bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinal Cord Stimulation and Cerebral Blood Flow in Stroke: Personal Experience
Authors: Visocchi M. , Giordano A. , Calcagni M. , Cioni B. , Di Rocco F. , Meglio M.
Published: April 2003

Spinal cord stimulation (SCS) can increase cerebral blood flow (CBF) and improve stroke patients. In order to better understand the haemodynamic changes underlining the clinical improvement, we have studied with transcranial Doppler (TCD), SPECT and NIRS 18 patients harbouring a stroke. SPECT Group: An increase of regional CBF during SCS was measured far from the stroke areas in 9 patients, further decrease in CBF was found in 2, no changes in 1. TCD Group: An increase of CBF velocities during SCS was found in 4 patients, no changes in 6, a decrease in 1. NIRS Group: Data consistent with and increase in CBF were obtained during SCS in the only patient undergone such a study. In 6 patients studied with different techniques, data obtained fitted only in 2 patients. In 3 patients no changes in TCD faced with changes in SPECT. In one case an improvement in TCD was evident in the left while an improvement of SPECT was shown in the right site. SCS is a valid therapeutic tool in stroke patient even if, as matter of fact, parallelism between clinical and haemodynamic changes during SCS is not demonstrated in our patients, rising the question on the role of ischemic penumbra in mediating clinical improvement.
Enhanced Epileptogenic Susceptibility in a Genetic Model of Reactive Synaptogenesis: The Spastic Han-Wistar Rat
Authors: Cepeda Carlos , Crawford Cynthia A. , Margulies Jody E. , Watson Joseph B. , Levine Michael S. , Cohen Randy W.
Published: April 2003

Our laboratory has been studying the spastic Han-Wistar (sHW) rat as a model of neuronal degeneration. Mutant sHW rats display a number of developmental abnormalities that eventually lead to hippocampal pyramidal cell death and synaptic reorganization starting around 30 days of age. The present study examined the contribution of hippocampal reorganization to the expression of seizures induced by systemic injections of kainic acid. Behavioral observations, EEG recordings and hippocampal Fos protein expression in these animals indicated that mutants develop paroxysmal discharges and seizures earlier than controls and the intensity of epileptic manifestations is greater. Kainate injections were lethal in 50% of mutants compared to only 5% of controls. Fos expression was increased approximately twofold in the mutant hippocampus, implicating abnormal excitation in this region. Additional studies in untreated animals indicated that GluR2 mRNA expression was significantly increased throughout the hippocampus in mutant animals, possibly contributing to the enhanced susceptibility to kainate treatment. These results confirm the role of synaptic reorganization in the increased propensity to develop epileptic discharges. Our data also underscore the usefulness of this natural model of cell degeneration and reactive synaptogenesis for understanding the mechanisms of neuronal hyperexcitability.
Changes in the Expression of Parvalbumin Immunoreactivity in the Lumbar Spinal Cord of the Rat following Neonatal Nerve Injury
Authors: Dekkers Joanna , Greensmith Linda , Navarrete Roberto
Published: April 2003

Nerve injury in newborn animals results in the loss of motoneurons and dorsal root ganglion neurons and long-term changes in reflex activation of surviving motoneurons. Parvalbumin has been previously shown to be found in large-diameter primary afferent axons and interneurons in the spinal cord, and was used here to study the changes in parvalbumin-immunoreactive appositions onto identified tibialis anterior/extensor digitorum longus (TA/EDL) motoneurons, during both normal development and following neonatal nerve injury in the rat spinal cord. During normal development, there was a decrease in the number of parvalbumin-immunoreactive appositions onto TA/EDL motoneurons. Thus, at postnatal day 7 (P7), there were 72.8 ± 17.5 (mean ± SD) appositions per motoneuron and by P14, it had decreased to 38.8 ± 13.2 (mean ± SD; p > 0.05). Following neonatal nerve injury at P2, there were fewer parvalbumin-positive afferent appositions close to the TA/EDL motoneurons than normal, so that at P7, there were 53.5 ± 17.1 (mean ± SD), and at P14, it further decreased to 25.8 ± 8.6 (mean ± SD; p > 0.05). This injury-induced reduction in the number of parvalbumin-immunoreactive boutons apposing TA/EDL motoneurons may result, at least in part, from the death of dorsal root ganglion cells with the consequent loss of their central projections. The alterations in the number of parvalbumin-positive appositions close to motoneurons observed in this study may contribute to the changes in the pattern of reflex activity observed in the developing spinal cord both during normal development and following neonatal injury.
Wnt/Beta-Catenin/Tcf Signaling: A Critical Pathway in Gastrointestinal Tumorigenesis
Authors: Kolligs Frank T. , Bommer Guido , Göke Burkhard
Published: April 2003

