 (HHV‐7) Infection in Three Cases of Pityriasis Rosea in Children
Authors: Chuh Antonio A.T. , Peiris J.S.M.
Published: March 2003

Three cases of pityriasis rosea in Chinese children are presented. Using polymerase chain reaction for detection of human herpesvirus 7 (HHV‐7) DNA in plasma and peripheral blood lymphocytes, we find no evidence of active HHV‐7 infection.
Waxy Keratoses of Childhood in a Segmental Distribution
Authors: Mehrabi Don , Thomas Jean E. , Angelica Selim M. , Prose Neil S.
Published: March 2003

Waxy keratoses of childhood is a rare genodermatosis previously noted in both familial and isolated presentations. Three previous cases have been described in which the lesions appeared over the trunk and extremities. We report a case in which the waxy keratoses of childhood lesions appeared in a segmental distribution along a single lower extremity, differing from the more extensive patterns reported previously. We suggest a possible postzygotic mutation hypothesis for this unique segmental distribution, addressing both the possibility of a genomic mosaicism and loss of heterozygosity.
Cyclic Neutropenia: An Unusual Disorder of Granulopoiesis Effectively Treated with Recombinant Granulocyte Colony‐Stimulating Factor
Authors: Lubitz Paul A. , Dower Nancy , Krol Alfons L.
Published: March 2003

Cyclic neutropenia (CN) is a rare hematologic disorder characterized by regular cycling of the absolute neutrophil count and a symptom complex presenting during the neutropenic nadirs. Despite the profound cyclic neutropenia, most patients have a benign course of recurrent fever, malaise, oral ulceration, and minor skin and upper respiratory tract infections. Recurrent infections, inflammation, and ulcers can lead to significant chronic morbidity. Severe dental disease is common, pregnancy complications are increased, and overwhelming infections, bowel necrosis, and mortality, although rare, are potential sequelae. We report a 10‐year‐old boy with a classical presentation of CN that had remained undiagnosed for 10 years. The difficulty in diagnosing this unusual disorder is highlighted. Treatment with daily recombinant granulocyte colony‐stimulating factor (rG‐CSF) resulted in a complete clearing of symptoms and a significant increase in quality of life. The excellent clinical response of CN to rG‐CSF, in the absence of major adverse effects, is strongly demonstrated by this case and supports rG‐CSF as a first‐line therapy for CN. The physiologic and adverse effects of rG‐CSF use in CN and other neutropenic disorders, including potential leukemic induction, are reviewed. The need for long‐term follow‐up to investigate the effects of chronic hematopoietic stimulation by rG‐CSF is emphasized.
Prominent Pruritic Periumbilical Papules: Allergic Contact Dermatitis to Nickel
Authors: Sharma Vidya , Beyer Deborah J. , Paruthi Shalini , Nopper Amy Jo
Published: March 2003

We report a case series of 38 children with suspected allergic contact dermatitis (ACD) to nickel who presented with prominent subumbilical and periumbilical papules and a generalized, lichenoid papular dermatitis resembling an id reaction. We speculated that this was an ACD to nickel and performed patch tests in 9 (24%) of these patients. All 9 (100%) patients had positive patch test results for nickel, thus confirming the diagnosis.
Efficacy of Imiquimod 5% Cream in the Treatment of Recalcitrant Warts in Children
Authors: Grussendorf‐Conen E.‐I. , Jacobs S.
Published: March 2003

Abstract: Long‐lasting cutaneous warts are a therapeutic challenge, especially widespread or symptomatic recalcitrant warts in children. It can be speculated that natural immunity to these human papillomavirus (HPV)‐ induced lesions is extremely poor. Therefore ideally treatment should focus on increasing local immune response. Recently imiquimod, a topical immune modifier, has been successfully used in the treatment of external genital warts. Our purpose is to report on our experiences with imiquimod 5% cream applied to therapy‐resistant, long‐lasting (duration 2–7 years) common warts in children. In 18 children, imiquimod cream was self‐applied by the patients or by their parents to the warts twice a day. Assessment for response and occurrence of adverse effects was performed every 4 weeks until clinical cure. Follow‐ups could be arranged in 14 of the 18 patients 1–2 years after total clearance. Sixteen of 18 patients experienced total clearance of their warts; 2 showed partial improvement but were lost to follow‐up. The mean duration of treatment was 5.8 months. Two of the 14 patients in whom a follow‐up was performed showed a small number of new warts after a period of at least 1 year without recurrence. Our data demonstrate that the topical application of imiquimod 5% cream is an effective treatment for long‐lasting cutaneous warts in children.
Scrofuloderma After BCG Vaccination
Authors: Tan Hüseyin , Karakuzu Ali , Arik Adem
Published: March 2003

