bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Osteonecrosis of the Femoral Head with VEGF165 Transgenic Bone Marrow Mesenchymal Stem Cells in Mongrel Dogs
Authors: Hang Donghua , Wang Qiugen , Guo Changan , Chen Zhengrong , Yan Zuoqin
Published: November 2011

We evaluated the efficacy of vascular endothelial growth factor 165 (VEGF165) transgenic bone marrow mesenchymal stem cells (BMSCs) for the repair of early-stage osteonecrosis of the femoral head (ONFH) in mature mongrel dogs. This animal model was surgically established by femoral neck osteotomy and subsequent repinning. Twenty-seven dogs (54 hips) were divided into 3 equal-sized groups: a pCI-neo-VEGF165 BMSC group, a pCI-neo BMSC group and a core decompression-alone group. The lipofectamine was used to introduce the VEGF165 gene into the BMSCs. After core decompression, transgenic and non-transgenic autologous BMSCs were implanted. Therapeutic efficacy, including new bone formation and neovascularization in the femoral head, was examined by computed radiography, single-photon emission computed tomography, histological and histomorphometric analysis and immunofluorescent staining for von Willebrand factor in pathological sections. The femoral osteotomy site healed completely by the 4th week after the osteotomy surgery and regions of histologically evident osteonecrosis were found 12 weeks later. A regular arrangement of trabeculae and obvious bone regeneration were observed in the animals receiving implanted VEGF-transgenic BMSCs. The quantity of newly generated capillaries was significantly increased in the pCI-neo-VEGF165 BMSC group, but there was no significant difference between the pCI-neo BMSC group and the core decompression-alone group. These results demonstrated that VEGF165 transgenic autologous BMSCs enhanced bone reconstruction and blood vessel regeneration in the ONFH model. Compared with non-transgenic BMSCs, this approach could provide advanced benefits in the treatment of ONFH.
MECP2 Duplication Syndrome
Authors: Van Esch H.
Published: November 2011

Since the initial report that clearly established a causal role between duplication of the MECP2 gene and a severe syndromic form of intellectual disability, many new patients have been identified and reported, and the etiology in already published families solved. This has led to the establishment of a clinically recognizable disorder. Here, we review the clinical data of 129 reported and nonreported male patients with MECP2 duplication syndrome.
Hemimegalencephaly: Prenatal Diagnosis and Outcome
Authors: Alvarez Rosa María , García-Díaz Lutgardo , Márquez Javier , Fajardo Manuel , Rivas Eloy , García-Lozano Juan Carlos , Antiñolo Guillermo
Published: November 2011

Hemimegalencephaly (HME) is a developmental abnormality of the central nervous system (CNS) which may present as either a syndromic or isolated case. Here, we present two cases of early prenatal diagnosis of HME. Prenatal CNS ultrasound and MRI in the first case revealed ventricular asymmetry, midline shift with displacement of the occipital lobe across the midline, large dilatation mainly at the posterior horn of the left lateral ventricle, and a head circumference in the 90th percentile without involvement of the brain stem and cerebellum, as well as abdominal lymphangioma. Right hemispherectomy was performed at 3 months of age due to intractable seizures. The pathological specimen showed findings characteristic of HME, including a disorganized cytoarchitecture with lack of neuronal lamination, focal areas of polymicrogyria, and neuronal heterotopias with dysplastic cells. In the second case, 2D and 3D neurosonography demonstrated similar findings (asymmetry of cerebral hemispheres, midline shift, and dilation of the posterior horn of the left lateral cerebral ventricle). Posterior fossa structures were unremarkable. HME was diagnosed and the pregnancy was terminated. Autopsy findings confirmed the diagnosis of HME.
Hemifacial Microsomia with Spinal and Rib Anomalies: Prenatal Diagnosis and Postmortem Confirmation Using 3-D Computed Tomography Reconstruction
Authors: Haratz Karina , Vinkler Chana , Lev Dorit , Schreiber Letizia , Malinger Gustavo
Published: November 2011

Hemifacial microsomia (OMIM164210) is a condition featuring unilateral ear anomalies and ocular epibulbar dermoids associated with unilateral underdevelopment of the craniofacial bony structures. Other associated anomalies have also been described, especially spinal malformations, and the term oculoauriculovertebral dysplasia spectrum (OVAS) was suggested to include the three predominant systems involved. Both genetic and environmental causes are implied in the pathogenesis of the syndrome, with a 3% recurrence rate according to reports of both vertical transmission and affected siblings. No specific gene was identified, albeit mutations in chromosome 10 and deficiencies of genes in the endothelin pathway in mice exhibited the same clinical features. We hereby describe the first case of prenatal diagnosis of spinal and rib malformations associated to hemifacial microsomia by means of 2-D and 3-D ultrasound in a 23-week fetus. The sonographic study depicted fetal scoliosis due to the presence of hemivertebrae, Sprengel’s deformity of the left shoulder, ribs fusion, asymmetric ears with unilateral microtia, mandible unilateral hypoplasia as well as single umbilical artery and a ‘golf ball’ sign in the left ventricle of the heart. The diagnosis of OVAS was suggested and the family received proper genetic consultation. After termination of the pregnancy, the syndrome was confirmed by postmortem 3-D computed tomography study. In view of the grim outcome, prenatal death rate and high mortality and morbidity when three or more systems are involved, prenatal diagnosis and appropriate counseling are warranted.
Endoscopic Removal of an Intravesical Calcified Sling Using Pneumatic Lithotripsy and Cystoscopic Resection
Authors: Osório Luís , Carvalho Filipe L. , Branco Frederico , Cavadas Vítor , Autorino Riccardo , Soares José
Published: November 2011