Cancers of the gastrointestinal tract, including the liver, bile ducts, and pancreas, constitute the largest group of malignant tumors. Colorectal cancer is one of the most common neoplastic diseases in Western countries and one of the leading causes of cancer-related deaths. Inactivation of the adenomatous polyposis coli (APC) tumor-suppressor gene during early adenoma formation is thought to be the first genetic event in the process of colorectal carcinogenesis followed by mutations in oncogenes like K-Ras and tumor-suppressor genes like p53. Identification of the interaction of APC with the proto-oncogene β-catenin has linked colorectal carcinogenesis to the Wnt-signal transduction pathway. The main function of APC is thought to be the regulation of free β-catenin in concert with the glycogen synthase kinase 3β (GSK-3β) and Axin proteins. Loss of APC function, inactivation of Axin or activating β-catenin mutations result in the cellular accumulation of β-catenin. Upon translocation to the nucleus β-catenin serves as an activator of T-cell factor (Tcf)-dependent transcription leading to an increased expression of several specific target genes including c-Myc, cyclin D1, MMP-7, and ITF-2. While APC mutations are almost exclusively found in colorectal cancers, deregulation of Wnt/β-catenin/Tcf signaling is also common in other gastrointestinal and extra-gastrointestinal human cancers. In a fraction of hepatocellular carcinomas the Wnt pathway is deregulated by inactivation of Axin or stabilizing mutations of β-catenin. The majority of hepatoblastomas and a group of gastric cancers also carry β-catenin mutations. Clearly, this pathway harbors great potential for future applications in cancer diagnostics, staging, and therapy.
Secretion of Cytokines, Histamine and Leukotrienes in Chronic Urticaria
Authors: Ferrer Marta , Luquin Esther , Sanchez-Ibarrola Alfonso , Moreno Cristina , Sanz Maria L. , Kaplan Allen P.
Published: April 2003

Background: Approximately 35–40% of patients with chronic urticaria have an IgG autoantibody to the IgE receptor which can activate basophils and mast cells so that they release histamine. In this study we assessed the cytokine profile present in chronic urticaria sera, and then measured cytokine and leukotriene release from basophils and mast cells upon incubation with chronic urticaria sera. Finally we assessed cytokine expression at the single-cell level and characterized the T cell subpopulations involved in their production. We chose IL-4 as representative of Th2 lymphocytes and IFN-γ for Th1 lymphocytes. Methods: We analyzed IL-4, IL-5 and IFN-γ in 60 chronic urticaria sera versus 51 controls. Sera were incubated with purified human basophils and cutaneous mast cells and the release of histamine, IL-4 and leukotrienes (C4, D4, E4) was quantitated. Immunoblotting was performed to identify IgG antibody to FcΕRIα, α subunit. We measured intracellular cytokine production in peripheral blood mononuclear cells of 17 chronic urticaria patients compared to 50 healthy controls. Results: We found higher IL-4 levels (p = 0.028) in the sera of chronic urticaria patients (1.03 pg/ml) versus healthy donors (0.20 pg/ml) but no difference between urticaria sera and atopic control sera (0.52 pg/ml). We did not detect IFN-γ or IL-5 in any serum. However, sera that activated basophils so that they released histamine also produced leukotriene and IL-4, and leukotriene production by cutaneous mast cells and basophils was closely correlated. However, there was no correlation between immunoblotting and the functional ability to induce either histamine or IL-4. After stimulating with PMA-ionomycin we found significant differences in CD4+ lymphocyte production of IL-4 and IFN-γ with no differences in CD8+ lymphocyte production of either cytokine. Conclusion: Our data support the presence of basophil and mast cell activators in the sera of patients with chronic urticaria which can lead to the production of leukotrienes and IL-4 in addition to the histamine. IL-4 levels are similar to those seen in atopic subjects. We found that CD4+ T cells from patients with chronic urticaria are activated and tend to produce higher cytokine levels than CD4+ T cells from healthy controls. There were no differences when cytokine production by CD8+ lymphocytes was similarly assessed. These results are consistent with the histology found in biopsies of chronic urticaria lesions, where a CD4+-predominant infiltrate is found with cytokine production suggesting either a Th0 response or a mixture of Th1 and Th2 lymphocytes.
Leukocyte Adhesion Deficiency II: Therapy and Genetic Defect
Authors: Wild Martin K. , Lühn Kerstin , Marquardt Thorsten , Vestweber Dietmar
Published: April 2003

Leukocyte adhesion deficiency II (LAD II) is a rare congenital disease which is caused by a defect in fucosylation of glycoconjugates. Hypofucosylated structures include ligands for the selectin family of adhesion molecules. This results in a leukocyte adhesion defect causing an immunodeficiency. In addition, LAD II patients show severe mental and growth retardations suggesting a role of fucose in development. Recently, a LAD II patient was treated with oral supplementation of fucose. This simple therapy restored selectin ligands and corrected the immunodeficiency. However, in another patient the treatment protocol had no effect indicating that the biochemical defect in the latter patient is somewhat different. The genetic defect in LAD II has now been located to a gene encoding a GDP-fucose transporter which gates GDP-fucose into the Golgi where fucose is transferred onto glycoconjugates. Point mutations have been detected in this gene in several LAD II patients, which inactivate the transporter function. Thus, LAD II represents the first developmental and immune defect that is based on a malfunctioning nucleotide sugar transporter.
Cerebrovascular Response in Small Preterm Infants during Routine Nursery Gavage Feedings
Authors: Baserga Mariana C. , Gregory George A. , Sola Augusto
Published: April 2003

Although gavage feedings are considered a standard of care, they are often accompanied by hemodynamic changes that may have important effects on the cerebral circulation. In 23 premature infants receiving intermittent bolus gavage feeds, changes in cerebral hemodynamics and oxygenation were studied using near-infrared spectroscopy. Orogastric tube insertion resulted in an increased cerebral blood volume in 73% of the infants and in an increase in reduced hemoglobin and in cytochrome aa3 oxygenase in approximately 66% of the patients. Within 10 min of initiating a gavage feed, cerebral blood volume, oxygenated hemoglobin, reduced hemoglobin, and cytochrome aa3 oxygenase decreased from baseline in about 60% of the infants. Towards the end of the study, during the postfeeding period, cytochrome aa3 oxygenase and oxygenated hemoglobin increased in 60%, while reduced hemoglobin decreased in 78% of the infants.
Foramen ovale Recordings: A Presurgical Investigation in Epilepsy
Authors: Wieshmann U.C. , Denby C.E. , Eldridge P.R. , Roberts N. , Mackay C.E. , Webb J.A. , Tedman B.M. , Chadwick D.W. , Smith D.F.
Published: April 2003