Abstract: A 7‐month‐old boy with scrofuloderma following BCG vaccination is presented. He had a 2 cm × 1 cm erythematous lesion with a sinus tract in the right cervical area. In addition, he had ulcerated erythematous lesions 0.5 cm × 0.5 cm in size on the left deltoid area and left forearm where BCG vaccination and a PPD test were performed, respectively. Histopathologic findings were consistent with the clinical diagnosis.
Tinea Capitis Due to Trichophyton rubrum in a Neonate
Authors: Chang Sung‐Eun , Kang Sook‐Kyoung , Choi Jee‐Ho , Sung Kyung‐Jeh , Moon Kee‐Chan , Koh Jai‐Kyoung
Published: March 2003

Abstract: Tinea capitis is a common infection of school‐aged children, but there have been only a few reports of tinea capitis in newborns. Furthermore, Trichophyton rubrum as a causative organism of tinea capitis is documented very rarely. We report herein a neonate in whom T. rubrum was the causative agent. This boy was successfully treated with three pulses of oral itraconazole solution.
Familial Generalized Multiple Glomangiomyoma: Report of a New Family, with Immunohistochemical and Ultrastructural Studies and Review of the Literature
Authors: Calduch Luis , Monteagudo Carlos , Martínez‐Ruiz Esperanza , Ramón Dolores , Pinazo Isabel , Cardá Carmen , Jordá Esperanza
Published: March 2003

Abstract: Glomus tumors are benign lesions which often appear as solitary bluish nodules. They can also be multiple, and can be either acquired or congenital. Histopathologically glomus tumors are classified into three different variants: solid glomus tumor, glomangioma, and glomangiomyoma, which is the least frequent type. We report three instances of familial generalized multiple glomangiomyoma in a woman and her two children. Seven members of the family in two consecutive generations were affected, suggesting autosomal dominant inheritance. We performed a thorough clinical study, complete blood and platelet counts, stool for occult blood, karyotype, abdominal echography (which showed an asymptomatic solitary hepatic vascular lesion in one of the patients), gastrointestinal endoscopy, and skin biopsy with immunohistologic and ultrastructural studies. We believe that the terms glomangioma and glomangiomyoma actually designate the same lesion, with transitional areas from typical glomus cells to well‐defined conventional smooth muscle cells. Although complete evaluation should be performed in all patients with multiple glomus tumors in order to detect possible occult systemic lesions, we only recommend treatment for symptomatic lesions. To our knowledge, this is the first report of an instance of familial multiple glomangiomyoma.
Biomedical Assessment and Instrumental Evaluation of Healthy Infant Skin
Authors: Visscher Marty O. , Chatterjee Ranjit , Ebel James P. , LaRuffa Angela A. , Hoath Steven B.
Published: March 2003

Abstract: The skin forms a critical structural boundary and a perceptual interface for the organism, yet the definition “healthy skin” is surprisingly difficult to describe. The present study's goal was to generate a technical definition of healthy infant skin by quantifying specific biophysical parameters before and after bathing in infants and correlating such parameters to a perceptual maternal evaluation. Fifty‐two healthy infants, 3–6 months old, were evaluated before and after freshwater bathing. Diapered skin had a higher transepidermal water loss (TEWL), surface hydration, moisture accumulation rate (MAT), and friction than nondiapered skin before the bath (p < 0.01). Bathing dramatically altered the biophysical properties at both skin sites, with decreased MAT and lower friction, indicating a drier skin surface (p < 0.01). Visual redness and dryness decreased after bathing (p < 0.01). Blinded grading of optical images showed a significant preference for the skin after bathing (p < 0.01). This study provides the first quantitative technical definition of healthy infant skin with positive correlation to perceptual assessment by independent observers (mothers). The findings support the hypothesis that water binding properties of the stratum corneum are altered by occlusion (diapering) and that bathing introduces acute changes in stratum corneum water interactions, leading to a drier skin surface and a preferred skin appearance.
Keratitis, Ichthyosis, and Deafness (KID) Syndrome
Authors: Miteva Ljubka
Published: March 2003

Abstract: An 8‐year‐old boy with keratitis, ichthyosis, and deafness (KID) syndrome is reported. The patient has ichthyosis and deafness. Additional clinical features include hair and tooth abnormalities, as well as absence of the mammary glands. Although keratitis is an important element in the triad of KID syndrome, this patient has another ophthalmologic defect, a developmental anomaly of the lacrimal puncta, characterized by their complete absence. The case appears to be unique in the literature in that, to my knowledge, this particular ocular anomaly has not been described previously.
Treatment of Psoriasis in Children: Is There a Role for Antibiotic Therapy and Tonsillectomy?
Authors: Wilson Jill K. , Al‐Suwaidan Sami N. , Krowchuk Daniel , Feldman Steven R.
Published: March 2003

