bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterolateral Approach to the V2 Segment of the Vertebral Artery
Authors: Bruneau Michaël , Cornelius Jan Frederick , George Bernard
Published: October 2005

OBJECTIVE:

We describe our surgical technique of exposure and control of the second segment of the vertebral artery (VA V2 segment). Our basic principle is that working in the VA vicinity is more confident under visual control.

METHODS:

The VA V2 segment extends classically in and between the transverse processes from C6 to C2. This segment can be exposed through an anterolateral approach, passing medially to the sternocleidomastoid muscle and laterally to the internal jugular vein. Except in case of anatomic variation, the VA V2 segment is protected by the transverse processes bone, even if a pathological process displaces the VA along its course between them. The safest technique to expose the VA V2 segment then is to reach first the transverse process by cutting the longus colli muscle. Afterward, dividing intertransversary muscles permits exposure of and safely controls the VA by following its course. If required, the VA V2 segment can even be freed by opening the transverse process as far as the dissection is performed in the subperiosteal plane. In fact, the VA V2 segment is surrounded by a venous plexus and a periosteal sheath. This sheath gives a plane out of which the dissection is safe, avoiding troublesome venous bleeding or VA damage.

RESULTS:

This technique is very efficient for degenerative disorders, hour glass tumors, and vascular surgeries.

CONCLUSION:

Exposure and control of the VA V2 segment is safe if anatomy and variations are perfectly known, and if a rigorous step-by-step surgical technique is followed.
Three-dimensional Relationships of The Optic Radiation
Authors: Rubino Pablo Augusto , Rhoton Albert L. , Tong Xiaoguang , de Oliveira Evandro
Published: October 2005

OBJECTIVE:

This study examined the relationship of the optic radiation to the landmarks important in temporal lobe surgery.

METHODS:

The optic radiation was dissected by applying Klingler's fiber dissection technique to 20 formalin-fixed human hemispheres. The dissections were performed with the operating microscope and imaged in three-dimensional photographs. Several measures quantified the relationship of the radiation to reliable surgical landmarks.

RESULTS:

In all specimens, the anterior loop of the radiation extended to the anterior tip of the roof of the temporal horn. The anterior edge of the optic radiation was located an average of 25 mm (range, 22–30 mm) behind the temporal pole. The optic radiation extended an average of 5 mm (range, 3–6 mm) anterior to the hippocampus head and 22 mm (range, 20–25 mm) anterior to the anterior edge of the lateral geniculate body. The optic radiation also extended an average of 2 mm (range, 1–3 mm) anterior to the tip of the temporal horn. The relationships of the optic radiation to important surgical landmarks are discussed.

CONCLUSION:

The optic radiation reached the anterior tip of the temporal horn. Resections that extend through the roof of the temporal horn more than 3 cm behind the temporal pole cross the anterior loop of the optic radiation.
Technical Improvements and Results of Open-door Expansive Laminoplasty with Hydroxyapatite Implants for Cervical Myelopathy
Authors: Kihara Shun-ichi , Umebayashi Takeshi , Hoshimaru Minoru
Published: October 2005

OBJECTIVE:

A new, modified technique of cervical open-door laminoplasty with hydroxyapatite implants was developed to enlarge the spinal canal in stable fashion yet preserve the architecture of the cervical spine and surrounding tissues. To assess the efficacy of this technique, a retrospective review of neurological and radiological outcomes after cervical laminoplasty was conducted.

METHODS:

Clinical charts and cervical x-rays of 151 patients with cervical stenotic myelopathy were reviewed. Patients were treated with the cervical laminoplasty between May 2001 and January 2002. The patient group comprised 69 women and 82 men ranging in age from 30 to 86 years (mean, 63 yr). Neurological outcomes were evaluated according to the Japanese Orthopaedic Association grade. To assess alignment and mobility of the cervical spine, the C2–C7 angle was used.

RESULTS:

The average Japanese Orthopaedic Association grade was 8.1 ± 2.5 before surgery and 15.2 ± 1.5 at 1 year after surgery (P < 0.01). No neurological complications were observed. The average C2–C7 angle at the neutral position increased from 8.3 ± 11.7 degrees before surgery to 14.9 ± 11.6 degrees at 1 year after surgery (P < 0.01). The range of motion between C2 and C7 was 36.9 ± 12.5 degrees and 29.1 ± 10.8 degrees before and 1 year after surgery, respectively.

