bluuebunny/crossref_metadata_2025 huggingface dataset:
Homeopathic Medicines Do Not Alter Growth and Gene Expression in Prostate and Breast Cancer Cells In Vitro
Authors: Thangapazham Rajesh L. , Gaddipati Jaya P. , Rajeshkumar N. V. , Sharma Anuj , Singh Anoop K. , Ives John A. , Maheshwari Radha K. , Jonas Wayne B.
Published: November 2006

Background: Homeopathy is an alternative medical system practiced in all parts of the world. Although several theories are proposed to explain the mechanisms of action, none are scientifically verified. In this study, the authors investigate the effect of selected homeopathic remedies often used to treat prostate and breast cancer. Materials and Methods: The authors investigated the effect of the homeopathic medicines Conium maculatum, Sabal serrulata, Thuja occidentalis, Asterias, Phytolacca, and Carcinosin on prostate and breast cancer cell (DU-145, LNCaP, MAT-LyLu, MDA-MB-231) growth and on gene expression that regulates apoptosis, using MTT and multiprobe ribonuclease protection assay. Results: None of the homeopathic remedies tested in different potencies produced significant inhibitory or growth-promoting activity in either prostate or breast cancer cells. Also, gene expression studies by ribonuclease protection assay produced no significant changes in mRNA levels of bax, bcl-2, bcl-x, caspase-1, caspase-2, caspase-3, Fas, or FasL after treatment with homeopathic medicines. Conclusions: The results demonstrate that the highly diluted homeopathic remedies used by homeopathic practitioners for cancer show no measurable effects on cell growth or gene expression in vitro using currently available methodologies.
Effect of Homeopathic Treatment on Gene Expression in Copenhagen Rat Tumor Tissues
Authors: Thangapazham Rajesh L. , Rajeshkumar N. V. , Sharma Anuj , Warren Jim , Singh Anoop K. , Ives John A. , Gaddipati Jaya P. , Maheshwari Radha K. , Jonas Wayne B.
Published: November 2006

Background: Increasing evidence suggests that the inability to undergo apoptosis is an important factor in the development and progression of prostate cancer. Agents that induce apoptosis may inhibit tumor growth and provide therapeutic benefit. In a recent study, the authors found that certain homeopathic treatments produced anticancer effects in an animal model. In this study, the authors examined the immunomodulating and apoptotic effects of these remedies. Materials and Methods: The authors investigated the effect of a homeopathic treatment regimen containing Conium maculatum, Sabal serrulata, Thuja occidentalis, and a MAT-LyLu Carcinosin nosode on the expression of cytokines and genes that regulate apoptosis. This was assessed in prostate cancer tissues, extracted from animals responsive to these drugs, using ribonuclease protection assay or reverse transcription polymerase chain reaction. Results: There were no significant changes in mRNA levels of the apoptotic genes bax, bcl-2, bcl-x, caspase-1, caspase-2, caspase-3, Fas, FasL, or the cytokines interleukin (IL)–1α, IL-1β, tumor necrosis factor (TNF)–β, IL-3, IL-4, IL-5, IL-6, IL-10, TNF-α, IL-2, and interferon-γ in prostate tumor and lung metastasis after treatment with homeopathic medicines. Conclusions: This study indicates that treatment with the highly diluted homeopathic remedies does not alter the gene expression in primary prostate tumors or in lung metastasis. The therapeutic effect of homeopathic treatments observed in the in vivo experiments cannot be explained by mechanisms based on distinct alterations in gene expression related to apoptosis or cytokines. Future research should explore subtle modulations in the expression of multiple genes in different biological pathways.
Laboratory Research in Homeopathy: Pro
Authors: Khuda-Bukhsh Anisur R.
Published: November 2006

Homeopathy is a holistic method of treatment that uses ultralow doses of highly diluted natural substances originating from plants, minerals, or animals and is based on the principle of “like cures like.” Despite being occasionally challenged for its scientific validity and mechanism of action, homeopathy continues to enjoy the confidence of millions of patients around the world who opt for this mode of treatment. Contrary to skeptics' views, research on home-opathy using modern tools mostly tends to support its efficacy and advocates new ideas toward understanding its mechanism of action. As part of a Point-Counterpoint feature, this review and its companion piece in this issue by Moffett et al (Integr Cancer Ther. 2006;5:333-342) are composed of a thesis section, a response section in reaction to the companion thesis, and a rebuttal section to address issues raised in the companion response.
Acupuncture Care for Breast Cancer Patients During Chemotherapy: A Feasibility Study
Authors: Price Sarah , Lewith George , Thomas Kate
Published: November 2006

Acupuncture care delivered pragmatically as an adjunct to conventional care may lead to improvements in quality of life and alleviation of conventional treatment-related side effects among breast cancer patients. Patient perceptions and expectations of treatment and the therapeutic relationship inherent to acupuncture care could modify treatment effects. The aim of this study was to design a rigorous feasibility study in preparation for trial to evaluate the effects of acupuncture care (a whole system) on the fatigue experienced by patients undergoing conventional treatment of their breast cancer. Phase 1 included the development of a treatment protocol for a short course of acupuncture care for patients with breast cancer undergoing chemotherapy. Defining best practice in this context will ensure that the intervention tested will have meaning and validity for all professional acupuncturists. Phase 2 will be a randomized feasibility pilot study using the acupuncture treatment protocol for 40 patients with breast cancer undergoing chemotherapy. The study will use a mixed-methods approach involving both qualitative and quantitative assessments. Outcome assessment will include validated measures for fatigue, quality of life, and depression. The proposed study will tell us what effects of acupuncture care are important to the patient and address acupuncture as it is practiced in the real world. Results from this study will enable a definitive randomized controlled trial to evaluate the effectiveness of acupuncture care for fatigue in breast cancer patients undergoing chemotherapy.
Case Report of a Pituitary Macroadenoma Treated With Artemether
Authors: Singh Narendra P. , Panwar Vijay Kumar
Published: November 2006