The aim of our study was to determine when foramen ovale recordings add useful information to scalp EEG recordings and magnetic resonance imaging (MRI) with hippocampal measurements. We evaluated the outcome of 79 patients with non-lesional partial epilepsy with presumed temporal seizure onset. Ictal foramen ovale recordings were performed in 16 patients with normal MRI (‘MRI-negative group’) and 41 patients with lateralizing MRI but non-lateralizing scalp EEG (‘discordant group’). 22 patients with concordant MRI and scalp EEG were not investigated with foramen ovale recordings (‘concordant group’). The seizure-free rate was higher in concordant than discordant patients despite additional investigation with foramen ovale electrodes (71 and 55% seizure free, respectively). No useful localizing information was added with foramen ovale recordings in MRI-negative patients.
Effects of Hypoxia on Retinal Pigmented Epithelium Cells: Protection by Antioxidants
Authors: Castillo M. , Bellot J.L. , García-Cabanes C. , Miquel J. , Orts A. , Palmero M.
Published: April 2003

Age-related macular degeneration and other eye diseases, such as diabetic retinopathy, are probably linked to the effects of oxygen radicals derived from light or metabolic reactions. We have investigated the effects of hypoxia on bovine retinal pigmented epithelial cells (RPE) and the response of these cells to two antioxidants that have previously shown a beneficial action against free radical-linked senescent involution. The main results of the study were as follows: (i) Hypoxia induced apoptotic damage on RPE cells, with LDH leakage and ATP reduction; (ii) both vitamin C (VC) and N-acetyl-cysteine (NAC) treatment protected against hypoxia-induced apoptosis, with less DNA fragmentation. In our opinion, these findings justify further experimental and clinical work to investigate the role of hypoxia in the mechanisms of age-related RPE injury and death as well as the potential of antioxidant administration to prevent or delay retinal degenerative processes caused by oxygen-dependent pathophysiological conditions.
The Frequency of Multiple Sclerosis in Jewish and Arab Populations in Greater Jerusalem
Authors: Karni Arnon , Kahana Esther , Zilber Nelly , Abramsky Oded , Alter Milton , Karussis Dimitrios
Published: April 2003

A comparison of the incidence rate (IR) and the prevalence rate (PR) of multiple sclerosis (MS) in subgroups of the same ethnic origin, but born and living in different geographical areas, may delineate the relationship between environmental and genetic risk factors for MS. Previous epidemiological studies of MS in Israel did not include the Arab population and used diagnostic criteria that did not include MRI findings. Therefore, we studied the age-adjusted IR and PR of MS in a more recent sample in different population groups, including Arabs, of Greater Jerusalem. We found that the PR of MS in Israeli Jews is higher than previously described. Furthermore, the PR was significantly lower among immigrant Jews from Asia/Africa (A/A) than among native-born Jews of Asian/African origin (I-A/A). Since these groups have similar genetic susceptibilities to MS, the higher PR in the latter is probably due to environmental factors. Our study does not support the effect of latitude on the risk of developing MS since no difference in the PR was found between immigrant Jews from Europe/America (E/A) and native-born Jews of European/American origin (I-E/A). Among Arabs, the PR was similar to that among A/A. Therefore, we hypothesized similarity in environmental etiologic factors for MS between the countries of origin of A/A immigrants and of Arabs communities in Greater Jerusalem. The IR of I-E/A was higher than that of I-A/A and Arabs, although this difference did not reach statistical significance.
Prevalence of Anemia in Cancer Patients Undergoing Radiotherapy: Prognostic Significance and Treatment
Authors: Harrison Louis B. , Shasha Daniel , Homel Peter
Published: April 2003

As the antitumor activity of radiation is mediated via its interaction with oxygen to form labile free radicals, the intratumoral oxygen level has an important influence on the ability of radiation therapy to kill malignant cells. By decreasing the oxygen-carrying capacity of the blood, anemia may result in tumor hypoxia and may have a negative influence on the outcome of radiotherapy for various malignancies, even for small tumors not normally assumed to be hypoxic. In addition, anemia also has a negative effect on the quality of life of cancer patients, as evidenced by worsening fatigue. As a high proportion (about 50%) of cancer patients undergoing radiotherapy are anemic prior to or during treatment, strategies to correct anemia and/or the resultant tumor hypoxia are increasingly being considered an important component of treatment. In particular, epoetin alfa (recombinant human erythropoietin), which has proved an effective and well-tolerated means of raising hemoglobin levels in anemic patients receiving radiotherapy, potentially could reverse the negative prognostic influence of a low hemoglobin in patients with certain malignancies. Radiation oncologists need to be aware of the possibility of anemia in cancer patients undergoing radiotherapy so that timely intervention can be instituted whenever anemia is diagnosed.
Infrared Thermography in Newborns: The First Hour after Birth
Authors: Christidis Iris , Zotter Heinz , Rosegger Hellfried , Engele Heidi , Kurz Ronald , Kerbl Reinhold
Published: April 2003