Abstract: Numerous studies implicate subclinical or recurrent streptococcal infection as a trigger or maintenance factor in the pathogenesis of psoriasis in children. The purpose of this article is to review the efficacy of antibiotic therapy and tonsillectomy as treatments for childhood psoriasis. Clinical trials assessing the efficacy of antibiotics or tonsillectomy as treatments for childhood psoriasis were identified with a search of the medical literature and the results were compared. Only one controlled clinical trial was identified and it did not find a significant effect of antibiotic treatment on psoriasis. In other studies, the percentage of psoriasis patients who experienced disease clearance with antibiotic therapy ranged from 0% to 55%, with no patients experiencing disease worsening during treatment. No controlled trials of tonsillectomy for psoriasis were identified. The percentage of patients who experienced disease clearance after tonsillectomy in uncontrolled trials ranged from 32% to 53% and a similar percentage reported significant improvement in their psoriasis, with a maximum of 7% noting worsening of the disease after the operation. The available evidence does not demonstrate the efficacy of either antibiotic therapy or tonsillectomy in the treatment of childhood psoriasis. Because these treatments are relatively benign compared to other treatments for severe psoriasis, the use of antibiotic therapy or tonsillectomy may still be worth considering, especially for those patients with recurrent streptococcal infections that seem to trigger or maintain their skin disease.
Myasthenic Crisis with Delayed Recovery after Plasmapheresis
Authors: Matsuo Hidenori , Goto Hirofumi , Ohtsuru Izumi , Izumoto Hajime , Fukudome Takayasu , Fujishita Satoshi , Shibuya Noritoshi
Published: March 2003

Abstract: We report on 2 elderly patients with myasthenia gravis in whom recovery from crisis was prolonged despite intensive plasmapheresis (PP). In both patients, the anti‐acetylcholine (anti‐AChR) titer failed to fall sufficiently after completing PP. These patients might have had antibodies that produced a more pronounced effect on the degradation of AChR, or the synthesis of AChR might have been reduced by aging. The anti‐AChR titer did not correlate with a reduction of IgG after PP in 1 patient. Successful treatment was achieved by keeping the anti‐AChR titer at a low level via the concomitant use of prednisolone with PP.
Therapeutic Membrane Plasmapheresis
Authors: Nosé Y. , Malchesky P.S.
Published: March 2003

Guest Editor's Introduction:This paper was presented as a keynote address at the first congress of the Japanese Society for Therapeutic Plasmapheresis on June 20, 1981 in Tokyo. It was printed inTherapeutic Plasmapheresis Iedited by Dr. T. Oda and published by FK Schattauer Verlag, Stuttgart, Germany, in 1981. This paper appears on Pages 3–14 of the congress proceedings. With permission, in 2000, it is reprinted inTherapeutic Apheresisas a millennium project of the International Society for Apheresis. This paper covers the historical development of membranes for therapeutic apheresis between 1959 and 1983.
Efficient Membrane and Adsorbent for Artificial Liver Support System
Authors: Abe T. , Sakurai T. , Inagaki K. , Kominami N. , Yamazaki Z. , Fujimori Y. , Sanjo K. , Kojima Y. , Sugiura M. , Wada T. , Inoue N. , Sakai T. , Oda T.
Published: March 2003

Guest Editor's Introduction: This paper was presented at the first congress of the International Society for Artificial Organs on August 26, 1977, Tokyo, Japan, and printed in the proceedings of the congress. (Artificial Organs Volume 2, supplement, 1978, p. 269–272). This paper describes the first technical description of the Asahi hollow fiber plasma separator. This cellulose acetate membrane module was the first clinically effective plasma separator introduced by Asahi Medical, Inc., Japan (Asahi Chemical, Inc. at that time) and clinically applied by Z. Yamazaki and N. Inoue (Reprint 4). In addition to the plasma separator module, various types of adsorbent units are also described.
On‐Line Separation of Macromolecules by Membrane Filtration with Cryogelation
Authors: Malchesky P.S. , Asanuma Y. , Zawicki I. , Blumenstein M. , Calabrese L. , Kyo A. , Krakauer R. , Nosé Y.
Published: March 2003