CONCLUSION:

A new modified technique of cervical open-door laminoplasty described herein offers some solutions to the problems associated with conventional techniques of cervical laminoplasty.
Craniofacial Resection for Cranial Base Malignancies Involving the Infratemporal Fossa
Authors: Bilsky Mark H. , Bentz Brandon , Vitaz Todd , Shah Jatin , Kraus Dennis
Published: October 2005

OBJECTIVE:

Cranial base malignancies involving the infratemporal fossa have been considered unresectable. Advanced operative techniques have made tumor resection feasible in an en bloc fashion with negative histological margins, but there are limited data regarding outcome analysis in patients who have undergone resection of malignant tumors in this area.

METHODS:

At Memorial Sloan-Kettering Cancer Center, 25 patients underwent anterolateral cranial base resections for tumors that involved the infratemporal fossa during a 7-year period. The most common tumors were sarcoma (n = 9), squamous cell carcinoma (n = 6), and adenoid cystic carcinoma (n = 3). The median size of the tumors was 6 cm, and 12 tumors involved the anterior cranial base and/or orbit.

Tumor resections were divided into three types. Twelve patients underwent Type 1 dissection for tumors involving only the infratemporal fossa and maxillary sinus; 2 patients underwent Type 2 dissections involving the infratemporal fossa and anterior cranial base; and 11 patients underwent Type 3 dissection, which included the infratemporal fossa, anterior cranial base, and orbit. All patients required free flap reconstruction, 22 of which were rectus abdominis free flaps.

RESULTS:

Complications occurred in seven patients, including a single mortality resulting from a myocardial infarction. The 2-, 3-, and 5-year survival rates were 69, 63, and 56%, respectively. The relapse-free survival rates were 47% at 2 and 3 years and 41% at 5 years. Recurrences were local in nine patients and distant in four patients.

CONCLUSION:

Despite the extensive nature of many infratemporal fossa tumors, they can be resected with acceptable morbidity. Survival rates approach those of anterior cranial base malignancies without infratemporal fossa involvement.
Transcallosal Transchoroidal Approach to Tumors of the Third Ventricle
Authors: Kasowski Hahnah J. , Nahed Brian V. , Piepmeier Joseph M.
Published: October 2005

ALTHOUGH THE LITERATURE is rich with descriptions of the approach to the third ventricle, surgeons remain cautiously reserved. In this report, we demonstrate that the transcallosal approach can be easily performed provided that preoperative planning is adequate. Familiarity with the course of major cortical and deep draining veins grants the surgeon a wide exposure of the posterior third ventricle. We discuss the indications, surgical technique, and pitfalls to this approach while providing an accompanying video mirroring our discussion.
Neuroendoscopic Aspiration of Hematocephalus Totalis: Technical Note
Authors: Longatti PierLuigi , Fiorindi Alessandro , Martinuzzi Andrea
Published: October 2005

OBJECTIVE AND IMPORTANCE:

Massive intraventricular hemorrhage requires aggressive and rapid management to decrease intracranial hypertension. The amount of intraventricular blood is a strong prognostic predictor, and its fast removal is a priority. Neuroendoscopy may offer some advantages over more traditional surgical approaches. We describe here the technical details and clinical outcomes of the neuroendoscopic management of massive tetraventricular hemorrhage in 25 consecutive patients, highlighting the potential pitfalls and the advantages of the technique.

CLINICAL PRESENTATION:

Twenty-five patients, aged 7 to 80 years, presenting with massive ventricular hemorrhage were admitted between January 1996 and May 2004 to our neurosurgery unit after an emergency computed tomographic scan. Severity of ventricular hemorrhage was graded according to the Graeb scale; the mean Graeb score was 9.8 ± 2.9. Hemorrhages were secondary to vascular malformation in 12 cases.