Introduction: This report describes the case of a male patient with pituitary macroadenoma treated with the artemisinin analog artemether. Patient and Methods: A 75 year-old male patient presented with vision, hearing, and locomotion-related problems. Artemether was administered orally to the patient over a period of 12 months. Results: Although the tumor remained consistent in size, CT scan shows a reduction in its density, and clinically, the related symptoms and signs resolved significantly as therapy progressed. Discussion: Overall, the artemether treatment was beneficial in improving the patient's quality of life. Artemether and other artemisinin analogs offer promise for cancer therapy.
Effects of Homeopathic Preparations on Human Prostate Cancer Growth in Cellular and Animal Models
Authors: MacLaughlin Brian W. , Gutsmuths Babett , Pretner Ewald , Jonas Wayne B. , Ives John , Kulawardane Don Victor , Amri Hakima
Published: November 2006

The use of dietary supplements for various ailments enjoys unprecedented popularity. As part of this trend, Sabal serrulata (saw palmetto) constitutes the complementary treatment of choice with regard to prostate health. In homeopathy, Sabal serrulata is commonly prescribed for prostate problems ranging from benign prostatic hyperplasia to prostate cancer. The authors' work assessed the antiproliferative effects of homeopathic preparations of Sabal serrulata, Thuja occidentalis, and Conium maculatum, in vivo, on nude mouse xenografts, and in vitro, on PC-3 and DU-145 human prostate cancer as well as MDA-MB-231 human breast cancer cell lines. Treatment with Sabal serrulata in vitro resulted in a 33% decrease of PC-3 cell proliferation at 72 hours and a 23% reduction of DU-145 cell proliferation at 24 hours (P<.01). The difference in reduction is likely due to the specific doubling time of each cell line. No effect was observed on MDA-MB-231 human breast cancer cells. Thuja occidentalis and Conium maculatum did not have any effect on human prostate cancer cell proliferation. In vivo, prostate tumor xenograft size was significantly reduced in Sabal serrulata–treated mice compared to untreated controls (P=.012). No effect was observed on breast tumor growth. Our study clearly demonstrates a biologic response to homeopathic treatment as manifested by cell proliferation and tumor growth. This biologic effect was (i)significantly stronger to Sabal serrulata than to controls and (ii)specific to human prostate cancer. Sabal serrulata should thus be further investigated as a specific homeopathic remedy for prostate pathology.
Proposal for an Integrated Evaluation Model for the Study of Whole Systems Health Care in Cancer
Authors: Jonas Wayne B. , Beckner William , Coulter Ian
Published: November 2006

For more than 200 years, biomedicine has approached the treatment of disease by studying disease processes (patho-genesis), inferring causal connections and developing specific approaches for therapeutically interfering with those processes. This pathogenic approach has been highly successful in acute and traumatic disease but less successful in chronic disease, primarily because of the complex, multi-factorial nature of most chronic disease, which does not allow for simple causal inference or for simple therapeutic interventions. This article suggests that chronic disease is best approached by enhancing healing processes (salutogenesis) as a whole system. Because of the nature of complex systems in chronic disease, an evaluation model based on integrative medicine is felt to be more appropriate than a disease model. The authors propose and describe an integrated model for the evaluation of healing (IMEH) that collects multilevel “thick case” observational data in assessing complex practices for chronic disease. If successful, this approach could become a blueprint for studying healing capacity in whole medical systems, including complementary medicine, traditional medicine, and conventional primary care. In addition, streamlining data collection and applying rapid informatics management might allow for such data to be used in guiding clinical practice. The IMEH involves collection, integration, and potentially feedback of relevant variables in the following areas: (1) sociocultural, (2) psychological and behavioral, (3) clinical (diagnosis based), and (4) biological. Evaluation and integration of these components would involve specialized research teams that feed their data into a single data management and information analysis center. These data can then be subjected to descriptive and pathway analysis providing “bench and bedside” information.
Scaling Up HIV Treatment in Peru
Authors: Sebastian Jose Luis , Munoz Maribel , Palacios Eda , Espiritu Beatriz , Mestanza Lorena , Chalco Katiuska , Llaro Karim , Guerra Dalia , Shin Sonya , Bayona Jaime
Published: November 2006

Many countries with financial support for HIV treatment experience delays in scale-up because of bureaucratic, operational, and technical obstacles. The authors describe the Peruvian National HIV Program's response to such challenges. A team of consultants experienced in the scale-up of the Peruvian national program to treat multidrug-resistant tuberculosis worked with the national HIV program to identify and address key factors contributing to slow enrollment of HIV patients into the antiretroviral treatment program. The rate of enrollment into the antiretroviral treatment program increased from 124 patients/month in the first 9 months of the program to 226 patients/month in the last 7 months, an increase of 83%. This strategy achieved 38.5% coverage of the population in need. Effective programmatic expansion of the Peruvian National HIV Program was facilitated by a multidisciplinary collaboration in a systematized effort to overcome barriers to scale-up.
Efficacy of an Individualized Adherence Support Program with Contingent Reinforcement Among Nonadherent HIV-Positive Patients
Authors: Javanbakht Marjan , Prosser Paul , Grimes Tim , Weinstein Michael , Farthing Charles
Published: November 2006