Guest Editor's Introduction: This paper was presented at the International Symposium on Plasma Exchange, Cologne, June 6–7, 1980. It was printed in its proceedings, Plasma Exchange Plasmapheresis and Plasmaseparation, (ed) Sieberth H.G., 1980, pages 133–139. It was published by F.K. Schattauer Verlag, Stuttgart, Germany. This paper describes the first clinical application of cryofiltration. The efficiency of double filtration was enhanced by keeping the plasma fractionator filter (cryofilter) at near zero temperature. Cryogel is formed inside the cryofilter and selective removal of macromolecules was achieved without any supplemental albumin supplement.
A New Device for Selective Removal of CD4+ T Cells
Authors: Onodera Hirokazu , Abe Yumi , Yoshida Makoto , Yamawaki Naokuni , Yamashita Yasuhiko , Matsuo Hidenori , Ichinose Katsuhiro , Otsuru Izumi , Shibuya Noritoshi
Published: March 2003

Abstract: Guest Editor's Introduction: As the leukocyte removal has been recognized as an effective means of therapy, efforts were focused on the device development for more specific removal of cellular components, which are related to the cause of the disease. Shibuya and Asahi Medical Co. developed the CD4+T removal column which consists of polystyrene fabrics with immobilized anti‐human CD4+ monoclonal antibodies. This paper describes the basic material design and the in vitro studies in terms of CD4+ removal. This paper was printed in Therapeutic Apheresis, vol. 2, page 37–42 (1998), and reprinted here with permission.

To control antigen (Ag)‐specific immune cells is important in the treatment of autoimmune diseases. In particular, a direct solution may be obtained by controlling the CD4+ cell function that controls the immune response of autoimmune T cells. Thus, a technique to selectively remove CD4+ cells has been developed, based on the consideration that the immune system may possibly be modified by selectively removing the CD4+ cells by means of extracorporeal circulation. The currently developed device to selectively remove CD4+ cells uses a material made of nonwoven fabric with monoclonal antibodies immobilized on the surface. With this device, removal of only CD4+ cells from human mononuclear cells suspension can be accomplished. Moreover, CD4+ cells can be specifically removed from peripheral whole blood by direct perfusion. This review outlines a series of procedures for selective cell removal and the results of our research.
Efficacy and Biocompatibility of a Novel Anti‐Cancer Fiber in Hemoperfusion on Cancer‐Bearing Rabbits
Authors: Tani T. , Kodama M. , Oka T. , Hanasawa K. , Teramoto K. , Nishiumi S.
Published: March 2003

Guest Editor's Introduction: Extracorporeal immunomodulation defined by Agishi is a term given to the medical concept or technique by which the immunological condition is modified, suppressed, or stimulated, in an extracorporeal circulation procedure, but not by the administration of pharmaceutical agents as it was formerly. Although the immunomodulations can be induced to a certain extent by the removal of the plasma or cellular components, the development of a technique which can be applied for cellular suppression or stimulation has been eagerly expected. Tani took the lead in the development of such a technique, and this paper is the first report regarding his device of immunomodulation for cancer treatment. This paper was printed in Tran Am Soc Artif Intern Organs, vol. 30, page 308–312 (1984) and reprinted here with permission.
Biocompatibility in Membrane Plasmapheresis: The Necessity of Global Understanding
Authors: Murabayashi Shun , Omokawa Susumu , Takaoka Tetsuro , Malchesky Paul S. , Nosé Yukihiko
Published: March 2003

Guest Editor's Introduction: Regarding immunomodulation to a patient, it is sometimes forgotten that the apheresis procedure itself induces immunomodulation effects to a certain extent. Such an effect is called procedurally associated immunomodulation and defined by Nosé as the immunological impacts induced by the device and the method other than the intended therapeutic immunomodulation to a patient. This paper is the first report describing the procedurally associated immunomodulation. This paper was originally printed in Therapeutic Plasmapheresis, vol. 6, page 27–43 (1987), and reprinted here with permission.
Apheresis Technology for Prevention and Regression of Atherosclerosis
Authors: Yamamoto Akira , Harada‐Shiba Mariko , Kawaguchi Akito , Tsushima Motoo
Published: March 2003