INTERVENTION:

Endoscopy was performed on the first day in 17 cases, with a delay of 1 to 5 days in the remaining 8 cases. A flexible endoscope with “free-hand” technique was always preferred. The ventricular cleaning proceeded in three phases: lateral ventricle, third ventricle, and then aqueduct and fourth ventricle. In selected patients, a catheter, both for intracranial pressure monitoring and for drainage, was positioned. The procedure was successfully completed in all cases. There was no surgery-related mortality. The mean length of intensive care unit stay after the operation was 18 ± 12 days. Short-term mortality (1 mo) was 12%, whereas long-term (>6 mo) mortality was 24%. Complete recovery (Glasgow Outcome Scale score, 5) was achieved in 40% of cases. A ventriculoperitoneal shunt was necessary in 12% of patients.

CONCLUSION:

Intraventricular hemorrhage, analogously to other ventricular diseases, can be treated successfully with flexible endoscopes. Obviously, the limitation of this study lies in its observational nature; however, the encouraging results reported here should prompt a randomized study to evaluate the effectiveness and efficiency of the endoscopic approach in comparison to the more established semiconservative management offered by external derivation with fibrinolytic agents.
Thalamic Stimulation as a Treatment for Primary Erythromelalgia: Technical Case Report
Authors: Delye Hans , Lagae Lieven , Vermylen Jos , Nuttin Bart
Published: October 2005

OBJECTIVE AND IMPORTANCE:

We report the use of bilateral thalamic stimulation in a case of primary erythromelalgia with immediate and important pain relief for 3 years.

CLINICAL PRESENTATION:

A 12-year-old boy experiencing primary erythromelalgia had a 4-year history of recurrent attacks of severe burning pain in both feet, accompanied by local reddening, swelling, and heating of the skin. The attacks were triggered by warmth and exercise. The pain was relieved only by elevation and cooling of the lower limbs, which he achieved by immersing his legs in a bucket of ice water, resulting in severe ulceration of the skin.

INTERVENTION:

Because of the gradual aggravation of the signs and symptoms and resistance of the patient's condition to several medical therapies, the patient received spinal cord stimulation. The implants were removed twice because of recurrent infection. Finally, the patient was treated with bilateral electrical stimulation of the ventral posterolateral thalamic nucleus, which resulted in important pain control until 3 years later. The patient was able to avoid water immersions, and all ulcerations disappeared.

CONCLUSION:

We conclude that thalamic stimulation was successful in this case of primary erythromelalgia.
Scaled Suction for Microneurosurgery: Technical Note
Authors: Okada Yoshikazu , Kawamata Takakazu , Chernov Mikhail F. , Hori Tomokatsu
Published: October 2005

OBJECTIVE:

We have developed scaled suction to facilitate the measurement of aneurysm neck width and tumor size during operations.

METHODS:

We constructed a new suction device scaled every 1 mm from the tip to 3 cm and every 5 mm from 3 to 5 cm. The scaled suction devices have been used in 50 aneurysm and brain tumor operations.

RESULTS:

The new suction device permits easy measurement of aneurysm neck width, tumor size, the extent of internal decompression of tumor, and depth from the surface of the brain to the lesion.

CONCLUSION:

Our scaled suction device is a simple and useful navigator for continuously measuring intraoperative variables such as lesion size and distance between the lesion and the surrounding vital structures.
Image-guided Transsacral Approach to Presacral Lesions of Nerve Root Origin: Technical Note
Authors: Lee Gabriel Y.F. , Massicotte Eric M.
Published: October 2005

OBJECTIVE AND IMPORTANCE:

The utility of image guidance in fashioning a posterior transsacral operative corridor for approaching small presacral neural lesions has not previously been reported.

CLINICAL PRESENTATION:

A 61-year-old woman presented with unilateral sciatica and worsening leg weakness. Subsequent investigations disclosed a well-defined, 1.4-cm lesion in continuity with the S1 nerve root distal to the anterior sacral foramen.

TECHNIQUE:

A minimally invasive approach was undertaken with use of the StealthStation (Medtronic Sofamor Danek, Inc., Memphis, TN). The amount of sacral bone resection was preplanned to ensure the most direct posterior access route. Intraoperative navigation was used to guide the trajectory of bone drilling. After adequate exposure was achieved, the lesion was resected using standard microsurgical techniques under continuous intraoperative electrophysiological monitoring.