The transobturator tape procedure is a minimally invasive treatment for stress urinary incontinence. The widespread use of these slings has led to an increase in the number of rare complications, such as bladder erosion. Although in the last few years several minimally invasive techniques have been described, surgical management of such complications remains an open issue. We report a case of a bladder stone formed on a transobturator sling after unrecognized bladder perforation. Using pneumatic lithotripsy, the calculus was fragmented and the intravesical portion of the tape was successfully excised and removed by transurethral resection and endoscopic scissors. This minimally invasive transurethral technique is challenging but can be a safe and successful way to deal with such rare complications.
Early Stroke following Acute Myocardial Infarction: Incidence, Predictors and Outcome in Six Middle-Eastern Countries
Authors: Albaker Osamah , Zubaid Mohammad , Alsheikh-Ali Alawi A. , Rashed Wafa , Alanbaei Muath , Almahmeed Wael , Al-Shereiqi Sulaiman Z. , Sulaiman Kadhim , Al Qahtani Awad , Al Suwaidi Jassim ,   for the Gulf RACE Investigators
Published: November 2011

Background and Objectives: Stroke is a potential complication of acute myocardial infarction (AMI). The aim of this study was to identify the incidence, risk factors predisposing to stroke and in-hospital outcome during the index admission with AMI among patients in the Middle East. Methods: For a period of 6 months in 2006 and 2007, 5,833 consecutive AMI patients were enrolled from 64 hospitals in 6 Middle East countries. Results: The incidence of in-hospital stroke following AMI was 0.85%. Most cases were ST segment elevation AMI-related and ischemic in nature. Patients with in-hospital stroke were older than patients without stroke and were more likely to be female (36 vs. 18.6%, p = 0.0033). They were also more likely to have diabetes mellitus, dyslipidemia, prior AMI, or percutaneous/surgical coronary revascularization. Patients with stroke were more likely to present with advanced Killip class II–IV, higher mean heart rate and higher serum creatinine. Independent predictors of stroke were age, prior stroke, prior coronary artery bypass surgery, anterior AMI and systolic blood pressure >190 mm Hg on presentation. Early administration of statins was independently associated with reduced stroke risk (odds ratio, OR, 0.4, 95% confidence interval, CI, 0.19–0.90, p = 0.025). Stroke was fatal in 44% of the cases and was independently associated with in-hospital mortality (adjusted OR 12.5, 95% CI 5.7–27.4, p < 0.01). Conclusion: There is a low incidence of in-hospital stroke in Middle-Eastern patients presenting with AMI but with very high fatality rates. Early statin therapy was associated with a significant reduction in stroke risk. Future work should be focused on reducing the risk and improving the outcome of this devastating complication.
An X-Linked Body Color Gene of the Frog Rana rugosa and Its Application to the Molecular Analysis of Gonadal Sex Differentiation
Authors: Miura I. , Kitamoto H. , Koizumi Y. , Ogata M. , Sasaki K.
Published: November 2011

We identified a sex-linked, recessive body color gene, presently designated w (whitish-yellow), in the frog Rana rugosa from the Iwakuni population in Western Japan. This is the first time a sex-linked body color gene was found in amphibians so far. In this population of R. rugosa, males are the heterogametic sex, but the sex chromosomes are still homomorphic. When heterozygous males (Ww), which were produced by crossing a whitish-yellow female (ww) found in the field and a wild-type male (WW) of the same population, were backcrossed to the homozygous whitish-yellow female (ww), the resultant male offspring were all wild-type, whereas the females were all whitish-yellow. This result definitely indicates that w is recessive and X-linked, and its wild-type allele W is located on the Y chromosome. Using this strain (XwXw female and XwYW male), we found that expression of Dmrt1 and Rspo1, which are involved in testicular and ovarian differentiation in vertebrates, was higher in males and females, respectively, prior to the onset of the sexually dimorphic expression of Cyp17 and Cyp19, which are involved in biosynthesis of sex steroids and are critical markers of gonadal sex differentiation.
Array CGH in Human Leukemia: From Somatics to Genetics
Authors: van der Veken L.T. , Buijs A.
Published: November 2011

During the past decade, array CGH has been applied to study copy number alterations in the genome in human leukemia in relation to prediction of prognosis or responsiveness to therapy. In the first segment of this review, we will focus on the identification of acquired mutations by array CGH, followed by studies on the pathogenesis of leukemia associated with germline genetic variants, phenotypic presentation and response to treatment. In the last section, we will discuss constitutional genomic aberrations causally related to myeloid leukemogenesis.
Jugular Vein Hypoplasia Can Preclude Extracorporeal Membrane Oxygenation Cannulation in the Neonate with Congenital Diaphragmatic Hernia: Potential Identification of the Neonate at Risk by Fetal Magnetic Resonance Imaging
Authors: Cassady Christopher I. , Mehollin-Ray Amy R. , Olutoye Oluyinka O. , Cass Darrell L.
Published: November 2011