Abstract:Familial hypercholesterolemia (FH) is a congenital disorder of cholesterol metabolism, which is due to a deficiency in low‐density lipoprotein (LDL) receptors. The homozygous form of FH is especially liable to coronary artery disease (CAD) in youth because of the very high LDL‐cholesterol levels. It is resistant to drug therapy, and LDL‐apheresis is the only practical way of treatment for these patients. Some patients with heterozygous FH also have high LDL‐cholesterol levels that cannot be brought down into the optimum range by any combination drug therapy. We have treated or are treating 10 homozygous and 28 heterozygous FH patients in our hospital or in affiliated hospitals expert in blood purification. Among the 10 homozygous patients, 2 died of myocardial infarction. Only one young female patient is still free of symptoms, and the other patients have been suffering from regurgitation through the aortic valve although they have not experienced myocardial infarction. Rapid rebound of LDL‐cholesterol after each apheresis treatment limits the period during which LDL‐cholesterol is in the optimum range. The use of atorvastatin at a high dose (40 mg/day) was attempted to suppress this rebound. In contrast with good results in receptor‐defective‐type patients, receptor‐negative‐type patients did not show a response in LDL‐cholesterol levels to the statin therapy although there was a slight increase in high‐density lipoprotein (HDL)‐cholesterol with a decrease in very‐low‐density lipoprotein‐triglyceride and ‐cholesterol. Follow‐up study of the patients with heterozygous FH revealed that LDL‐apheresis was effective in lengthening the life expectancy of the patients with pre‐existing CAD, especially those who had received intervention coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA). It was also shown that the use of probucol in combination with LDL‐apheresis was effective in reducing coronary events as shown by the necessity of CABG or PTCA. Clinical data on the effect of LDL‐apheresis, recently reported from some other institutions in Japan, will also be reviewed.
Current Topics on Low‐Density Lipoprotein Apheresis
Authors: Bambauer Rolf , Schiel Ralf , Latza Reinhard
Published: March 2003

Abstract: The prognosis of patients suffering from severe hyperlipidemia, sometimes combined with elevated lipoprotein (a) (Lp[a]) levels, and coronary heart disease (CHD) refractory to diet and lipid‐lowering drugs is poor. For such patients, regular treatment with low‐density lipoprotein (LDL) apheresis is the therapeutic option. Today, there are four different LDL‐apheresis systems available: immunoadsorption, heparin‐induced extracorporeal LDL/fibrinogen precipitation, dextran sulfate LDL‐adsorption, and LDL‐hemoperfusion. Despite substantial progress in diagnostics, drug therapy, and cardiosurgical procedures, atherosclerosis with myocardial infarction, stroke, and peripheral cellular disease still maintains its position at the top of morbidity and mortality statistics in industrialized nations. Established risk factors widely accepted are smoking, arterial hypertension, diabetes mellitus, and central obesity. Furthermore, there is a strong correlation between hyperlipidemia and atherosclerosis. Besides the elimination of other risk factors, in severe hyperlipidemia (HLP) therapeutic strategies should focus on a drastic reduction of serum lipoproteins. Despite maximum conventional therapy with a combination of different kinds of lipid‐lowering drugs, however, sometimes the goal of therapy cannot be reached. Mostly, the prognosis of patients suffering from severe HLP, sometimes combined with elevated Lp(a) levels and CHD refractory to diet and lipid‐lowering drugs is poor. Hence, in such patients, treatment with LDL‐apheresis can be useful. Regarding the different LDL‐apheresis systems used, there were no significant differences with respect to the clinical outcome or concerning total cholesterol, LDL, high‐density lipoprotein, or triglyceride concentrations. With respect to elevated Lp(a) levels, however, the immunoadsorption method seems to be the most effective. The published data clearly demonstrate that treatment with LDL‐apheresis in patients suffering from severe hyperlipidemia refractory to maximum conservative therapy is effective and safe in long‐term application.
Leukocytapheresis Using a Leukocyte Removal Filter
Authors: Shirokaze Junichi
Published: March 2003

Abstract: Leukocytapheresis (LCAP) long has been investigated with a leukocyte removal filter for the treatment of various kinds of autoimmune related and inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and so on. A lot of patients with such diseases have been reported to respond to LCAP. Asahi Medical Co. has developed the leukocyte removal filter Cellsorba and an extracorporeal treatment unit Plasauto LC so that the LCAP technique can be performed easily with a high performance filter, easy attachment of the blood circuit tubing set, and automatic operation. Cellsorba E has been listed as a medical device reimbursed by Japanese national health insurance to be used in LCAP for active ulcerative colitis since October 2001. Although the effective mechanism of LCAP is still controversial, the removal of activated leukocyte from the peripheral blood and the reaction by blood contacting materials in Cellsorba can be triggers of the immunomodulation for the treatment of immune disorder. This review introduces the development of LCAP technologies and several reports on therapeutic results.
B Cells and Immunoglobulins Dependent Mechanisms in Rheumatoid Arthritis: A Possible Rationale of the Extracorporeal Immunomodulation for Rheumatoid Arthritis
Authors: Matsumoto Isao , Sumida Takayuki
Published: March 2003

Abstract: Patients with rheumatoid arthritis (RA) have several options for treatment nowadays, although we do not know what types of therapies are effective for these patients because RA is a very heterogenous disease. We discuss several possible mechanisms of RA in this review and explain one possible scenario of autoantibodies dependent arthritis confirmed by anti‐glucose‐6‐phosphate isomerase antibodies. We also propose several efficacious treatments for treating these patients as made‐to‐order therapies.
Combination of Therapeutic Apheresis and Therapeutic Ventricular Assistance for End‐Stage Heart Failure Patients
Authors: Schulte‐Eistrup Sebastian , Ashizawa Satoshi , Nonaka Kenji , Ichikawa Seiji , Motomura Tadashi , Murai Noriyuki , Nosé Yukihiko
Published: March 2003