CONCLUSION:

An image-guided transsacral approach is a viable option for accessing small to moderately sized lesions of nerve root origin located within the presacral space.
Surgical Technique to Retract the Tentorial Edge during Subtemporal Approach: Technical Note
Authors: Hernesniemi Juha , Ishii Keisuke , Karatas Ayse , Kivipelto Leena , Niemelä Mika , Nagy Laszlo , Shen Hu
Published: October 2005

OBJECTIVE:

To describe a surgical technique to retract the tentorial edge during the subtemporal approach initially introduced and used widely by Drake and Peerless to treat distal basilar artery aneurysms.

METHODS:

One of the most important parts of the exposure is to reflect the edge of the tentorium downward by 1 cm or more and to tether it with a suture placed lateral to or behind the insertion of the trochlear nerve and then to the dura mater of the floor of the middle fossa. Surgical forceps or a sharp dural hook are used to elevate the tentorial edge, in front of the trochlear nerve. A small incision is made on the surface of the floor of the middle fossa using a sharp bipolar forceps, and a small straight microclip is inserted with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge.

RESULTS:

The method described has been used by the senior author in more than 100 operations as a simple and fast means of tethering the free margin of the tentorial edge simply and quickly.

CONCLUSION:

We inserted a small straight microclip with one arm through the incision on the surface of the floor of the middle fossa and the other at the free margin of the tentorial edge as a fast and simple method of retracting the tentorial edge during a subtemporal approach.
Microsurgical Resection of Spinal Cord Hemangioblastomas
Authors: Lonser Russell R. , Oldfield Edward H.
Published: October 2005

HEMANGIOBLASTOMAS ARE NOT uncommon intramedullary spinal cord neoplasms. They are highly vascular, benign tumors that occur either sporadically or in the presence of von Hippel-Lindau disease. Despite their exceptionally vascular nature, these lesions can consistently be resected completely and safely with minimal blood loss. We describe a microsurgical method for removal of these tumors from the spinal cord.
Posterior Subscapular Approach to the Brachial Plexus
Authors: Tender Gabriel C. , Kline David G.
Published: October 2005

THE POSTERIOR SUBSCAPULAR APPROACH to the brachial plexus is commonly indicated in patients with neural entrapment (neurogenic thoracic outlet syndrome, especially when associated with a large C7 transverse process or cervical rib) and paraspinal tumors or lacerating injuries involving the spinal nerves close to the spine. This approach is also preferred in patients with previous anterior neck operations and/or morbid obesity. We describe the anatomy and operative technique of this approach, which has been used by the senior author (DGK) for the past 25 years.
Successful Intra-arterial Basilar Artery Thrombolysis in a Patient with Bilateral Vertebral Artery Occlusion: Technical Case Report
Authors: Wang Huan , Fraser Kenneth , Wang David , Alvernia Jorge , Lanzino Giuseppe
Published: October 2005

OBJECTIVE AND IMPORTANCE:

Basilar artery occlusion is a clinical event with an exceedingly high mortality rate. Improved survival is closely associated with successful recanalization of the occluded basilar artery. Bilateral vertebral artery occlusion (BVAO) is a unique disease entity that effectively denies any direct access to the basilar artery for endovascular rescue therapy. We report a case of successful intra-arterial basilar artery thrombolysis in a patient with BVAO.

CLINICAL PRESENTATION:

A 78-year-old man was transferred to our hospital after intravenous administration of tissue plasminogen activator and with deteriorating neurological status requiring intubation. His clinical presentation was highly suggestive of acute basilar artery thrombosis. The cerebral angiogram showed a BVAO and collateral flow reconstituting both distal extracranial vertebral arteries but with significant contrast stasis. There was no retrograde filling of the basilar artery through the only angiographically visible posterior communicating artery.

TECHNIQUE:

Selective catheterizations of the left occipital artery and the left ascending cervical branch of the thyrocervical trunk were performed to deliver a total of 12 mg of tissue plasminogen activator. At that point, the patient showed significant neurological improvement. The post-tissue plasminogen activator angiogram showed improved flow through the basilar artery. The patient was independent and well at his 1-year follow-up visit.