Objective: To evaluate the efficacy of a program designed to improve adherence to antiretroviral therapy among patients with poor adherence. Methods: A randomized intervention trial was conducted among 90 HIV-positive patients experiencing treatment failure as a result of noncompliance with their medication regimen. Eligible participants were randomly assigned to an adherence case management intervention with monetary reinforcement (CM) or to a standard of care group (SC). The CM participants met regularly with a treatment advocate for individualized adherence support. Efficacy was measured in terms of reductions in viral load and improvements in immune function at weeks 12, 24, and 48. Results: After 48 weeks, 55% (n = 26) of those in the CM achieved at least a 1-log10 drop in viral load as compared to 28% (n = 12) in the SC group (P = .0089). Furthermore, the mean CD4 count was 209 cells/mm3 for the CM group as compared to 150 cells/mm3 in the SC group (P = .0333). Based on logistic regression analysis, being in the CM was an independent predictor of reduction in viral load (odds ratio = 2.49; P = .0514). Conclusion: The individualized adherence intervention is feasible and effective in reducing viral load and improving immune function.
High Rate Multiple Drug Resistances in HIV-Infected Patients Failing Nonnucleoside Reverse Transcriptase Inhibitor Regimens in Thailand, Where Subtype A/E is Predominant
Authors: Chetchotisakd Ploenchan , Anunnatsiri Siriluck , Kiertiburanakul Sasisopin , Sutthent Ruengpung , Anekthananon Thanomsak , Bowonwatanuwong Chureeratana , Kowadisaiburana Boonchai , Supparatpinyo Khuanchai , Horsakulthai Manassinee , Chasombat Sanchai , Ruxrungtham Kiat , Team the Study
Published: November 2006

The prevalence of drug resistance was determined among 64 HIV-infected Thai patients who were failed while receiving nonnucleoside reverse transcriptase inhibitor (NNRTI)–based regimens. Eighty-nine percent of patients had 1 or more NNRTI mutation resistances. Almost all patients had resistance to at least 1 nucleoside reverse transcriptase inhibitor (NRTI), and 42% had multiple-NRTI resistance.
Administering Medical Procedures to Patients Living With AIDS: How Comfortable Are Physicians?
Authors: Oyeyemi Adetoyeje , Oyeyemi Bashir , Bello Ibrahim
Published: November 2006

Background: Feeling of comfort is important for efficient and compassionate care. This study aimed to determine physicians’ level of comfort in administering common medical procedures to patients living with AIDS and to identify the demographic variables that may influence level of comfort. Methods: Residents and house officers (n = 211) in 2 Nigerian teaching hospitals were surveyed by a questionnaire that elicited demographic information and information on physicians’ level of comfort in administering medical procedures. Results: Overall, physicians were very uncomfortable with mouth-to-mouth resuscitation. Invasive procedures evoked a lower level of comfort than noninvasive procedures. Knowing a person living with AIDS influenced the comfort level. Older age and professed willingness to treat persons with AIDS were associated with a higher comfort level. Conclusions: This study reinforced the need to address idiosyncrasies as they relate to the AIDS epidemic and to emphasize ethics and altruistic feelings of responsibility to care for those in need.
Mecanisme de passage de l'etat hydrate a une couche a l'etat ‘zero couche’ d'une vermiculite-Li de Santa-Olalla
Authors: Pons C. H. , Pozzuoli A. , Rausell-Colom J. A. , De La Calle C.
Published: November 2006

Par diffraction des Rayons X sur la vermiculite-Li de Santa-Olalla, il a été montré en fonction de la température qu'il existait différentes phases homogènes (d001 = 12·17 Å, T = 25°C; d001 = 12·02 Å, T = 60°C; d001 = 11·89 Å, T = 70°C; d001 = 10·04 Å, T = 100°C). Par ailleurs, pendant le processus de déshydratation entre les phases homogènes à 11·89 Å et 10·04 Å, il a été mis en évidence l'apparition d'états inhomogènes (interstratifiés). L'utilisation parallèle des méthodes directes d'étude des diagrammes de rayons X par transformée de Fourier monodimentionnelle pour les phases homogènes et d'une méthode indirecte de modélisation pour les états interstratifiés a permis de montrer que le passage de la phase 11·89 Å à la phase 10·04 Å se fait conjointement par une ségrégation de ces phases et un interstratifié aléatoire (11·89–10·04). Ce travail a en outre montré que la caractérisation des états intermédiaires entre phases homogènes ne peut être faite sans une étude structurale préalable des phases homogènes.
The surface energies of cation substituted Laponite
Authors: Norris J. , Giese R. F. , Costanzo P. M. , van Oss C. J.
Published: November 2006