Abstract: Dilated cardiomyopathy is a cardiac disease of unknown origin which is characterized by the gradual development of cardiac failure associated with four‐chamber dilatation of the heart. Heart transplantation has been considered as the last resort for this disease. However, some patients who received support with a ventricular assist device (VAD) as a bridge‐to‐transplantation and then recovered without transplantation have been reported. This new concept of treating heart failure is termed bridge‐to‐recovery. A VAD can inhibit the heart failure compensatory mechanisms by extreme ventricular unloading. Also, heart failure is a complex neurohormonal/autocrine‐paracrine syndrome, and these mechanisms consecutively lead to inflammatory response by proinflammatory cytokines; interleukin‐1α (IL‐1α), interleukin‐1β (IL‐1β), interleukin‐2 (IL‐2), interleukin‐6 (IL‐6), and tumor necrosis factor‐α (TNF‐α). Furthermore, the existence of anti‐β1‐adrenoceptor autoantibodies (A‐β1‐AABs) in a patient with dilated cardiomyopathy has been reported. These proinflammatory cytokines and this antibody accelerate a ventricular remodeling and a contractile dysfunction over the long term. Apheresis can also inhibit the vicious cycle in heart failure by removing the factors that are produced by activated neurohormonal/autocrine‐paracrine compensatory mechanisms. Therefore, we propose that the combined therapies, therapeutic VAD and therapeutic apheresis, will provide a prominent outcome for a patient who is suffering from end‐stage heart failure.
Practical Issues in Therapeutic Apheresis
Authors: Teruya Jun
Published: March 2003

Abstract: Although therapeutic plasma exchange is known to be the most effective and efficient therapeutic modality for some disorders such as thrombotic thrombocytopenic purpura and hyperviscosity syndrome, no standard protocol of plasma exchange has been developed. A protocol based on evidence needs to be established for standard of care. It should include exchange volume, replacement fluid, frequency, and end point. Indication of plasma exchange is not always clear because prospective randomized clinical trials, especially blinded trials, are difficult to perform. The standard guideline is now available from Category 1 to Category 4 and is published by the American Association of Blood Banks and the American Society for Apheresis. Each institution should establish its own pheresis guideline and protocol for each disorder.
The Effects of Organic Amendments on the Restoration of a Disturbed Coastal Sage Scrub Habitat
Authors: Ret;Michael F. Allen Thomas A. Zink
Published: March 2003

The effectiveness of organic mulch as a simple means of enhancing the restoration of disturbed lands by providing a competitive edge to native perennials, such asArtemisia californica(California sagebrush), over exotic annuals, such asAvena fatua(wild oat), was studied by investigating the effect of organic amendments on microbial activity and nitrogen immobilization through both soil analysis and aboveground plant growth. The addition of organic amendment resulted in an increase in microbial activity, a parallel increase in nitrogen immobilization, and no significant differences in total soil nitrogen. It is likely that nitrogen was gradually being removed from its more available form of nitrate and being immobilized in the tissues of the increasing microbial biomass. The survival rate of planted native perennial seedlings ofA. californicain organic amended plots was almost double that of control‐plot seedlings, and plant volume was significantly higher. When the availability of nitrogen was reduced through increased immobilization, amended plots established an environment more conducive to native perennial shrubs, allowing them to outcompete exotic annuals for water and nutrients. This simple procedure could have major implications for enhancing the restoration of disturbed lands.
Arbuscular Mycorrhizae of Leymus arenarius on Coastal Sands and Reclamation Sites in Iceland and Response to Inoculation
Authors: Greipsson S. , El‐Mayas H.
Published: March 2003