Objective: It was the aim of this study to investigate the surface temperature in newborns within the first hour after delivery. Furthermore, the influence of different environmental conditions with regard to surface temperature was documented. Methods: Body surface temperature was recorded under several environmental conditions by use of infrared thermography. 42 newborns, all delivered at term and with weight appropriate for date, were investigated under controlled conditions. Results: The surface temperature immediately after birth shows a uniform picture of the whole body; however, it is significantly lower than the core temperature. Soon after birth, peripheral sites become cooler whereas a constant temperature is maintained at the trunk. Bathing in warm water again leads to a more even temperature profile. Radiant heaters and skin-to-skin contact with the mother are both effective methods to prevent heat loss in neonates. Conclusions: Infrared thermography is a simple and reliable tool for the measurement of skin temperature profiles in neonates. Without the need of direct skin contact, it may be helpful for optimizing environmental conditions at delivery suites and neonatal intensive-care units.
Serotonin and Apoptosis: Studies on Rat Lymphocytes
Authors: Stefulj Jasminka , Jakopec Sanjica , Osmak Maja , Jernej Branimir
Published: April 2003

Objective: The apoptogenic potential of serotonin (5-hydroxytryptamine) on mitogen-stimulated lymphocytes was studied in primary cultures of rat spleen cells, in two sets of experiments. Methods: Apoptosis was measured by morphologic criteria and flow cytometry. Results: In both assays, serotonin, at a concentration producing half-maximal inhibition of lymphocyte proliferation, significantly increased the basal levels of apoptosis. Conclusion: An apoptotic mechanism should be taken into account when considering immunoinhibition induced by serotonin.
Collagenase-Induced Changes in Articular Cartilage as Detected by Electron-Microscopic Stereology, Quantitative Polarized Light Microscopy and Biochemical Assays
Authors: Långsjö Teemu K. , Rieppo Jarno , Pelttari Alpo , Oksala Niku , Kovanen Vuokko , Helminen Heikki J.
Published: April 2003

The purpose of this study was to compare the ability of electron-microscopic (EM) stereology with quantitative polarized light microscopy (PLM) and biochemical collagen (hydroxyproline) and crosslink (pyridinoline) analyses to detect changes in the superficial collagen network of bovine articular cartilage after digestion in vitro with purified bacterial (Clostridium histolyticum) collagenase (30 U/ml) for 24 and 48 h. Collagen volume (VV) and surface (SV) densities of the uppermost third of the superficial zone were estimated indirectly from zonal isotropic uniform random sections using collagen length density (LV) and average collagen fibril diameter, or its average second power. Collagenase digestion caused a significant decrease in fibril diameter (64 to 62%), VV (89 to 95%) and SV (64 to 86%) after incubation for 24 and 48 h. Collagen LV remained unchanged after 24 h incubation but decreased 63% after 48 h. Collagen concentration per dry weight, assayed biochemically from the whole superficial zone, decreased also significantly (29 to 60%) after 24 and 48 h digestions, respectively. The pyridinoline concentration per dry weight of the superficial zone decreased (31 to 57%) whereas the pyridinoline concentration per collagen remained unchanged. PLM revealed that the birefringence of the uppermost third of the superficial zone was decreased by 36% after digestion for 24 h though the total birefringence of the whole zone was not reduced. However, after 48 h, the birefringence of the whole superficial zone was significantly reduced (76%). All of the techniques compared in this study could detect collagen network degradation in bovine articular cartilage but the EM stereological technique was more sensitive at detecting the changes than PLM or biochemical assays.
Morphology of the Intrinsic Cardiac Nervous System in the Dog: A Whole-Mount Study Employing Histochemical Staining with Acetylcholinesterase
Authors: Pauza Dainius H. , Skripka Valdas , Pauziene Neringa
Published: April 2003

The intrinsic cardiac nervous system is known to be important both in the prevention and treatment of risky heart diseases. The present study was designed to determine the topography and 3-dimensional architecture of the intrinsic nervous system in the canine heart highlighting the differences of this system in dogs and humans. The morphology of the intrinsic cardiac neural plexus was revealed with a histochemical method using acetylcholinesterase in whole hearts of 18 mongrel dogs and examined with the aid of dissecting stereoscopic and contact microscopes. The present study identified 13 locations between the canine ascending aorta and pulmonary trunk, around the pulmonary veins, and on every side of the superior vena cava, through which mediastinal cardiac nerves accessed the canine heart. Intrinsic nerves from these locations extended within the canine epicardium by seven neuronal subplexuses. Intrinsic nerves and ganglia were found to be widely distributed in topographically consistent atrial and ventricular regions. In general, the canine right atrium, including the sinoatrial node, was innervated by two subplexuses, the wall of the left atrium by three, and the right and left ventricles by two subplexuses. Depending on the age of the animal, the number of intrinsic ganglia per one canine heart might range from 400 up to 1,500. By taking into account the ganglion size and potential approximate number of neurons residing inside a ganglion of a certain size, it was estimated that on average about 80,000 intrinsic neurons are associated with the canine heart. A comparative analysis of the morphological patterns of the canine and human intrinsic cardiac neural plexuses showed that the topographies of these plexuses may be considered as quite similar, but the structural and quantitative differences of the intrinsic cardiac neural subplexuses between dogs and humans are significant.
Reverse Remodeling of the Failing Human Heart with Mechanical Unloading
Authors: Razeghi Peter , Myers Timothy J. , Frazier O.H. , Taegtmeyer Heinrich
Published: April 2003