Laponite RD forms stable, coherent films which adhere strongly to glass slides. Such films are capable of supporting liquid drops allowing the direct measurement of contact angles for five liquids of which, two were apolar (0:-bromonaphthalene and diiodomethane) and three were polar (water, formamide, glycerol); surface tension components and parameters (γLw, γ⊕ and γ⊖) were determined by solving the Young equation. These determinations were made for homoionic samples saturated with Li, Na, K, Rb, Cs, Mg, Ca, Sr, Ba and NH4 as well as the natural material. Whereas the values of γLw (the apolar Lifshitz-van der Waals component) varied only within narrow limits (41-44 mJ/m2), the Lewis base parameter varied comparatively widely (24-41 mJ/m2). The Lewis acid parameter was small and relatively constant (1·3-3·0 mJ/m2). The variation of γ⊖ as a function of the exchangeable cation suggests that the divalent cations are shielded from the silicate surface by the water molecules of their sphere of hydration, whereas the monovalent cations are in direct contact with the oxygen atoms of the silicate surface. Furthermore, the divalent cations may screen the Lewis base sites to a greater degree than do the monovalent cations. Lithium behaves anomalously and this may indicate that it physically enters into the ditrigonal hole in the silicate layer.
Preparation and properties of a basic lead carbonate–montmorillonite complex
Authors: Tsutsumi S. , Yamazaki A. , Uehara M. , Otsuka R.
Published: November 2006

A basic lead carbonate-montmorillonitec omplexw as prepared by treating a natural montmorillonite hydrothermally for 120 h at 250°C with lead powder, dry ice and lead nitrate solution. The product is a non-swelling material showing well-outlined, hexagonal, thin plates <1 µm in size; the symmetry is pseudo-orthorhombic, a = 5·141(7) Å, b = 9·005(5) Å, c = 17·420(4) Å, and Z = 2. The X-ray powder pattern is characterized by a 17·4 Å reflection and an integral series to the 14th order. The TG-DTA curves of this 17 Å-mineral showed one endotherm around 400°C accompanied by weight loss and two exthotherms at about 680 and 780°C By applying hightemperature X-ray diffractometry (XRD) and infrared (IR) spectroscopy, it was found that the endotherm is due to decomposition of carbonate hydroxide in the interlayer, while the two exthotherms are caused by crystallization of a hexagonal phase of PbAl2Si2O8 and by the conversion of this phase into lead feldspar, respectively. The crystal structure of the 17 Å-mineral was determined and refined as a 2:1 dioctahedral smectite interlayered with a hydrocerussite-like layer by a one-dimensional Fourier synthesis method.
Synthesis of illite-smectite from smectite at Earth surface temperatures and high pH
Authors: Eberl D. D. , Velde B. , Mccormick T.
Published: November 2006

It is well known that illite-smectite can form from smectite at elevated temperatures in natural and experimental systems. However, the conversion of smectite to illite-smectite is also found in some natural systems that have never been heated. The present experiments show that illite layers can form from smectite by chemical reaction at 35° and 60°C at high solution pH. The rate of this reaction is accelerated by wetting and drying.
De-intercalated kaolinites: The nature of created defects and estimation of structural characteristics by the expert system of Plançon and Zacharie
Authors: Plastinina M. A. , Fedorenko Ju. G. , Shpigun A. A.
Published: November 2006

Initial and de-intercalated (by washing with water from formamide molecules) kaolinite was investigated by X-ray and IR spectroscopic methods. As a result of de-intercalation by water washing, changes in structural characteristics and in some physical-chemical properties of kaolinites take place: (1) the content of low-defect phase (%ldp) evaluated by the expert system of Plançon & Zacharie (1990) decreases; (2) the degree of order of the structure as determined by the Hinckley index decreases; (3) the size of coherent scattering regions (CSR) determined by the method of fourth moments decrease; (4) the rate of repeated introduction of the formamide molecules to the interlayer increases. The cause of these changes are water molecules introduced into the kaolinite interlayer as a result of de-intercalation. These water molecules have IR absorption bands at 3646 (vas), 3550 (vs) and 1650 (vα) cm-1. The results obtained are discussed in relation to modern ideas on disorder models of kaolinite crystals.
Surface free energy of a soil clay fraction in relation to aggregate stability
Authors: Jańczuk B. , Józefaciuk G. , Hajnos M. , Bialopiotrowicz T. , Kliszcz A.
Published: November 2006

When studying surface free energies of clays in relation to clay composition, we calculated that in some instances the aggregate stability should be higher for Na- then for Ca-forms. This raised the question as to whether the results obtained with the surface free energy approach are reliable for estimation of soil aggregate stability. The aim of the present work was to measure the surface free energy components and attractive forces for a clay calculated from measurements of the contact angle of glycerol, diiodomethane and cis-decalin and to compare them with results of penetrometrical measurements.
Acid Dissolution of Hematites of Different Morphologies
Authors: Cornell R. M. , Giovanoli R.
Published: November 2006

Dissolution in HCl of hematite particles with different morphologies led to sigmoidal dissolution vs. time curves. The rate of dissolution was directly proportional to the sample surface area and independent of crystal morphology. Hematites produced by heating goethite at 600 or 800~ dissolved more rapidly per unit area than did hematites grown from solution. TEM showed that some platy crystals developed central holes after prolonged acid attack; the hole formation was attributed to enhanced dissolution at screw dislocations present on the (001) faces of the crystals. Except where particularly susceptible regions involving strained areas or dislocations were present, there appeared to be no preferential acid attack at any particular crystal face. The original morphology was usually maintained during the reaction.
The Effects of Lithology, Bulk Chemistry and Modal Composition on Illite "Crystallinity"-A Case Study from the Bakony Mts., Hungary
Authors: Árkai P. , Lelkes-Felvári GY.
Published: November 2006