The occurrence of arbuscular mycorrhizae fungi (AMF) was examined in natural and reclaimed sand dunes in Iceland. On the coastal sand‐plain of Myrdalssandur no spores of AMF were found on barren sand, and very few were found in 1‐ and 5‐year‐old reclamation sites of Leymus arenarius (lymegrass). A significantly higher number of AMF spores and root colonization were found in a 10‐year‐old reclamation site and in a natural old dune system of L. arenarius. AMF spores showed seasonal variation with higher occurrence in the fall than in the spring. On the volcanic island Surtsey, no AMF spores or root colonization were found on L. arenarius in 6‐ and 10‐year‐old dunes. However, AMF spores and root colonization were found in the 22‐year‐old Leymus dune. On Surtsey, a colonization pattern was found where AMF non‐dependent plants were the first colonizers followed by AMF facultative plants, then by AMF‐dependent plants. Today AMF facultative plants have the highest number of species but AMF non‐dependent plants have the largest population size. Three different AMF inocula were tested on L. arenarius; growth of seedlings was improved significantly by an indigenous AMF inoculum compared with commercial inocula. Inoculation of nursery grown seedlings of L. arenarius followed by transplantation into barren sand seeded with L. arenarius is recommended because this method will ensure establishment of the plant and enhance succession.
Barriers to Forest Regeneration in an Abandoned Pasture in Puerto Rico
Authors: Zimmerman Jess K. , Pascarella John B. , Aide T. Mitchell
Published: March 2003

Sources of forest regeneration (soil seed bank, seed rain) and barriers to seedling establishment were examined in a recently abandoned pasture in eastern Puerto Rico. Few woody species were found in the soil seed bank or in the seed rain. The number of seeds and species in the seed rain and soil seed bank declined with distance from the adjacent secondary forest. Nine species naturally dispersed and colonized plots during the study, with the wind‐dispersed tree Tabebuia heterophylla being the predominant colonizer (91% of all seedlings). Barriers to seedling establishment were determined using a blocked field experiment with eleven woody species representative of a variety of life histories. Each species was planted under the pasture vegetation (control) or in areas where all vegetation was removed (removal). Germination was enhanced for four species in the control treatment, five species were not affected, and two species did not germinate under either treatment. Survival to 6 months was higher in the removal treatment for two species. Seedling biomass was greater in the removal treatment at 12 months for one species. Seed mass was a good predictor of germination success and final shoot biomass, but not survival. This study demonstrates that seeding recently abandoned pastures with a mix of known pioneer species may accelerate the rate of secondary succession, but some species will have to be planted in later successional stages in order to overcome strong barriers to establishment.
Soil Microfungi in Two Post‐Mining Chronosequences with Different Vegetation Types
Authors: Nováková Alena
Published: March 2003

Soil microfungi were studied in the Sokolov (Czech Republic) post‐mining dumps afforested withAlnus glutinosaand in the Lusatian (Germany) post‐mining dumps afforested withPinus sylvestrisorP. nigra. Microfungi were isolated using the soil dilution plate method. Soil microfungi communities of two chronosequences were compared by species composition, frequency of species occurrence, and colony forming units of fungi (CFU‐counts). Differences in species occurrence were determined. More species of entomopathogenic microfungi were found from the Sokolov post‐mining area in comparison with the Cottbus post‐mining area.Absidia glauca,A. cylindrospora,Penicillium glabrum, andP. janthinellumwere the most frequently isolated species from the Cottbus post‐mining area, whileA. glauca,Geomyces pannorum, andTrichoderma koningiipredominated at the Sokolov post‐mining area.
Application of Landscape Allometry to Restoration of Tidal Channels
Authors: Hood W. Gregory
Published: March 2003

Oligohaline tidal channels (sloughs) in the Pacific Northwest were shown to have allometric form with respect to outlet width and depth, channel length, perimeter, and surface area. In contrast, an artificial slough, excavated to mitigate port improvements, did not conform to natural slough allometry, resulting in high retention of allochthonous inputs and sediment accumulation. Additionally, intertidal sedge habitat abundance was related to slough size for smaller sloughs, but larger sloughs did not fit this allometric pattern. This suggests that sedge habitat in large sloughs has been destroyed due to extensive log storage and transportation from the 1890s to the 1970s. Finally, the abundance of salmonid prey of terrestrial origin—aphids and adult flies—in slough surface waters was correlated with slough perimeter and, for aphids, with the amount of intertidal sedge habitat. An allometric perspective on landscape form and function has several implications for habitat restoration and mitigation: (1) Size‐related constraints on replication for landscape‐scale studies are loosened (e.g., rather than requiring reference sites that are similar in size to experimental sites, analysis of covariance can be used to control size effects); (2) physical processes, such as sedimentation and erosion, affect landscape form, whereas landscape form can affect ecological processes, so design of restoration or mitigation projects should conform to allometric patterns to maximize physical and ecological predictability; (3) landscape allometry may provide insight into undocumented human disturbances; and (4) allometric patterns suggest design goals and criteria for success.
Roads as Ecological Edges for Rehabilitating Coastal Dune Assemblages in Northern KwaZulu‐Natal, South Africa
Authors: Weiermans Jacolette , Van Aarde Rudi J.
Published: March 2003