Anecdotal and clinical evidence suggests that mechanical unloading may restore cardiac function by inducing changes in the biological properties of the failing heart. This challenges the notion that the progression of end-stage heart failure is an irreversible process ending in either death of the patient or transplantation. Although it is still not clear how mechanical unloading of the failing heart improves cardiac function, the process likely involves adaptive responses of cardiac myocytes on the cellular, extracellular, and subcellular levels.
Comparison between Percutaneous Balloon Valvuloplasty and Open Commissurotomy for Mitral Stenosis
Authors: Cardoso Luiz F. , Grinberg Max , Rati Miguel A. , Pomerantzeff Pablo M. , Medeiros Caio C. J. , Tarasoutchi Flávio , Martinez Eulógio
Published: April 2003

Eighty patients with tight and pliable mitral stenosis were randomized in a prospective trial comparing percutaneous balloon valvuloplasty and open commissurotomy. Mitral valve area increased significantly in both groups immediately after the procedures. However, a decrease in mitral valve area occurred in both groups at 6, 12 and 24 months during the follow-up. There was no death in either group. Two patients had significant mitral regurgitation after percutaneous balloon valvuloplasty. After 24 months, all patients in the commissurotomy group and 97.4% of the patients in the balloon valvuloplasty group were in New York Heart Association functional class I or II.
Mitochondrial COII Gene Sequences Provide New Insights into the Phylogeny of Marmoset Species Groups (Callitrichidae, Primates)
Authors: Sena Leonardo , Vallinoto Marcelo , Sampaio Iracilda , Schneider Horacio , Ferrari Stephen F. , Schneider Maria Paula Cruz
Published: April 2003

Mitochondrial cytochrome oxidase II (COII) gene sequences (549 base pairs) were used to investigate the taxonomic relationships among 12 marmoset (Callithrix, Cebuella and Mico) taxa. A large number of substitutions were found in the third base codon positions, providing a strong phylogenetic signal in a gene coding a conserved protein. Despite the significant affinity between the 2 Amazonian genera Cebuella and Mico, found in recent molecular studies, the analysis presented here did not resolve convincingly the phylogenetic relationships between the 3 genera. Mico nevertheless formed 3 distinct clades, reflecting a basic division of species groups based on geographic distribution (east or west of the Rio Tapajós) rather than morphology (presence or absence of auricular hair). This supports the taxonomic distinction of the allopatric emiliae forms. In Callithrix, Callithrix aurita forms a distinct clade, but the remaining morphotypes form a somewhat contradictory cluster, possibly resulting from an extremely rapid radiation.
Bronchial Hyperresponsiveness in Subjects with Gastroesophageal Reflux
Authors: Bagnato G.F. , Gulli S. , Giacobbe O. , De Pasquale R. , Purello D’Ambrosio F.
Published: April 2003

Background: The relationship between gastroesophageal reflux (GER) and asthma has been widely studied in the last years. GER may interfere with airway reactivity and aggravate or even induce asthma. Objective: To assess the prevalence of bronchial hyperresponsiveness (BHR) in patients with GER disease with a view to judging the potential influence of GER on BHR. Methods: 30 patients with GER disease and no clinical evidence of asthma and 30 normal subjects underwent a methacholine bronchial challenge. The methacholine concentration that caused a 20% fall in the FEV1 (PC20) was used to assess bronchial responsiveness. Results: In the GER group 11 subjects of the 30 studied showed a PC20 methacholine equal to or less than 8 mg/ml while in the control group only 2 subjects had a PC20 methacholine equal to or less than 8 mg/ml (p < 0.01; ANOVA test). Conclusions: Subjects with GER had a greater increase in airway reactivity when inhaling methacholine compared to disease-free normal subjects.
Endoscopic Techniques for Enteral Nutrition: Standards and Innovations
Authors: Dormann A.J. , Huchzermeyer H.
Published: April 2003

Enteral nutrition has been increasingly used in clinical practice during the past decades. Today, nasogastric, nasoenteric, and transcutaneous gastric or enteral feeding tubes are well established as a routine endoscopic intervention. After clinical introduction of percutaneous endoscopic gastrostomy (PEG) in 1980, the sutureless ‘pull’ PEG has become a widespread endoscopic technique for transcutaneous gastric long-term nutrition. Multiple new techniques have been introduced since then, and today even long-term jejunal nutrition can be achieved with modified techniques. The introducer PEG (first reported in 1984) has not become an established procedure, but new techniques with an endoscopic gastropexy might be a more effective approach. To increase the qualitiy of life of the patients, skin-level devices were designed and successfully introduced in 1984. A new development has been the one-step feeding tubes which provide the patients with a permanent tube. The standard techniques for long-term enteral feeding, new developments of feeding tubes, and future concepts are discussed in this review.
Endoscopic Interventions for Preneoplastic and Neoplastic Lesions: Mucosectomy, Argon Plasma Coagulation, and Photodynamic Therapy
Authors: Ortner Maria-Anna , Dorta Gian , Blum André Louis , Michetti Pierre
Published: April 2003

The classical treatment of neoplastic lesions is surgical resection. Improved detection of early lesions has offered new therapeutic strategies. Thus, for the last 20 years it has been increasingly attempted to undertake endoscopic resection of such tumors. While there is no doubt that morbidity and mortality are lower than after surgery, it was assumed that the long-term prognosis is not as good as with surgery. Surprisingly, however, the 5-year survival rates are excellent. Therefore, in local mucosal lesions of colon, stomach, and esophagus, endoscopic removal has become standard treatment. In Barrett’s esophagus, the treatment modality it is still discussed controversially, despite encouraging results. Since we are yet not able to completely eliminate the premalignant specialized intestinal epithelium of the esophagus, it is still uncertain whether eradication of the malignant or dysplastic lesion is sufficient.
Noradrenaline, but Not Neuropeptide Y, Is Elevated in Cerebrospinal Fluid from the Third Cerebral Ventricle following Audiovisual Stress in Gonadectomised Rams and Ewes
Authors: Turner Anne I. , Rivalland Elizabeth T.A. , Clarke Iain J. , Lambert Gavin W. , Morris Margaret J. , Tilbrook Alan J.
Published: April 2003