Modal and bulk chemical compositions, illite and chlorite "crystallinity" indices (IC and ChC), white mica bo and vitrinite reflectance values of a Palaeozoic variegated clastic sequence have been determined. The strongly varying IC values are inadequate for the determination of metamorphic zones. Based on statistical analyses of the factors which might affect IC, the presence of paragonite, even in very small quantities as a discrete phase and/or as mixed-layers with illitemuscovite, proved to be the decisive factor. In contrast, no significant correlations were found between the modal composition of the main phases, bulk chemical composition (including Fe3+/Fe2+ ratio) and IC, ChC, or white mica bo values. Thus, neither lithofacies (granulometric), nor redox conditions had any effect on "crystallinity" and bo parameters. Chlorite crystallinity indices and vitrinite reflectance values, together with IC values of selected samples, indicate "anchizonal" conditions. The distribution of white mica bo values indicates that this Hercynian metamorphism was of low-pressure type.
Particle Size and Shape Effects in Materials Science: Examples from Polymer and Paper Systems
Authors: Adams J. M.
Published: November 2006

Large quantities of clay minerals (and other micron-sized mineral powders) are used widely in materials science. Mineral fillers are major components, for example, of paints, rubber, plastics and paper and board. While the original object of such incorporation was to reduce costs, performance is now being “engineered” by design or choice of the relevant mineral particles. This paper concentrates on the use of mineral powders in polymer and paper science. In both application areas, the size and shape of the mineral particles can affect mechanical properties such as stiffness and tensile and impact strength. However, other characteristics are also modified. For example, the drainage rate in paper formation and the rheology of a polymer melt, properties which are critically important to the rate of processing of the relevant materials, can be greatly affected. Finally, the size and shape of the mineral particles also affect appearance, i.e. the smoothness, uniformity, optical properties etc. Mechanical and rheological data are presented for mineral-filled polypropylene, as are mechanical and optical data for filled and coated paper.
High-Resolution Particle Size Analysis from Nanometres to Microns
Authors: McFadyen P. , Fairhurst D.
Published: November 2006

Modem disc centrifuge technology has extended the range of application of sedimentation particle size analysis to include the submicron region. An overall size range of approximately 10 nm to 100 pm is now accessible. The principles of both the disc centrifuge photosedimentometer, which employs optical detection with full Mie light scattering corrections, and the X-ray disc centrifuge are described. Examples of their application to a variety of samples are given to illustrate the performance characteristics of the instruments including a direct comparison of resolving power with that of the laser diffraction technique.
L’Utilisation des Resines Echangeuses de Cations (Amberlite IRC-50H) dans la Dispersion et la Purification des Argiles des Roches a Carbonates, Phosphates et Sulfates
Authors: Chahi A. , Weber F. , Prevot L. , Lucas J.
Published: November 2006

Les traitements classiques appliqués pour disperser les argiles et les séparer des carbonates, des phosphates et des sulfates, sont souvent agressifs vis a vis de celles-ci. Une méthode de traitement utilisant les résines échangeuses de cations (REC) a été mise au point. La résine utilisee est l’amberlite IRC-50H. Elle a été éluée ã HCl 1·5 N et utilisée a une température de 60°C. Ce traitement a permis une très bonne dispersion des suspensions de matière d’argile, et l’élimination complete des carbonates, des sulfates et des phosphates. En raison de leur structure silicatée et de leur composition chimique, les argiles sont peu attaquees par les REC, de plus elles sont protegees par les minéraux susceptibles d’être dissous par les REC (carbonates, phosphates et sulfates).
1,111 Patients with Adrenal Incidentalomas Observed at a Single Endocrinological Center
Authors: KASPERLIK‐ZALUSKA ANNA A. , ROSLONOWSKA ELŻBIETA , SLOWINSKA‐SRZEDNICKA JADWIGA , OTTO MACIEJ , CICHOCKI ANDRZEJ , CWIKLA JAROSLAW , SLAPA RAFAL , EISENHOFER GRAEME
Published: November 2006

Abstract:  A majority of incidentally found adrenal tumors derive from the adrenal cortex. The aim of our study was evaluation of the incidence of chromaffin tumors in a group of 1,111 patients with adrenal incidentalomas. In this group there were 803 women and 308 men, aged 10–87 years. Clinical examination, imaging studies (ultrasound scans, CT, and MRI if necessary), and hormonal determinations (cortisol, ACTH and androgens in the blood, dexamethasone suppression test, urinary excretion of 17‐OHCS, aldosterone and 17‐KS, as well as PRA/aldosterone stimulation test and metanephrines in hypertensive patients and those with density in CT over 20 HU) were used. In 380 patients treated by surgery (mainly by laparoscopic approach), histological and immunocytochemical examinations were performed. Clinical examination revealed hypertension in 25% of the patients under study. Chromaffin tumors were detected in 43 patients, 33 women, and 10 men aged 20–75 years: pheochromocytoma in 36 (malignant in 3); chromaffin cells hyperplasia in 2; paraganglioma in 3; ganglioneuroblastoma in 1; ganglioneuroma in 1; and schwannoma in 2. The tumors' diameter ranged between 1.1 and 20.0 cm, density = 25 Hounsfield units (HU) or more before contrast medium injection. Hypertension was present in 53% of these patients. The urinary metanephrines excretion was elevated in 31 of 38 patients, in whom the determinations were done. Chromaffin tumors were detected in 4% (pheochromocytomas in 3%) of 1,111 patients with adrenal incidentalomas. Malignancy was present in 9% of 43 patients with chromaffin tumors. High density in CT was a very important diagnostic finding in the incidentally found medullary tumors.
Incus reposition: Goblet prosthesis
Authors: Pappas Dennis G.
Published: November 2006

A stainless steel goblet shaped prosthesis is used to attach the repositioned incus to the stapes. A two year follow‐up was made of the first 116 patients in which the prosthesis was used for ossicular reconstruction.