Abstract Post‐mining coastal dune rehabilitation north of Richards Bay, KwaZulu‐Natal started 20 years before field work for the present study commenced. This resulted in the development of a known age sere of coastal dune forest succession. These rehabilitating areas are fragmented by roads that may act as ecological edges. To establish whether roads affect regenerating bird, millipede, and rodent assemblages, multivariate techniques were applied to test for existence of edge and core assemblages within seral stages representative of the coastal dune forest successional sere. Edge and core assemblages were identified for both the bird and millipede communities but not for the rodent community. Low rodent numbers may have concealed edge effects, but the absence of edge and core assemblages could also be ascribed to the absence of a forest core. In the bird community species composition, richness, density, and total number of species contributed to the identification of edge and core assemblages. Within seral stages the species composition of millipedes differed between the edge and core assemblages. However, if the site was the same age the number of species in edge and core assemblages was similar. The generality of the edge concept should be approached with caution when dealing with taxa comprising species with such diverse natural histories as in the present study. It should also be kept in mind that some species require forest interiors for survival.
Glucose‐Induced Map Kinase Activation And Aldose Reductase Expression In Primary Schwann Cell Culture
Authors: Mouchot C , Tomlinson Dr
Published: March 2003

Diabetic hyperglycaemia creates biochemical alterations in nerve that lead to Wallerian degeneration, resulting in the modification of the Schwann cell phenotype. This suggests that the peripheral neuroglia could play a crucial role in diabetes‐induced peripheral neuropathy. Hyperglycaemia‐induced cellular stresses result in up‐regulation of aldose reductase (AR) protein expression. This study aimed to determine whether activation of mitogen‐activated protein kinases (MAPK) in Schwann cells in vitro might represent an early step in the transduction of hyperglycaemia to diabetes‐induced increased AR protein expression. We observed MAPK activation (Western blots for JNK and p38) in response to raised glucose and MAPK responses were expressed as the ratio of phosphorylated to total form. Neonatal rat Schwann cell cultures were treated with glucose (50, 200mM) for up to 24 hours. Mannitol (45, 195mM) was used as an osmotic control. Glucose for 1 hour (200mM) caused transient activation of both p38 (1.9 fold) and JNK (p < 0.01 for p56 and p46) versus controls (5.6mM glucose). Similar results were seen for JNK in response to mannitol. The mannitol‐induced p38 activation was sustained from 1 to 8 hours of treatment (p < 0.01 versus controls and p < 0.05 versus glucose treatment). Similarly, we observed a significant increase of AR content (p < 0.01 and p < 0.05 in response to glucose and mannitol, respectively). However, the maximum response occurred at 24 hours of treatment. Immunocytochemistry studies showed that activated JNK was located both in cytoplasm and nucleus, while accumulation of AR was mainly restricted to the cytoplasm surrounding the nucleus. These results suggest that JNK and/or p38 could transduce increased AR expression in response to high glucose, at least under in vitro conditions.
Hippocampal Apoptosis Is Ameliorated By C‐Peptide Replacement In Type 1 BB/W‐Rat
Authors: Sima Aaf , Z‐G Li , W‐X. Zhang
Published: March 2003

It has been suggested that perturbed insulin‐like growth factors (IGFs) may be involved in CNS complications of diabetes. We examined IGF messages, hippocampal apoptosis and the effect of C‐peptide replacement on encephalopathy in type‐1 diabetic BB/Wor‐rats. By Northern blot analysis, we found decreased (50%) mRNA expression of IGF‐I, IGF‐II and IGF‐I receptor (IGF‐IR) in 2‐month diabetic rats. In 6‐month diabetic rats, these changes were associated with positive TUNEL staining, nucleosomal DNA fragmentation and an elevated (∼2.5‐fold) ratio of Bax/Bcl‐xL in hippocampus as assessed by Western blotting and LM‐PCR assays. C‐peptide replacement (75 ng/kg body weight/day) partially corrected the expression of IGF‐I, IGF‐II and IGF‐IR and eliminated hippocampal apoptosis. To investigate the mechanisms by which C‐peptide exerts its antiapoptotic effect, human neuroblastoma SH‐SY5Y cells were incubated in high concentrations of glucose (300 mM), which caused significant apoptosis of SH‐SY5Y cells as shown by nuclear shrinkage, positive TUNEL staining and DNA laddering. This increased apoptotic activity was delayed in SH‐SY5Y cells to which 10 nM C‐peptide had been added. In the same cell system, the insulin‐induced effect on PI‐3 kinase activity was enhanced by C‐peptide, in keeping with the notion that PI‐kinase plays a role in antiapoptotic signaling. We therefore conclude that insulin and C‐peptide deficiencies in type‐1 diabetic BB/Wor‐rats are associated with hippocampal apoptosis, which can be prevented by C‐peptide replacement.