CONCLUSION:

Knowledge of potential collateral pathways is important when direct access to the main intracranial vessels is not available. Basilar artery thrombolysis through collateral vessels is clinically effective when a direct approach to the artery is not feasible.
Bilateral Internal Carotid to Anterior Cerebral Artery Anastomosis with Anterior Communicating Artery Aneurysm: Technical Case Report
Authors: Kılıç Kaya , Orakdöğen Metin , Bakırcı Aram , Berkman Zafer
Published: October 2005

OBJECTIVE AND IMPORTANCE:

The present case report is the first one to report a bilateral anastomotic artery between the internal carotid artery and the anterior communicating artery in the presence of a bilateral A1 segment, fenestrated anterior communicating artery (AComA), and associated aneurysm of the AComA, which was discovered by magnetic resonance angiography and treated surgically.

CLINICAL PRESENTATION:

A 38-year-old man who was previously in good health experienced a sudden onset of nuchal headache, vomiting, and confusion. Computed tomography revealed a subarachnoid hemorrhage. Magnetic resonance angiography and four-vessel angiography documented an aneurysm of the AComA and two anastomotic vessels of common origin with the ophthalmic artery, between the internal carotid artery and AComA.

INTERVENTION:

A fenestrated clip, introduced by a left pterional craniotomy, leaving in its loop the left A1 segment, sparing the perforating and hypothalamic arteries, excluded the aneurysm.

CONCLUSION:

The postoperative course was uneventful, with complete recovery. Follow-up angiograms documented the successful exclusion of the aneurysm. Defining this particular internal carotid-anterior cerebral artery anastomosis as an infraoptic anterior cerebral artery is not appropriate because there is already an A1 segment in its habitual localization. Therefore, it is also thought that, embryologically, this anomaly is not a misplaced A1 segment but the persistence of an embryological vessel such as the variation of the primitive prechiasmatic arterial anastomosis. The favorable outcome for our patient suggests that surgical treatment may be appropriate for many patients with this anomaly because it provides a complete and definitive occlusion of the aneurysm.
Recanalization of Long-lasting Middle Cerebral Artery Occlusion by a Combination of Surgical and Interventional Approaches: Technical Case Report
Authors: Beneš Vladimir , Netuka David , Charvát František , Mohapl Milan
Published: October 2005

OBJECTIVE AND IMPORTANCE:

In strictly selected cases of middle cerebral artery (MCA) occlusion, revascularization by extracranial-intracranial (EC-IC) bypass can be considered. The interventional recanalization of the occlusion under direct surgical control has not been reported in the literature so far.

CLINICAL PRESENTATION:

A 39-year-old Caucasian female patient had experienced an ischemic stroke 15 years before she came to our attention. At that time, occlusion of the right MCA was diagnosed by angiography. Her neurological deficit resolved within 6 months. Fifteen years later, the patient experienced repeated numbness of her left-sided extremities, which was refractory to medical treatment. Angiography revealed an occluded M1 segment of the MCA. Perfusion computed tomography without and after CO2 stimulation disclosed impaired cerebrovascular capacity.

INTERVENTION:

The patient was scheduled for EC-IC bypass. The MCA tree was exposed, and the occluded portion was found to be 10 mm long. We then decided to reopen the vessel by balloon dilation under direct visual control. A catheter was advanced to the M1 origin, where a glidewire was passed into the vessel lumen. With only a little help from the surgeon, it was surprisingly easy to direct the glidewire through the occluded segment. At this time, flow through the M1 segment was re-established. Flow through the MCA that had occluded for 15 years was re-established.

CONCLUSION:

On the basis of our experience, in nonatherosclerotic occlusions, intravascular intervention may be considered.
Reduction of Magnetic Resonance Imaging-related Heating in Deep Brain Stimulation Leads Using a Lead Management Device
Authors: Baker Kenneth B. , Tkach Jean , Hall John D. , Nyenhuis John A. , Shellock Frank G. , Rezai Ali R.
Published: October 2005

OBJECTIVE:

To evaluate the ability of a lead management device to reduce magnetic resonance imaging (MRI)-related heating of deep brain stimulation (DBS) leads and thereby to decrease the risks of exposing patients with these implants to MRI procedures.