The incidence of extrusion and ankylosis is diminished, and 75% of all cases had closure within 10 db. An additonal 20% had closure within 20 db of bone conduction thresholds. Revisions have been less with this technique than with others: 40% of 116 patients had an uncomplicated tympanoplasty; 60% had a tympanoplasty with mastoidectomy. The results are, of course, more favorable in the group without mastoidectomy. Of these, 86% had closure to within 10 db of bone conduction level. These findings suggest that the use of the goblet prosthesis results in improved hearing. These findings conclude that the use of the goblet prosthesis results in better hearing than that obtained with other methods of ossicular chain reconstruction.
A typical mycobacterial otomastoiditis
Authors: Terkonda Raj P. , Levine Samuel C. , Duvall Arndt J. , Giebink G. Scott
Published: November 2006

A typical mycobacterial infections of the middle ear and mastoid are rare; only 4 isolated cases and an outbreak of 17 cases have been reported. Herein are presented three additional cases with chronic otorrhea unresponsive to routine medical therapy. Two were due to Mycobacterium avium‐intracellulare and the third to Mycobacterium chelonei. All three patients had negative tuberculin test results and normal chest radiographs. Pathologic study reveals granulomatous inflammation, usually with negative acid‐fast stains. Tissue culture should be incubated for a minimum of 4 weeks. These patients often undergo multiple otologic procedures and have abundant granulation tissue with normal ossicles. The antibiotic therapy is prolonged, and the organisms may be resistant to the usual antituberculous drugs. Unlike many atypical mycobacterial infections today, those involving the middle ear can occur in immunologically normal individuals.
P‐Glycoprotein expression in the squamous cell carcinoma of the tongue base
Authors: Rabkin Dimitry , Chhieng David C. , Miller Mitchell B. , Jennings Timothy , Feustel Paul , Steinisrer Josenh , Parnes Steven M.
Published: November 2006

P‐glycoprotein (PGP), which is a product of the multidrug resistance gene (MDR1), is an active transmembrane efflux pump responsible for detoxifying normal cells as well as rendering tumor cells resistant to chemotherapy. It has also been implicated to be expressed by more aggressive cancers. It has not been well described in squamous cell carcinoma of the head and neck. In this investigation, an attempt was made to characterize advanced squamous cell carcinoma of the base of tongue with respect to expression of PGP. Using immunohistochemical techniques two anti‐PGP monoclonal antibodies (JSB1and C494) were used to detect PGP in these lesions, and an attempt was made to correlate levels of PGP staining and various tumor parameters. Usefulness of PGP in predicting survival and time to recurrence was also examined for these advanced lesions. All 33 base of tongue lesions showed staining for PGP with these monoclonal antibodies. This was the first study examining utility of C494 in detecting PGP in squamous cell carcinoma at this site. Increased level of PGP expression was seen in better‐differentiated tumors as well as in tumors with diploid DNA. A trend of higher PGP expression and decreased survival emerged. This may represent a true relationship, but inherent heterogeneity of PGP expression within cells cannot be excluded.

Both antibodies examined appear to be useful in the investigations of PGP distribution in squamous cell carcinomas of the head and neck sites by immunohistochemical techniques. Prognostic value of the level of PGP expression remains to be seen.
Functional magnetic resonance imaging of the central auditory pathway following speech and pure‐tone stimuli
Authors: Millen Steven J. , Haughton V. M. , Yetkin Z.
Published: November 2006

Functional magnetic resonance imaging (FMRI) is a new noninvasive technique for imaging cerebral function. Studies of the human central auditory pathway examined responses in eight normal hearing volunteers following auditory stimuli, including narrative speech and pure‐tone audiometry.

The activation demonstrated by FMRI is modeled on an increase in regional blood flow with increased neuronal activity. The FMRI signals represent deoxyhemoglobin concentration changes in capillaries within the region of the brain that is activated. Brain activation was imaged in the superior temporal gyrus during text reading and pure tones. Activation in both text and pure‐tone presentation did not vary with the intensity of the auditory stimulus and elicited a dominant response in the left temporal lobe.

These observations demonstrate the capability of FMRI to correlate anatomic and functional relationships in the human central auditory pathway.
Survival of composite chondrocutaneous grafts by vessel implantation: A study in the rabbit ear model
Authors: Arden Richard L. , Smith Duane M. , Salley Steve O. , Sakr Wael A. , Doerr Timothy D.
Published: November 2006

Composite chondrocutaneous graft reconstruction or reattachment has limited applicability, is traditionally restricted to small segmental losses, and is dependent on the status of the recipient bed and graft periphery for successful revascularization. Surgical enhancement of composite graft survival was experimentally investigated in the rabbit ear model through transposition and appositional placement of an adjacent vascular pedicle. Fluorescein‐derived surface‐survival determinations, microangiographic vessel‐counting methods, and histologic analysis were used to study the effects of vascular augmentation, pedicle design variations, and angiogenic substance in sixty 8‐cm2, full‐thickness auricular grafts. A statistically significant survival advantage was demonstrated for the implanted grafts, without derived benefit from angiogenic substance, secondary to perivascular angiogenesis from the implanted pedicle.
Accuracy of intraoperative staging of the N0 neck in squamous cell carcinoma
Authors: Kassekh Christopher H. , Johnson Jonas T. , Myers Eugene N.
Published: November 2006