Magnetic resonance imaging (MRI) is used routinely in many fetal care centers for the evaluation of the fetus with congenital diaphragmatic hernia (CDH). Current MRI strategies focus on identifying the type of hernia and its contents, as well as calculating fetal lung volumes, in order to plan appropriately for neonatal support, including the use of extracorporeal membrane oxygenation (ECMO). Single-shot fast spin-echo T2-weighted sequences are fundamental, with additional sequences used variably as indicated. We report the case of a fetus with CDH in whom ECMO cannulation was attempted as a neonate but was unsuccessful because of variant anatomy of the internal jugular vein. A retrospective review of gradient echo sequences obtained through the fetal neck and chest showed the abnormality could have been anticipated. During multidisciplinary assessment of the fetus with CDH, consideration should be given to imaging evaluation of the neck to evaluate the cervical vascular anatomy, particularly in cases with poorer prognosis in whom it is anticipated that neonatal ECMO may be an option.
Verrucous Carcinoma of the Renal Pelvis with a Focus of Conventional Squamous Cell Carcinoma
Authors: Baseskioğlu Barbaros , Yenilmez Aydın , Acıkalın Mustafa , Can Cavit , Dönmez Turgut
Published: November 2011

Verrucous carcinoma (VC) is a rare variant of squamous cell carcinoma (SCC) with an extremely well-differentiated microscopic appearance. It is able to show extensive local invasion, but practically never metastasizes. VCs mostly occur in the oral cavity, larynx, nasal cavity, esophagus, vulva, vagina, anorectal region, penis and skin. VCs sometimes coexist with conventional SCCs, and in these instances they are associated with a higher recurrence rate than pure VCs. The occurrence of VC in the renal pelvis is very rare and to date only 4 cases have been reported. We report here a case of VC with a focus of conventional SCC in the renal pelvis. The patient showed fistula formation by residual tumor in the follow-up period.
Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review
Authors: Arrabal-Polo Miguel Angel , Jimenez-Pacheco Antonio , Arrabal-Martin Miguel
Published: November 2011

The incidence of prostatic abscess is 0.5% in relation to all prostate pathologies and usually occurs in patients with diabetes or with some degree of immunosuppression. The case of a male patient, 84 years old, with a history of arterial hypertension and mild renal failure, presenting high fever, prostate syndrome, genital edema and constipation is reported. He was diagnosed with prostate abscess via transrectal ultrasonography (TRUS). Treatment was started with empirical meropenem and a puncture of the abscess was performed transperineally under TRUS guidance placing an 8-Fr nephrostomy tube for 36 h. The patient was discharged 48 h after the puncture with a good prognosis. TRUS-guided transperineal drainage is a safe, adequate and effective treatment for prostate abscess, and allows the placement of drainage for several hours thereby avoiding the communication between the abscessed cavity and the urethra or rectum. Therefore, after having reviewed the literature, we consider this approach suitable for drainage.
XX SRY-Negative True Hermaphrodism in Two Dogs: Clinical, Morphological, Genetic and Cytogenetic Studies
Authors: Groppetti D. , Genualdo V. , Bosi G. , Pecile A. , Iannuzzi A. , Perucatti A. , De Lorenzi L. , Parma P. , Arrighi S.
Published: November 2011

This work aimed at giving a deeper insight into peculiar cases of intersexuality occurring in dogs and known as XX true hermaphrodism due to the existence of both testicular and ovarian tissue in one or both gonads in the presence of an XX chromosome constitution. Clinical, histological and genetic approaches were used in the study of an 8-month-old Cocker Spaniel dog and a 3-year-old mixed-breed Pitbull, both showing a female phenotype, clitoromegaly and male behavior. A normal female karyotype (2n = 78,XX) was noticed, and polymerase chain reaction failed to detect SRY in genomic DNA obtained from peripheral blood lymphocytes of both dogs. The reproductive tract was removed by standard ovariohysterectomy and processed for histology. Thereafter, a normal female phenotype was reconstructed by vaginoplasty. Histological examination revealed bilateral ovotestis in both cases: the gonads showed immature testicular parenchyma containing seminiferous tubules, Sertoli and Leydig cells, but no signs of spermatogenesis, together with differently developed ovarian follicles containing oocytes. In the ovotestes, steroidogenesis was detected by P450c17-immunoreactivity in Leydig cells as well as in theca cells, whereas no MIS-immunoreactivity was shown by the Sertoli cells. Genital tracts of Wolffian and Müllerian origin co-existed in both subjects. Both dogs belong to the very rare cases in which testicular tissue develops in the absence of the key gene, SRY. Up to date very few genetic events have been associated with this abnormal sexual differentiation: SOX9 over-expression and RSPO1 mutation. Nevertheless, neither of them has been found in these dogs.
Comparison of Grid Laser, Intravitreal Triamcinolone, and Intravitreal Bevacizumab in the Treatment of Diffuse Diabetic Macular Edema
Authors: Sobaci Güngör , Özge Gökhan , Erdurman Cüneyt , Durukan Hakan A. , Bayraktar Zeki M.
Published: November 2011

Purpose: To compare the effects of grid laser (GL), intravitreal bevacizumab (IVB), and intravitreal triamcinolone acetonide (IVTA) in diffuse diabetic macular edema (DDME). Procedures: One hundred and twenty-six patients (126 eyes) treated with GL (modified grid), IVTA (4 mg), and IVB (1.25 mg) injections, matched for best corrected visual acuity (BCVA) and OCT-based central macular thickness at presentation, were enrolled. Primary outcome measure was change in best corrected logMAR visual acuity at 1-year follow-up. Results: Rates of visual stabilization (within ±0.2 logMAR of baseline BCVA) (71.4, 83.3, 78.6%, respectively) were not different between the groups (p = 0.41) at 12-month follow-up. Higher rates of anatomical and functional success, however, were evident in IVB and IVTA groups within 6 months of treatment (p < 0.05 for both). No severe adverse effects except higher intraocular pressure (10 mm Hg from baseline) in one third (14 eyes) of the IVTA cases, who required trabeculectomy in 2 (4.8%) eyes, were observed. Conclusions: Intraocular injections may give favorable results within the first 6 months, and after 6 months, GL results seem to be more favorable in the treatment of treatment-naïve, acute, nonischemic, and center-involving DDME.
Survival in a German Population with Frontotemporal Lobar Degeneration
Authors: Nunnemann Sabine , Last Dirk , Schuster Tibor , Förstl Hans , Kurz Alexander , Diehl-Schmid Janine
Published: November 2011