There are sex differences in the activation of the hypothalamo-pituitary-adrenal axis in response to stress, but the source of these differences is unknown. The hypothalamo-pituitary-adrenal axis is regulated by corticotropin-releasing hormone and arginine-vasopressin neurones located in the paraventricular nucleus and these, in turn, are regulated by neural systems that include afferent noradrenergic and neuropeptide Y (NPY)-producing neural pathways. We tested the hypothesis that concentrations of noradrenaline and NPY will be elevated in cerebrospinal fluid (CSF) sampled from the third cerebral ventricle in response to stress, and these responses will differ in males and females. We collected concurrent samples of CSF (1 ml) from the third ventricle and blood (5 ml) from the jugular vein from gonadectomised rams (n = 7) and ewes (n = 5) at 10-min intervals for 3 h. This procedure was conducted on a day when no stress was imposed and on a day when audiovisual stress was imposed for 5 min after 1 h of sampling. Following the audiovisual stress, plasma concentrations of cortisol and CSF concentrations of noradrenaline were elevated (p < 0.05), but CSF concentrations of NPY did not change. Adrenaline was not detected in samples of CSF. The rise in plasma cortisol following the stress was greater (p < 0.05) in ewes than in rams, but there were no sex differences in the rise in noradrenaline. Basal concentrations of NPY in the CSF were higher (p < 0.05) in rams than in ewes. We conclude that the sex differences in the stress-induced activity of the hypothalamo-pituitary-adrenal axis in sheep are not likely to be due to differences in the level of noradrenergic and/or NPY input to the hypothalamus.
Is There Additional Information from Laparoscopic Ultrasound in Tumor Staging?
Authors: Rau Beate , Hünerbein Michael , Schlag Peter M.
Published: April 2003

Accurate preoperative staging of gastrointestinal malignancies is of major importance in the decision for adequate stage-related therapy. There is evidence that laparoscopy in combination with laparoscopic ultrasound is more accurate in the detection of intra-abdominal metastases than conventional preoperative imaging. Staging laparoscopy in combination with laparoscopic ultrasound is a minimally invasive technique that reveals intra-abdominal disseminated tumor spread and local tumor extent. Therefore laparoscopic ultrasound is an ideal adjunct to laparoscopy because this technique may compensate for the lack of tactile feedback with laparoscopic instruments. Color-coded Doppler imaging can be very valuable for the assessment of resectability in patients with pancreatic cancer. Current data confirm that laparoscopic ultrasound is capable of enhancing the accuracy of staging laparoscopy. Compared to standard laparoscopy, a combination of both techniques markedly increases the sensitivity of staging laparoscopy in the determination of unresectable disease. This is of major importance in the assessment of occult liver metastases and lymph node involvement. Laparoscopic ultrasonography improves the diagnostic accuracy compared to conventional imaging techniques and should be considered as integral part of staging laparoscopy.
Percutaneous Endoscopic Gastrostomy: Adequacy and Quality of Information Given to Decision-Makers
Authors: Ladas S.D. , Triantafyllou K. , Liappas I. , Hatziargyriou M. , Tzavellas E. , Barbatzas C. , Christodoulou G. , Raptis S.A.
Published: April 2003

Background/Aim: Nowadays percutaneous endoscopic gastrostomy (PEG) is widely available, but patient-selection criteria and quality of informed consent are debated. The aims of this retrospective study were to evaluate the quality of information given to the decision-makers (relatives) and determine the overall acceptance of the procedure by the patients’ family. Methods: The relatives of patients with PEG were interviewed by telephone, using a structured questionnaire. They (n = 55; 36% spouses, 34% children, 30% other) gave information about themselves and the patient (34 males, 21 females, median age 69, range 16–92 years) who underwent PEG tube placement for eating disorders or dysphagia. Results: At the time of evaluation 30/55 (54.6%) patients had died. The cumulative median survival was significantly longer in patients younger than 75 years by 58 days (p = 0.009). Relatives believed that PEG could improve the patients’ quality of life (56%) or/and the underlying disease. Although 93% of the decision-makers considered that their opinion had been taken into account when the procedure was done, 25% said that they had not adequately been informed about alternative methods and the complications of the procedure (38%). 54% said that the procedure had improved the quality of life of the family. Most of the decision-makers believed that their decision was correct (87%) and they would recommend PEG (84%) to other patients suffering from dysphagia. Conclusion: Though several decision-makers were not satisfied with the quality of information given before informed consent, the overall acceptance of the PEG placement for nutritional support is high.
Are Gastroenterologists Aware of the Role of Ethics Committees?
Authors: Triantafyllou K. , Stanciu C. , Kruse A. , Malfertheiner P. , Axon A. , Ladas S.D.
Published: April 2003