METHODS:

Experiments were performed using the Activa series (Medtronic, Inc., Minneapolis, MN) DBS systems in an in vitro, gelled-saline head and torso phantom. Temperature change was recorded using fluoroptic thermometry during MRI performed using a transmit-and-receive radiofrequency body coil at 1.5 T and a transmit-and-receive radiofrequency head coil at 3 T. A cranial model placed in the phantom was used to test a custom-designed burr hole device that permitted the placement of small-diameter, concentric loops around the burr hole at the DBS lead as it exited the cranium.

RESULTS:

A total of 41 scans were performed, with absolute temperature changes ranging from 0.8 to 10.3°C. Depending on the MRI system tested and the side of the phantom on which the hardware was placed, loop placement resulted in reductions in temperature rise of 41 to 74%. The effect was linearly related to the number of loops formed (P < 0.01) over the range tested (0–2.75 loops).

CONCLUSION:

Small, concentric loops placed around the burr hole seem to reduce MRI-related heating for these implants. Although the mechanism is still not fully understood, a device such as that used in the present study could permit a wider range of clinical scanning sequences to be used at 1.5 and 3 T in patients with DBS implants, in addition to increasing the margin of safety for the patient.
Ten-year Experience with the Supraorbital Subfrontal Approach through an Eyebrow Skin Incision
Authors: Reisch Robert , Perneczky Axel
Published: October 2005

OBJECTIVE:

More than ever before, the priority in contemporary neurosurgery is to achieve the greatest therapeutic effect while causing the least iatrogenic injury. The evolution of microsurgical techniques with refined instrumentation and illumination and the enormous development of preoperative and intraoperative diagnostic tools enable neurosurgeons to treat different lesions through limited and specific keyhole approaches.

METHODS:

Based on our surgical experience, the technique of supraorbital subfrontal craniotomy is described in detail in this article. After an eyebrow skin incision is made, a limited supraorbital craniotomy is performed with a width of 15 to 25 mm and a height of 10 to 15 mm.

RESULTS:

We have been using the supraorbital keyhole craniotomy since 1985 and have approached a variety of lesions within the anterior, middle, and posterior cranial fossae. During a 10-year period between July 1994 and June 2004, the lesions treated via the supraorbital approach in our department comprised 1125 intracranial tumors or cystic lesions, cerebral aneurysms, and other miscellaneous diseases, performed by 23 different surgeons and residents. Of these 1125 patients, we operated on 471 of them, and information obtained from 450 contributed to the follow-up data. Three months after surgery, the Glasgow Outcome Scale scores for this very heterogeneous group of patients were as follows: 5 in 387 patients (86.0%), 4 in 29 patients (6.4%), 3 in 16 patients (3.5%), 2 in 10 patients (2.2%), and 1 in 8 patients (1.8%). Of the 450 patients, 229 were treated for intracranial aneurysms, 93 for cranial base meningiomas, 39 for craniopharyngiomas, 23 for pituitary adenomas, 18 for deep-seated brainstem tumors, and 48 for other miscellaneous frontotemporal or suprasellar lesions.

CONCLUSION:

In our experience, the supraorbital craniotomy allows a wide, intracranial exposure for extended, bilaterally situated, or even deep-seated intracranial areas, according to the strategy of keyhole craniotomies. The supraorbital craniotomy offers equal surgical possibilities with less approach-related morbidity owing to limited exposure of the cerebral surface and minimal brain retraction. In addition, the short skin incision within the eyebrow and careful soft tissue dissection result in a pleasing cosmetic outcome.
Interaction of fibroblast growth factor and C-natriuretic peptide signaling in regulation of chondrocyte proliferation and extracellular matrix homeostasis
Authors: Krejci Pavel , Masri Bernard , Fontaine Vincent , Mekikian Pertchoui B. , Weis MaryAnn , Prats Herve , Wilcox William R.
Published: October 2005