Background: The present study aimed at analysing survival of patients with behavioural-variant frontotemporal dementia (bvFTD), semantic dementia (SD) and progressive non-fluent aphasia (PNFA). Furthermore, the objective of the study was to identify prognostic factors associated with survival and to examine causes of death. Methods: Interviews were performed with the proxies of 124 patients with frontotemporal lobar degeneration (FTLD). Results: Survival from the onset of first symptoms was significantly longer in SD than in bvFTD (10.5 years). Median survival in PNFA was 12.6 years. Age at onset, gender, education and severity of dementia at diagnosis did not significantly influence survival. We did not identify any phenocopy cases. The most frequent cause of death as reported by caregivers was respiratory system disorder. Conclusion: This study adds to the growing literature on survival in patients with FTLD and provides insights into the causes of death.
Combination of Channel-TURP and ILC versus Standard TURP or ILC for Elderly with Benign Prostatic Hyperplasia: A Randomized Prospective Trial
Authors: Zhang Bo , Wu Guojun , Chen Changsheng , Song Bin , Li Xin , Zhong Lin , Wang He
Published: November 2011

Purpose: A prospective randomized controlled trial was performed in elderly patients with benign prostatic hyperplasia (BPH) to evaluate the clinical effectiveness of channel transurethral resection of the prostate (C-TURP) combined with an interstitial laser coagulation (ILC) technique during a 4-year follow-up period. Methods: A total of 150 consecutive BPH patients were randomized to an ILC+C-TURP group (n = 50), an ILC group (n = 50) and a TURP group (n = 50). Urinary tract infection, acute urinary retention and retrograde ejaculation were monitored, and the retreatment rate, international prostate symptom score (IPSS) and maximum flow rate (Qmax) were measured. Results: A total of 142 patients completed the follow-up and were recruited for further analysis. At 1 month, the proportion of patients with urinary tract infection was similar between the C-TURP+ILC group and the TURP group (8.5 and 6.5%, p > 0.05), but significantly higher than that in the ILC group (51%, p < 0.001). Acute urinary retention was found in 30.6% of patients in the ILC group, but was not observed in the C-TURP+ILC and TURP groups. In the TURP group, the rate of retrograde ejaculation was significantly higher than that in the other 2 groups (p < 0.001). The retreatment rate was 8.5, 36.7 and 2.2% in the C-TURP+ILC, ILC and TURP groups, respectively (p < 0.001). When compared with baseline, the IPSS in the C-TURP+ILC, ILC and TURP groups was decreased by 70.6, 45.4, and 81.0%, respectively (ILC vs. C-TURP+ILC or TURP, p < 0.01) at the 48-month follow-up. One month after surgery, the Qmax was significantly increased in the C-TURP+ILC group and the TURP group when compared with that at baseline (p < 0.01). The TURP group had the highest and the ILC group had the lowest increase in the Qmax at the 12-, 24-, and 48-month follow-ups (p < 0.05). Conclusions: C-TURP+ILC is a safe and effective modality for the treatment of BPH, and exhibits favorable short-term clinical response and long-term durability. It is relatively reasonable and acceptable for treatment of high-risk elderly patients or those with a limited life expectancy.
Creating a Working Group for Prenatal Diagnosis and Management as a Venue to Facilitate Neurosurgery Health Care Delivery
Authors: James Hector E. , MacGregor Teresa L. , Aldana Philipp R.
Published: November 2011

Background/Aims: To facilitate the communication and engagement with the parents of a fetus with a neurosurgical condition, as well as subsequent care of the newborn, the Division of Pediatric Neurosurgery of the University of Florida College of Medicine Jacksonville created a multidisciplinary working group. Methods: The University of Florida Division of Pediatric Neurosurgery performed a staged process to develop a multidisciplinary prenatal working group. Phase I: establish communications with perinatology, neonatology and radiology. Phase II: initiate clinical working sessions with neurosurgery, neonatology, perinatology, radiology. Phase III: the working sessions were progressively expanded to include other specialties of interest. Results: This report addresses the development and the subsequent monthly meetings that were held between March 2004 and October 2008. There were a total of 246 pregnancies in which a significant fetal condition was present. Of these, 53 generated neurosurgical consultations on the basis of fetal imaging (ultrasound and/or MRI). Those that required postnatal surgery were able to have timely coordinated scheduled delivery and subsequent neurosurgical procedures. Conclusions: If neurosurgeons do not have access to a multidisciplinary prenatal working group, they may take the lead and facilitate the establishment of such a team approach. This can lead to better prenatal communications with the parents/families, coordination of delivery and timely postnatal neurosurgical management.
Ganglioglioma of the Thoracolumbar Spinal Cord in a Patient with Neurofibromatosis Type 1: A Case Report and Literature Review
Authors: Hayashi Yutaka , Nakada Mitsutoshi , Mohri Masanao , Murakami Hideki , Kawahara Norio , Hamada Jun-ichiro
Published: November 2011