Management of the neck in squamous cell carcinoma of the upper aerodigestive tract continues to be a topic of great debate. One major problem is that incorrect clinical staging is expected in approximately 20% of necks. This is true of both clinical stage N0 and N+ necks, even when imaging studies are used. This prospective study of 108 necks in 79 patients examined the role of intraoperative palpation and inspection in improving the surgeon's ability to predict nodal stage. Of 62 patients with N0 necks clinically on both sides, 26 were staged N+ by intraoperative node examination. Nineteen of the 26 were histologically negative (73% false‐positive). Of the 36 patients staged intraoperatively as N0, 10 were histologically positive (28% false‐negative). Of 108 necks judged clinically to be N0, 25 (23%) had occult metastases and 11 (10%) had extracapsular spread. Forty‐one of 108 clinical N0 necks were believed to have positive nodes at the time of neck dissection. Of these 41 necks, 30 (73%) were found to be histologically N0 (false‐positive). Of the 67 clinical N0 necks that were also believed to be N0 intraoperatively, occult metastases were found in 14 (21% false‐negative). Therefore, intraoperative staging did not significantly improve the false‐negative rate. Frozen‐section biopsy obtained in the operating room was reliable in 24 (92.3%) of 26 patients. Although frozen‐section biopsy was not performed in all patients, these data suggest that upstaging the neck without frozen‐section biopsy is much less reliable. This study supports the use of frozen‐section biopsy before converting the selective dissection to a radical or modified neck dissection in most instances.
Assessment of Serum Antibodies in Patients With Rapidly Progressive SensorineuralHearing Loss and Meniere's Disease
Authors: Gottschlich Stefan , Billings Peter B. , Keithley Elizabeth M. , Weisman Michael H. , Harris Jeffrey P.
Published: November 2006

The immunoreactivity of sera from patients with rapidly progressive sensorineural hearing loss (SNHL) or Meniere's disease with bovine inner ear material was determined using the Western blot technique. Patients with other otologic conditions, autoimmune disorders, or arthritic disorders and age‐matched randomly chosen patients with no hearing complaints served as controls. Twenty‐two percent of the patients with bilateral rapidly progressive SNHL and 30% of the patients with Meniere's disease had antibodies that reacted with a 68 kd antigen in the inner ear material. In the control groups, the incidence of reactivity was 5.0% (P<.001).

When the results of this study were compiled with data collected previously, it was found that of 279 patients with bilateral rapidly progressive SNHL, 90 (32%) were positive with the 68 kd protein. Thus, the anti‐68 kd antibody may provide a good marker for an immune etiology of these patients' hearing loss.
Changes in middle ear pressure in daily life
Authors: Sakikawa Yasuhiko , Kobayashi Hitome , Nomura Yasuya
Published: November 2006

The present study was performed to estimate changes of middle ear pressure (ME‐P) during actions of daily life such as nose blowing and sniffing. ME‐P was measured in 18 patients with perforation of the eardrum. They were asked to perform actions which included nose blowing and sniffing. Eustachian catheterization and politzerization were also applied. Change of ME‐P before and after these actions was recorded using a pressure monitor. Results showed that changes of ME‐P after nose blowing with both nostrils closed were large and rapid. The mean value of ME‐P after nose blowing was 252 mmH2O. In our previous study, the mean value of cerebrospinal fluid pressure (CSF‐P) after nose blowing was 388 mmH2O.1 Therefore, the pressure gradient across the cochlear windows is about 130 mmH2O during nose blowing. The cochlear windows may have been pressed toward the middle ear side. After sniffing, ME‐P was unchanged. These results suggest that nose blowing may be an important cause of perilymphatic fistula (PLF) via the “explosive route,”2 while sniffing is not likely to cause PLF.
Experimentally Induced Glochidiosis in Smallmouth Bass (Micropterus dolomieu)
Authors: Howerth E. W. , Keller A. E.
Published: November 2006

Necropsy was performed on 2 smallmouth bass ( Micropterus dolomieu) that died 8 days after experimental gill inoculation with Actinonaias pectorosa glochidia. The salient feature at necropsy was ragged gills containing multiple petechial hemorrhages and numerous white, iridescent dust-like particles easily confirmed as glochidia in squash preparations of the gill filaments. Microscopically, the gills contained multiple rounded glochidia encysted at the tips or along the length of the filaments. Parasitized filaments were thickened, blunted, and often fused. Lamellae were extensively fused and obliterated, with proliferation of the epithelial cells giving the filament a smooth outline. Sometimes glochidia were associated with necrosis and/or hemorrhage. These fish most likely died due to asphyxia associated with the severe branchial lesions caused by the glochidia.
Anal Sac Gland Carcinoma in a Cat
Authors: Parry N. M. A.
Published: November 2006

A perianal mass in a 15-year-old domestic shorthair cat with a history of a firm, painful swelling in the left ventrolateral perianal region was surgically excised and submitted for light microscopic evaluation. Histologically, this was a poorly demarcated, unencapsulated, multilobulated neoplasm that invaded surrounding perirectal skeletal muscle bundles. Lobules were composed of sheets and acinar arrangements of cuboidal to round neoplastic epithelial cells with scant to moderate eosinophilic to amphophilic cytoplasm and a round or oval nucleus with coarse chromatin. Mitotic figures were 2 per 40 x objective field. Acinar lumina sometimes contained eosinophilic proteinaceous material or cell debris. These microscopic features are consistent with anal sac gland carcinoma. This is the second report of this neoplasm in a cat.
Medullary Sponge Kidney in a 10-Year-Old Shih Tzu Dog
Authors: Akihara Y. , Shimoyama Y. , Ohya K. , Hirayama K. , Yoshida K. , Matsuda K. , Okamoto M. , Taniyama H.
Published: November 2006