Background/Aims: A hospital ethics committee (EC) is an organized body of people, convened to identify, analyze and help resolve moral problems that arise in the care of patients. The aim of this study was to investigate the need to educate endoscopists about the role of the ECs in European and Mediterranean countries. Methods: A structured questionnaire concerning the role of ECs was sent to the representatives of endoscopy societies, which are also members of the European Society of Gastrointestinal Endoscopy. Results: The response rate was 59% (26/44). About half of the responding representatives had attended more than 1 lecture or read more than 1 article about ethics during the previous 10 years. The percentage of hospitals with an established EC varied between countries. In 15% of the countries <20% but in 58% of the countries >60% of the hospitals have established ECs. Sixty-five percent of the responders believe that the EC is an advisory committee and 31% an executive committee. Endoscopists believe that ECs have been of great help to their specialty in their country. Conclusions: The roles of the ECs are not clear to endoscopists and there is a need for education in this field.
Distal Ureteral Stenosis after Early Adjuvant Intravesical Mitomycin C Application for Superficial Bladder Cancer
Authors: Oehlschläger Sven , Loessnitzer A. , Froehner Michael , Hakenberg Oliver W. , Manseck Andreas , Wirth Manfred P.
Published: April 2003

We report a case of distal ureteral stenosis after transurethral resection of a small bladder tumor near the left ureteral orifice and early postoperative mitomycin C instillation for prevention of recurrence. The patient developed late recurrent stenosis of the ureteral orifice with histologic evidence of localized, severe benign inflammatory reaction. The recurrent stenosis was successfully managed by transurethral resection of the scar tissue and ureteric stenting. Although ureteral stenosis does occur after transurethral resection, the severity and time course of the stenosis in this case suggest an influence of the intravesical chemoprophylaxis used.
Effect of Transurethral Resection of the Prostate on Blood Coagulation Test Results
Authors: Özmen Sadık , Koşar Alim , Sayın Adnan , Aydın Cemalettin , Yavuz Lütfi
Published: April 2003

Aim: To evaluate results of coagulation tests and serum sodium levels during the early postoperative period in patients undergoing transurethral resection of the prostate. Patients and Methods: In a prospective study, blood coagulation tests were performed and serum sodium levels measured in 27 patients before and at the end of transurethral resection of the prostate and 24 h later. The causes of the changes in coagulation test results were also investigated. Results: There were significant decreases in the platelet counts (p < 0.001) and fibrinogen (p < 0.001), hemoglobin (p < 0.05), and sodium (p < 0.0001) concentrations at the end of the operation. The prothrombin time was prolonged (p < 0.01). The activated partial thromboplastin time did not change. There was a statistically significant correlation between the changes in prothrombin time and fibrinogen concentration and the amount of irrigating solution used during the operation and the difference between the volume given and collected as irrigation. Coagulation test results, hemoglobin concentration, and serum sodium level returned to normal values 24 h after the operation. Conclusion: Our results show that there was a transient change in platelet count, prothrombin time, and fibrinogen and serum sodium concentrations during the early postoperative period which can be explained on the basis of dilution of the blood.
Ultrasound Assessment of Biometric Trends in a Case of Thanatophoric Dysplasia
Authors: Fieni S. , Gramellini D. , Vadora E.
Published: April 2003

We present a case of thanatophoric dysplasia diagnosed at the 21st week of gestation. Serial ultrasound was performed throughout pregnancy. The scans showed a distinctive pattern of development of the fetal long bones. Up to week 25, the fetal long bones appeared to grow steadily but slower compared to normal measurements (4–5 SD below the mean); then, between weeks 26 and 30, long bone growth was further and more severely hampered, until it almost stopped altogether approaching term, with measurements 9–12 SD below the mean at week 38.
Conservative Management of Cervical Intraepithelial Neoplasia (CIN2–3) in Pregnant Women
Authors: Vlahos G. , Rodolakis A. , Diakomanolis E. , Stefanidis K. , Haidopoulos D. , Abela K. , Georgountzos V. , Michalas S.
Published: April 2003

The management of cervical intraepithelial neoplasia (CIN2–3) diagnosed during pregnancy was the subject of this study. Two hundred and eight pregnant women with an abnormal cytology were assessed in our unit over a 10-year period. The age of the patients ranged from 20 to 45 (mean 28) years. Seventy-eight of these women were histologically proven to have CIN2–3. All patients were followed up every 8–10 weeks by cytology and colposcopy during pregnancy and reassessed 8–12 weeks postpartum. The disease persisted in 30 cases (38.4%), whereas in the remaining 48 cases it regressed to CIN1. No case of invasive disease developed during the follow-up period in these pregnant patients. Conservative management of CIN2–3 during pregnancy is acceptable, but close follow-up and colposcopic expertise are necessary.
Postmenopausal Hormone Replacement Therapy Use Decreases Oxidative Protein Damage
Authors: Telci Ayşegül , Çakatay Ufuk , Akhan Süleyman E. , Bilgin Murat E. , Turfanda Abdullah , Sivas Ahmet
Published: April 2003

Objectives: The aim of this study is to evaluate oxidative protein damage (OPD) by investigating protein carbonyl (PCO) and nitrotyrosine (NT) levels, oxidative stress by total thiol (T-SH), erythrocyte glutathione (GSH) and nitric oxide (NO) levels in women receiving hormone replacement therapy (HRT). Materials and Methods: To examine the influence of oxidative stress on OPD, we studied 12 postmenopausal women who had received HRT for 6 months, and 13 postmenopausal women who did not receive HRT, as the control group. All subjects were non-smokers. Blood samples were drawn in the fasting state and processed within 1 h of collection. For NT and NO, serum samples were stored at –70°C until analysis; all other parameters were determined on the same day of collection. Results: After 6 months, plasma PCO and T-SH levels were decreased, GSH and NO levels were increased, and NT levels were not changed in 12 postmenopausal women receiving HRT. Except the NT levels, the rest of the parameters did not significantly change in the control group. Interestingly, mean NT levels in the control group increased significantly. Conclusions: A crucial part of the protective effect of HRT on the cardiovascular system arises secondary to the interaction between estrogen and vessel wall. Our results suggest that an important component of the mechanism underlying this interaction may depend on estrogen’s antioxidant effect and its preventive role in OPD.
Impact of Insulin Resistance on Pregnancy Complications and Outcome in Women with Polycystic Ovary Syndrome
Authors: Bjercke Sverre , Dale Per Olav , Tanbo Tom , Storeng Ritsa , Ertzeid Gudvor , Åbyholm Thomas
Published: April 2003