Gangliogliomas of the spinal cord are rare, and the conus medullaris is an extremely rare site for their occurrence. The authors present a case in which a ganglioglioma was found in the thoracolumbar spinal cord, including the conus medullaris, of a 5-year-old female patient with neurofibromatosis type 1 (NF1) who presented with paraparesis and urinary disturbance. MRI revealed an intramedullary lesion within the thoracolumbar spinal cord, including the conus medullaris, which was surgically removed. Pathological investigation showed a ganglioglioma consisting of glioneuronal tumor cells. This is the first report to provide a pathological description of a spinal cord ganglioglioma in a patient with NF1. Because gangliogliomas usually have a good prognosis following resection, it is important to clearly distinguish them from other NF1-associated lesions, even though ganglioglioma of the thoracolumbar spinal cord, including the conus medullaris, is an extremely rare condition.
Fourth Ventricular Hamartoma Presenting with Status Epilepticus Treated with Emergency Surgery in an Infant
Authors: Chandra P. Sarat , Gulati Sheffali , Kalra Veena , Garg Ajay , Mishra Nalin K. , Bal C.S. , Sarkar Chitra , Tripathi Manjari
Published: November 2011

A 4-week-old infant presented with hemifacial spasms noticed from the 4th day after delivery. These progressed in severity, with generalization every 3–4 h. On admission, the infant went into refractory status epilepticus and had to be electively ventilated and taken for surgery on a semi-emergency basis. MRI showed a fourth ventricular hamartoma and video EEG showed spikes that were synchronous with the facial ‘twitches’ with generalization. Following the first surgery, the infant had an initial complete recovery, but developed recurrence of facial twitches after 2 weeks. Repeat MRI showed a small residual tumor which was re-operated and completely excised (at 8 weeks). Following this, the patient had complete recovery from seizures (5-year follow-up). This is the youngest patient reported presenting with status epilepticus with a fourth ventricular hamartoma operated successfully.
Antimicrobial Therapy for Asymptomatic Patients with Elevated Prostate-Specific Antigen: Can the Change in Prostate-Specific Antigen Reliably Guide Prostate Biopsy Decisions?
Authors: Torky Mohammed , Mosharafa Ashraf , Emran Ashraf , Kamal Ayman , Abdelhamid Mohammed
Published: November 2011

Objectives: To assess the effects of a 4-week levofloxacin course on PSA in asymptomatic men with elevated prostate-specific antigen (PSA) and on prostate biopsy decision. Methods: Fifty asymptomatic men with elevated PSA (4.0–10.0 ng/dl) were given levofloxacin 500 mg/day for 4 weeks followed by repeat PSA. Prostate biopsy was recommended at the end of the study. We compared pre- and post-treatment PSA as well as PSA changes between prostate cancer cases and non-cancer patients. Results: Mean (±SD) PSA decreased from 6.91 ± 2.13 to 6.05 ± 3.0 ng/dl after antimicrobial treatment (p = 0.025). Twenty-five (56.8%) patients had a post-treatment decrease in PSA, including 20 (45.5%) patients to <4.0 ng/dl and/or >25% of the initial PSA value. The difference in PSA change between prostate cancer and non-cancer patients was not statistically significant (p = 0.104). Conclusions: Levofloxacin resulted in an overall decrease in PSA for asymptomatic men with PSA in the 4–10 ng/dl range. PSA changes, however, were not significantly different between patients with prostate cancer and non-cancer patients. Prostate cancer was detected in 20% of patients with a clinically relevant PSA decline.
Metabolic Outcomes 1 Year after Gastric Bypass Surgery in Obese People with Type 2 Diabetes
Authors: Demssie Yared N. , Jawaheer Jhalini , Farook Seleena , New John P. , Syed Akheel A.
Published: November 2011

Objective: To assess metabolic outcomes in obese people with type 2 diabetes (T2D) in the first year following gastric bypass surgery. Subjects and Methods: Forty-nine obese patients with T2D who had undergone gastric bypass surgery 12 or more months previously were identified. Body weight and glycosylated haemoglobin (HbA1c) pre-operatively and 3, 6 and 12 months postoperatively, changes to glucose-lowering therapies, and blood pressure (BP) and total and high-density lipoprotein (HDL) cholesterol pre-operatively and 12 months postoperatively were recorded. The primary outcome measure was change in HbA1c; secondary outcomes included changes in BP and lipid profile. Results: The mean pre-operative body weight was 141.4 kg, the body mass index 49.4 and HbA1c 8.1%. The mean postoperative percentage of excess body weight loss at 3, 6 and 12 months was 39.0, 53.9 and 71.1 with reduction in HbA1c to 6.6, 6.2 and 5.8%, respectively (p < 0.0001). Remission of diabetes (HbA1c <6.5%) occurred in 12 of 18 patients (67%) at 3 months, 20 of 27 (74%) at 6 months and 21 of 25 (84%) at 12 months; of 41 patients under glucose-lowering treatment, 26 (63%) achieved complete withdrawal of treatment and 7 (17%) had their doses reduced. The mean of differences between baseline and 12-month measurements of systolic BP was 10.5 mm Hg (p = 0.021) and the total-to-HDL cholesterol ratio 0.9 (p < 0.002). Conclusion: Our study confirmed the finding of previous studies that gastric bypass surgery in obese people with T2D results in significant weight loss, and improved glycaemic, BP and lipid profiles. Bariatric surgery should be regarded as an effective therapeutic intervention in this patient population.
Stimulation of Glucose Uptake and Improvement of Insulin Resistance by Aromadendrin
Authors: Zhang Wei Yun , Lee Jung-Jin , Kim In-Su , Kim Yohan , Myung Chang-Seon
Published: November 2011