Medullary sponge kidney was diagnosed in a 10-year-old male Shih Tzu dog with a long history of hyposthenuria, but with no other findings indicating renal failure or hormonal aberration. At the dog's death from heart failure, an autopsy was performed. On gross morphology, bilateral kidneys were normal size and had many cysts ranging from the corticomedullary junction to renal papillae. Histopathologic findings showed that almost all of the cysts were lined by monolayered or multilayered and columnar or cuboidal epithelium with chilium similar to epididymis. immunohistochemically, all of these cells were strongly positive for AE1/AE3 and negative for vimentin. Many of these cells were positive for cytokeratin 7 (CK7), and only a few cells were positive for desmin. The results of staining are the same as those for epithelium of the collecting duct of normal canine kidney. This is the first report of this pathologic entity in the canine kidney.
Neuronal Storage Disease in a Group of Captive Humboldt Penguins (Spheniscus humboldti)
Authors: Wünschmann A. , Armien A. , Wallace R. , Wictor M. , Oglesbee M.
Published: November 2006

A neuronal storage disease affecting 5 captive Humboldt penguins is described. One bird died after 3 days of lethargy and anorexia. The 4 remaining birds died after a slowly progressing course of disease with signs that included lethargy, weakness, and neurologic dysfunction. Neurologic signs included dysphagia and ataxia. Gross lesions in the first animal to die consisted of hepatosplenomegaly indicative of avian malaria, which was confirmed histologically. The 4 remaining animals were mildly to moderately emaciated. Moderate to marked vacuolation of the neuronal perikarya was observed in Purkinje cells, neurons of the brainstem nuclei, and motorneurons of the spinal cord in all birds. By electron microscopy the vacuoles represented multilayered concentric lamellar structures. These findings were indicative of sphingolipidosis. All animals had been prophylactically treated for avian malaria, aspergillosis, and possible bacterial infections with chloroquine, itraconazole, and enrofloxacin. circumstantial evidence implicates chloroquine therapy as the possible cause of the storage disease.
Thymic Granulomatous Lesions in Pigs
Authors: Baba Y. , Nakayama H. , Yasoshima A. , Uetsuka K. , Kumagai S. , Doi K.
Published: November 2006

Rare cases of thymic granulomatous lesions were found in pigs. The lesions consisted of epithelioid cells, multinucleated giant cells, and lymphocytes. Such lesions also were observed in the mesenteric lymph nodes, spleen, kidney, and stomach. The cytoplasm of the majority of giant cells and some epithlioid cells was periodic acid-Schiff (PAS) positive. All cells were positive for vimentin, lysozyme, and desmin. Ultrastructurally, the giant cells were rich in organella and attached to adjacent epithelioid cells by membrane interdigitation. The cells included numerous coated vesicles and granules. No etiologic pathogen, including porcine circovirus type 2, was detected in the lesions. This is the rare case of idiopathic thymic granulomatous lesion in pigs.
Myosin Heavy Chain Composition in Normal and Atrophic Equine Laryngeal Muscle
Authors: Adreani C. M. , Li Z. B. , Lehar M. , Southwood L. L. , Habecker P. L. , Flint P. W. , Parente E. J.
Published: November 2006

The myosin heavy chain (MHC) composition of a given muscle determines the contractile properties and, therefore, the fiber type distribution of the muscle. MHC isoform expression in the laryngeal muscle is modulated by neural input and function, and it represents the cellular level changes that occur with denervation and reinnervation of skeletal muscle. The objective of this study was to evaluate the pattern of MHC isoform expression in laryngeal muscle harvested from normal cadavers and cadavers with naturally occurring left laryngeal hemiplegia secondary to recurrent laryngeal neuropathy. Left and right thyroarytenoideus (TA) and cricoarytenoideus dorsalis (CAD) were obtained from 7 horses affected with left-sided intrinsic laryngeal muscle atrophy and from 2 normal horses. Frozen sections were evaluated histologically for degree of atrophy and fiber type composition. MHC isoform expression was determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of muscle protein. Histologic atrophy was seen in all atrophic muscles and some right-sided muscles of 3 affected horses, as well as the left TA of 1 normal horse. Fiber type grouping or loss of type I muscle fibers was observed in the left-sided laryngeal muscles in all but 1 affected horse, as well as in the right muscles of 2 affected horses, and the left TA of 1 normal horse. SDS-PAGE showed 2 bands corresponding to the type I and type IIB myosin isoforms in the CAD and TA of the 2 normal horses. Affected horses demonstrated a trend toward increased expression of the type IIB isoform and decreased expression of the type I isoform in atrophic muscles. This study confirmed the presence of histologic abnormalities in grossly normal equine laryngeal muscle, and it demonstrated an increased expression of type IIB MHC with a concurrent decreased expression of type I MHC in affected muscles. Evaluation of muscle fiber changes at the cellular level under denervated and reinnervated conditions may aid in assessing future strategies for reinnervation or regeneration of atrophic laryngeal muscle.