The aim of the study was to determine the risk of developing gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH)/pre-eclampsia in a cohort of pregnant women with the polycystic ovary syndrome (PCOS) and known insulin sensitivity status. Pregnancies and neonatal outcome were recorded in a prospective cohort study comprising 29 non-insulin-resistant PCOS women, 23 insulin-resistant PCOS women and a control group of 355 women who had conceived after assisted reproduction. Hypertension, pre-eclampsia and GDM were recorded as well as pregnancy duration, method of delivery and birth weight. The frequency of hypertension was significantly elevated in PCOS women (11.5%) compared to controls (0.3%), p < 0.01. However, the frequency of pre-eclampsia was significantly elevated only in the insulin resistant PCOS women (13.5%) compared to controls (7.0%), p < 0.02. GDM was significantly more frequent in PCOS women (7.7%) than controls (0.6%), p < 0.01. Insulin resistance prior to pregnancy, determined by continuous infusion of glucose with model assessment (CIGMA) test, did not further increase the frequency of GDM. Newborns from PCOS pregnancies were significantly more often delivered by Caesarean section than controls (40.3 vs. 27.3%, p < 0.05) and transferred to neonatal intensive care unit more often than controls (19.2 vs. 9.0%, p < 0.01). Thus we show that the frequencies of pre-eclampsia and GDM are increased in PCOS pregnancies.
A Novel Geranylated Derivative, Ethyl 3-(4′-Geranyloxy-3′-Methoxyphenyl)-2-Propenoate, Synthesized from Ferulic Acid Suppresses Carcinogenesis and Inducible Nitric Oxide Synthase in Rat Tongue
Authors: Tanaka Takuji , Kohno Hiroyuki , Nomura Eisaku , Taniguchi Hisaji , Tsuno Takuo , Tsuda Hiroyuki
Published: April 2003

Objectives: We have previously observed the inhibitory effect of ferulic acid on rat tongue carcinogenesis. In this study, we investigated the modifying effects of a novel geranylated derivative, ethyl 3-(4′-geranyloxy-3′-methoxyphenyl)-2-propenoate (EGMP), synthesized from ferulic acid on tongue carcinogenesis initiated with 4-nitroquinoline 1-oxide (4-NQO). Methods: F344 male rats except those treated with EGMP alone and untreated rats were given 20 ppm 4-NQO in drinking water for 9 weeks to induce tongue neoplasms. Starting 1 week after the cessation of exposure to 4-NQO, the experimental groups given 4-NQO and a basal diet were fed the experimental diets containing EGMP (0.2% and 2%) for 20 weeks. The activities of glutathione S-transferase (GST) and quinone reductase (QR), the expression of proliferating cell nuclear antigen, polyamine content and ornithine decarboxylase activity in the tongue were examined for mechanistic analysis of modifying effects of EGMP on carcinogenesis. The expression of inducible nitric acid synthase (iNOS) was also assessed immunohistochemically. Results: At week 30, the incidence and multiplicity of tongue squamous cell carcinoma were significantly reduced by feeding of a 2% EGMP diet. EGMP feeding (2% in diet) elevated tongue GST activity and lowered QR activity in the tongue. Dietary EGMP decreased the expression of cell proliferation biomarker expression. Interestingly, EGMP feeding altered iNOS expression in the invasive parts of carcinoma. Conclusions: These results suggest that EGMP, when given at the 2% dose level during the promotion phase, exerts a chemopreventive action against tongue tumorigenesis through modification of cell proliferation activity and/or detoxifying enzymatic activity.
Association of the Vitamin D Receptor Genotype with Bone Metastases in Breast Cancer Patients
Authors: Schöndorf Thomas , Eisberg Carsten , Wassmer Gernot , Warm Mathias , Becker Martina , Rein Daniel T. , Göhring Uwe-Jochen
Published: April 2003

This study was designed in order to evaluate specific vitamin D receptor (VDR) genotypes as indicators of the likelihood of developing osseous metastases in breast cancer patients. Therefore, we determined polymorphisms of the VDR gene in a study group comprising 183 breast cancer patients. Specific fragments spanning over intron 8 and exon 9 of the VDR gene were amplified by polymerase chain reaction. The fragments were then incubated with each of the specific endonucleases ApaI, BsmI or TaqI, respectively. The VDR gene polymorphisms were detected by the presence or absence of the particular restriction site using agarose gel electrophoresis. Statistical analyses revealed a significant correlation between both the VDR gene polymorphisms indicated as AA (absence of the ApaI restriction site in both alleles) or TT (absence of the TaqI restriction site in both alleles), respectively, and the occurrence of bone metastases. Patients with the AA genotype have a 1.7-fold increased risk of developing bone metastases, whereas patients with the TT genotype have a 0.5-fold risk. Neither other genotypes nor allelic combinations displayed any further correlation with the clinical stage. The data suggest that the AA genotype of the VDR gene might be useful to identify breast cancer patients with a high probability of forming occult bone metastases who are considered to benefit from an adjuvant bone-protective therapy.