Agents that stimulate glucose uptake and improve insulin resistance may be useful in the management of type 2 diabetes mellitus (DM). Thus, the aims of this study were to assess the effects of aromadendrin, a flavonoid from Gleditsia sinensis Lam., on stimulation of glucose uptake and improvement of insulin resistance and to characterize the molecular mechanisms underlying these activities. Insulin-stimulated glucose uptake was measured in HepG2 cells and in differentiated 3T3-L1 adipocytes using 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxy-D-glucose (2-NBDG), a fluorescent D-glucose analog. Expression of the peroxisome proliferator-activated receptor-γ2 (PPARγ2) and adipocyte-specific fatty acid binding protein (aP2) mRNAs and the PPARγ2 protein was analyzed in adipocytes using RT-PCR and immunoblotting, respectively. Insulin-stimulated protein kinase B (Akt/PKB) phosphorylation was measured in high glucose-induced, insulin-resistant HepG2 cells. Similar to 30 µmol/l rosiglitazone, treatment with 30 µmol/l aromadendrin significantly stimulated insulin-sensitive glucose uptake in both HepG2 cells and 3T3-L1 adipocytes. Aromadendrin treatment also enhanced adipogenesis and caused increases in the expression of PPARγ2 and aP2 mRNAs and the PPARγ2 protein in differentiated 3T3-L1 adipocytes. In high glucose-induced, insulin-resistant HepG2 cells, aromadendrin reversed the inhibition of Akt/PKB phosphorylation in response to insulin, which could be abrogated by pretreatment with LY294002, a phosphatidylinositol 3-kinase (PI3K) inhibitor. Aromadendrin treatment induced adipogenesis by increases in PPARγ2 expression, resulting in stimulation of glucose uptake and ameliorated insulin resistance. These findings suggest that aromadendrin may represent a potential therapeutic candidate for the management of type 2 DM.
Effects of YC-1 on Hypoxia-Inducible Factor 1 Alpha in Hypoxic Human Bladder Transitional Carcinoma Cell Line T24 Cells
Authors: Li Yangle , Zhao Xiaokun , Tang Huiting , Zhong Zhaohui , Zhang Lei , Xu Ran , Li Songchao , Wang Yi
Published: November 2011

Objectives: It was the aim of this study to explore the effects of 3-(5′-hydroxymethyl-2′-furyl)-l-benzyl indazole (YC-1) on transcription activity, cell proliferation and apoptosis of hypoxic human bladder transitional carcinoma cells (BTCC), mediated by hypoxia-inducible factor 1α (HIF-1α). Methods: BTCC cell line T24 cells were incubated under normoxic or hypoxic conditions, adding different doses of YC-1. The protein expression of HIF-1α and HIF-1α-mediated genes was detected by Western blotting. RT-PCR was used to detect HIF-1α mRNA expression. Cell proliferation, apoptosis and migration activity were determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, flow cytometry and transwell migration assay. The cells were pretreated by two ERK/p38 MAPK pathway-specific inhibitors, PD98059 or SB203580, and then incubated with YC-1 treatment under hypoxic condition. HIF-1α protein expression was detected by Western blotting. Results: Hypoxic T24 cells expressed a higher level of HIF-1α, vascular endothelial growth factor, matrix metalloproteinases-2, B-cell lymphoma/leukemia-2 protein and HIF-1α mRNA compared with normoxic controls, in which the above-mentioned expression was downregulated by YC-1 in a dose-dependent manner. Cell proliferation and migration activity were inhibited while apoptosis was induced by YC-1 under hypoxic condition. Moreover, YC-1-downregulated HIF-1α expression was reversed by PD98059 and SB203580, respectively. Conclusions: YC-1 inhibits HIF-1α and HIF-1α-mediated gene expression, cell proliferation and migration activity and induces apoptosis in hypoxic BTCC. The ERK/p38 MAPK pathway may be involved in YC-1-mediated inhibition of HIF-1α.
Multiple Factor Analysis of Urine Leaks after Retroperitoneal Laparoscopic Partial Nephrectomy
Authors: Wang Ping , Xia Dan , Wang Shuo
Published: November 2011

Laparoscopic partial nephrectomy (LPN) is increasingly becoming a definitive therapeutic option for the treatment of small (less than 4 cm) and select moderate-sized (less than 7 cm) renal tumors. Postoperative hemorrhage and urine leak are the most pertinent complications after nephron-sparing surgery, open or laparoscopic. To our knowledge, the risk factors of urine leaks after retroperitoneal LPN have not been studied. We retrospectively analyzed our experience with retroperitoneal LPN to determine risk factors for postoperative urine leak complications. The records of 236 patients who underwent retroperitoneal LPN for renal tumor from March 2003 to October 2010 were reviewed retrospectively. Urine leak was strictly defined as continued urine output from the drain after postoperative day 2. In our series, 39 patients (16.5%) had urine leak complications. On multivariate analysis, mean estimated blood loss (p = 0.0120) and computed tomography angiogram (CTA) examination (p = 0.0286) were independent predictive factors of urine leaks. Moreover, the intraoperative blood loss was significantly reduced in patients undergoing CTA examination (p = 0.0375). Our investigation showed that factors such as intraoperative blood loss and CTA examination are predictors of urine leaks after retroperitoneal LPN. Less intraoperative blood loss to obtain a clear operative field and meticulous suturing technique are necessary to reduce urine leak probability.
Localising Prostate Cancer: Comparison of Endorectal Magnetic Resonance (MR) Imaging and 3D-MR Spectroscopic Imaging with Transrectal Ultrasound-Guided Biopsy
Authors: Goris Gbenou Maximilien C. , Peltier Alexandre , Addla Sanjai K. , Lemort Marc , Bollens Renaud , Larsimont Denis , Roumeguère Thierry , Schulman Claude C. , van Velthoven Roland
Published: November 2011

Background: Magnetic resonance imaging (MRI) and MR spectroscopic imaging (MRSI) have been gaining acceptance as tools in the evaluation of prostate cancer. We compared the accuracy of transrectal ultrasound (TRUS)-guided biopsy and dynamic contrast-enhanced MRI combined with three-dimensional (3D) MRSI in locating prostate tumours and determined the influence of prostate weight on MRI accuracy. Patients and Methods: Between March 1999 and October 2006, 507 patients with localised prostate cancer underwent radical prostatectomy (RP) at the Jules Bordet Institute. Of these, 220 had undergone endorectal MRI (1.5 T Siemens Quantum Symphony) and 3D-MRSI prior to RP. We retrospectively reviewed data on tumour location and compared the results obtained by MRI and by TRUS-guided biopsy with those obtained on histopathology of the RP specimen. Results: Patient data were as follows: median age 62.4 years (45–74); median PSA 6.36 ng/ml (0.5–22.6); 73.6% of patients had non-palpable disease (T1c); median biopsy Gleason score 6 (3–9); median RP specimen weight 50 g (12–172); median pathological Gleason score 7 (4–10); 68.64% of patients had organ-confined (pT2) disease. Tumour localisation was correlated with RP data in a significantly higher percentage of patients when using MRI rather than TRUS-guided biopsy (47.4 vs. 36.6%, p < 0.0001). MRI was marginally superior to TRUS-guided biopsy in detecting malignancy at the prostate apex (48.3 vs. 41.9%, p = 0.0687) and somewhat better at the prostate base (46 vs. 39.1%, p = 0.0413). It was highly significantly better at mid-gland (52 vs. 41.1%, p = 0.0015) and in the transition zone (40.1 vs. 24.3%, p < 0.0001). MRI had higher sensitivity in larger (≧50 g) than smaller (<50 g) prostates (50.3 vs. 42.2%, p = 0.0017). Conclusions: MRI was superior to TRUS-guided biopsy in locating prostate tumours except at the gland apex. MRI was more accurate in larger (≧50 g) than smaller prostates.
Histological and Biochemical Findings in Membranous Cataract
Authors: Gatzioufas Zisis , Huchzermeyer Cord R. , Hasenfus Andrea , El-Husseiny Moatasem , Seitz Berthold
Published: November 2011

Background: In this report we present a patient with unilateral membranous cataract and describe the histological and biochemical findings accompanying this rare condition. Methods: The patient underwent an uneventful cataract extraction. Aqueous humor (20 µl) was aspirated from the anterior chamber intraoperatively and processed for fibroblast growth factor (FGF) and epidermal growth factor (EGF) using an immunoassay method (ELISA). The lens material was subjected to histological examination. Results: The patient had increased levels of FGF and EGF in the aqueous humor, as measured by ELISA. Histological examination of the lens material showed a marked fibrous metaplasia and thickening of the anterior lens capsule, while the lens epithelial cells were transformed to active myofibroblasts which generated a fibrous matrix of collagen lamellae. Unfortunately, visual function was not restored postoperatively due to underlying amblyopia. Conclusions: Our histological and biochemical findings suggest that FGF and EGF may play a key role in the formation of membranous cataract, and therefore their impact on lens physiology should be further investigated.
Evaluation of Leukocyte-Endothelial Interactions in Retinal Diseases
Authors: Tsujikawa Akitaka , Ogura Yuichiro
Published: November 2011

Purpose: We reviewed various methodologies for studying leukocyte-retinal endothelial interactions in vivo, and summarized the information obtained from studies employing these methods. Procedures: Fluorescence dye-enhanced scanning laser ophthalmoscopy facilitates study of leukocyte-cell interactions in the retinal microcirculation. Results: Various methods such as adaptive optics scanning laser ophthalmoscopy (AO-SLO), acridine orange digital angiography, and intravital microscopy provided evidence of the mechanisms of leukocyte recruitment in the retina and of their importance in the pathogenesis of various retinal diseases. Conclusions: Leukocyte behavior can be easily examined in the retina in vivo because the optical media is transparent. SLO substantially contributes to visualizing leukocyte-endothelial interactions in retinal vessels, although most of the methods employing SLO could only be used for animal studies. AO-SLO noninvasively demonstrates the movement of each leukocyte in the parafoveal capillaries in humans. Message: AO-SLO could be useful in investigating the leukocyte-retinal endothelial interactions in various diseases in humans.
Postmortem Fetal Imaging of a Metabolic Pluricystic Kidney Disease
Authors: Claus Filip , Hindryckx An , de Ravel Thomy , Sandaite Inga , De Catte Luc , Moerman Philippe
Published: November 2011

Postmortem magnetic resonance images of a pluricystic kidney disease due to an inborn error of the fatty acid metabolism are presented.
Developments in Obesity Genetics in the Era of Genome-Wide Association Studies
Authors: Day Felix R. , Loos Ruth J.F.
Published: November 2011

Obesity is an important factor contributing to the global burden of morbidity and mortality. By identifying obesity susceptibility genes, scientists aim to elucidate some of its aetiology. Early studies used candidate gene and genome-wide linkage approaches to search for such genes with limited success. However, the advent of genome-wide association studies (GWAS) has dramatically increased the pace of gene discovery. So far, GWAS have identified at least 50 loci robustly associated with body mass index (BMI), waist-to-hip ratio, body fat percentage and extreme obesity. Some of these have been shown to replicate in non-white populations and in children and adolescents. Furthermore, for some loci interaction studies have shown that the BMI-increasing effect is attenuated in physically active individuals. Despite many successful discoveries, the effect sizes of the established loci are small, and combined they explain only a fraction of the inter-individual variation in BMI. The low predictive value means that their value in mainstream health care is limited. However, as most of these newly established loci were not previously linked to obesity, they may provide new insights into body weight regulation. Continued efforts in gene discovery, using a range of approaches, will be needed to increase our understanding of obesity.
Targeting Mitochondria by Olesoxime or Complement 1q Binding Protein as a Novel Management for Autism: A Hypothesis
Authors: Ghanizadeh A.
Published: November 2011

Excitotoxicity, oxidative stress, and mitochondrial dysfunction are associated with autism. Considering the preventive role of complement 1q binding protein or olesoxime for the opening of mitochondrial permeability transition pore mediated by oxidative stress, it is hypothesized that complement 1q binding protein or olesoxime may improve some symptoms of autism.
Molecular Mechanisms of Sexual Development
Authors: Parma P. , Radi O.
Published: November 2011

Gonadal cellular organization is very similar in all vertebrates, though different processes can trigger bipotential gonads to develop into either testes or ovaries. While mammals and birds, apart from some exceptions, show genetic sex determination (GSD), other animals, like turtles and crocodiles, express temperature-dependent sex determination. In some groups of animals, GSD can also be overridden by hormone or temperature influences, indicating how fragile this system can be. This review aims to explain the fundamental molecular mechanisms involved in mammalian GSD, mainly referring to mouse as a major model. Conceivably, other mammals might show a molecular mechanism different from the commonly investigated murine species.
Cytogenetic and Molecular Characterization of Y Isochromosome in a 63XO/64Xi(Yq) Mosaic Karyotype of an Intersex Horse
Authors: Das P.J. , Lyle S.K. , Beehan D. , Chowdhary B.P. , Raudsepp T.
Published: November 2011

Sex chromosome aberrations commonly lead to abnormal sexual development. Here we cytogenetically and molecularly characterized Y isochromosome in an intersex horse. Blood lymphocyte analysis showed a mosaic karyotype with 96% 63,XO and 4% 64,Xi(Y) cells. Molecular analysis of the isochromosome was carried out by fluorescence in situ hybridization and polymerase chain reaction with male-specific and pseudoautosomal markers from the horse Y chromosome. We found that the isochromosome was monocentric, composed of 2 long arms, carrying 2 sets of genes of the pseudoautosomal region (PAR) and the male-specific region of the Y (MSY), including the SRY - thus being genetically equivalent to Y disomy. Sequence analysis of a 1,955-bp region including the SRY exon, the promoter and the UTRs, revealed no mutations in the aberrant Y. The presence of an intact SRY in a small proportion of cells is the proposed cause for the intersex phenotype. Given that the i(Yq) was present in a mosaic form, both post-zygotic and meiotic mechanisms of its origin were proposed. We speculated that nonmosaic 64,Xi(Yq) karyotypes might be rare or absent because of the likely instability of the i(Yq) during cell division. Genetic and phenotypic implications of Y isochromosome formation in other mammals are discussed in the light of the diversity of Y chromosome organization between species.
Is the Presence or Absence of Tumour Necrosis a Significant Predictor of Survival in Renal Cell Cancer?
Authors: Qayyum T. , McArdle P.A. , Going J.J. , Orange C. , Seywright M. , Aitchison M.A. , Edwards J.
Published: November 2011

Objective: Currently when renal cancer pathology is assessed the presence or absence of necrosis is simply reported. It has been suggested that a presence or absence response ignores heterogeneity and a classification based on the extent of necrosis involvement would aid prognostic value in cancer-specific survival. The aim of this study was to determine whether a quantitative assessment of tumour necrosis would provide additional prognostic information. Methods: We studied the pathological features and cancer-specific survival of 47 patients with renal cancer undergoing surgery with curative intent. A quantitative assessment of tumour necrosis was compared to the presence or absence of necrosis. Results: Tumour necrosis was present in 27 of 47 cases. A simple assessment of the presence or absence was not associated with cancer-specific survival (p = 0.052). When assessed quantitatively, tumour necrosis was associated with decreased cancer-specific survival (p < 0.001). A 2-tiered assessment, <25% and >25% involvement of necrosis, was further utilised and shown to predict cancer-specific survival (p < 0.001). On multivariate analysis, using this 2-tiered assessment of <25% and >25% involvement of necrosis was retained as a significant independent factor for cancer-specific survival (HR 11.84, 95% CI 3.81–36.75, p < 0.001). Conclusion: A simple assessment of the presence/absence of tumour necrosis is reported to be a prognostic factor in renal cell cancer. In this study, the presence/absence was not shown to be a significant prognostic marker of cancer-specific survival. However, a more accurate quantitative assessment of tumour necrosis, whereby a 2-tiered response is still utilised, but basing this on <25% and >25% involvement of necrosis was statistically significant and independent in predicting cancer-specific survival.
Independent Regulation of Na+ and K+ Balance by the Kidney
Authors: Castañeda-Bueno María , Arroyo Juan Pablo , Gamba Gerardo
Published: November 2011

The understanding of the independent regulation of sodium and potassium by the kidney has remained elusive. Recent evidence now points to dissimilar regulatory mechanisms in ion handling, dependent on the presence of either aldosterone alone or angiotensin II with aldosterone among other factors. This review summarizes past and present information in an attempt to reconcile the current concepts of differential regulation of sodium and potassium balance through the with-no-lysine (K) kinase (WNK) system and the previous knowledge regarding ion transport mechanisms in the distal nephron.