Overexpression of C-natriuretic peptide (CNP) in cartilage partially rescues achondroplasia in the mouse. Here, we studied the interaction of fibroblast growth factor (FGF) and CNP signaling in chondrocytes. CNP antagonized FGF2-induced growth arrest of rat chondrosarcoma (RCS) chondrocytes by inhibition of the Erk mitogen activated protein kinase pathway. This effect of CNP was protein kinase G-dependent and was mimicked by the cGMP analog pCPT-cGMP. FGF2-mediated activation of both MEK and Raf-1 but not Ras or FRS2 was abolished by CNP demonstrating that CNP blocks the Erk pathway at the level of Raf-1. CNP also counteracted the FGF2-mediated degradation of RCS extracellular matrix. CNP partially antagonized FGF2-induced expression, release and activation of several matrix-remodeling molecules including matrix metalloproteinase 2 (MMP2), MMP3, MMP9, MMP10 and MMP13. In addition, CNP compensated for FGF2-mediated matrix loss by upregulation of matrix production independent of its interference with FGF signaling. We conclude that CNP utilizes both direct and indirect ways to counteract the effects of FGF signaling in a chondrocyte environment.
Chemotaxis towards hyaluronan is dependent on CD44 expression and modulated by cell type variation in CD44-hyaluronan binding
Authors: Tzircotis George , Thorne Rick F. , Isacke Clare M.
Published: October 2005

The accumulation of the extracellular matrix glycosaminoglycan hyaluronan by tumours and tumour-associated stroma promotes cancer cell invasion and metastasis. Using the Dunn chamber chemotaxis assay, we demonstrate for the first time that high molecular mass hyaluronan acts as a soluble chemoattractant promoting the directional migration of MDA-MB-468 and MDA-MB-231 breast cancer cells. Moreover, chemotaxis towards hyaluronan, but not foetal bovine serum, can be abrogated following treatment of the cells with siRNA oligonucleotides to downregulate CD44 expression. These data indicate that CD44 is the principal receptor mediating this response and that CD44 expression is not a general requirement for cell migration and gradient sensing, rather it elicits a ligand-specific response. However, expression of CD44 alone is not sufficient to drive chemotaxis towards hyaluronan, as NIH-3T3 fibroblasts were unable to respond to a hyaluronan gradient even when transfected with high levels of human CD44. For NIH-3T3 cells to bind exogenous hyaluronan, it was necessary to both increase the level of receptor expression and remove a hyaluronan pericellular matrix. Together, these studies reveal a direct mechanism for promoting cell invasion into the hyaluronan-rich matrix and predict that in the complex multicellular environment in vivo, multiple mechanisms exist to regulate the ability of a cell to respond to a chemotactic hyaluronan gradient.
Paracellin-1 and the modulation of ion selectivity of tight junctions
Authors: Hou Jianghui , Paul David L. , Goodenough Daniel A.
Published: October 2005

Tight junctions play a key selectivity role in the paracellular conductance of ions. Paracellin-1 is a member of the tight junction claudin protein family and mutations in the paracellin-1 gene cause a human hereditary disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) with severe renal Mg2+ wasting. The mechanism of paracellin-1 function and its role in FHHNC are not known. Here, we report that in LLC-PK1 epithelial cells paracellin-1 modulated the ion selectivity of the tight junction by selectively and significantly increasing the permeability of Na+ (with no effects on Cl-) and generated a high permeability ratio of Na+ to Cl-. Mutagenesis studies identified a locus of amino acids in paracellin-1 critical for this function. Mg2+ flux across cell monolayers showed a far less-pronounced change (compared to monovalent alkali cations) following exogenous protein expression, suggesting that paracellin-1 did not form Mg2+-selective paracellular channels. We hypothesize that in the thick ascending limb of the nephron, paracellin-1 dysfunction, with a concomitant loss of cation selectivity, could contribute to the dissipation of the lumen-positive potential that is the driving force for the reabsorption of Mg2+.
Immunohistochemical Expression of Endothelial Markers CD31, CD34, von Willebrand Factor, and Fli-1 in Normal Human Tissues
Authors: Pusztaszeri Marc P. , Seelentag Walter , Bosman Fred T.
Published: October 2005

Few systematic studies have been published comparing the expression and distribution of endothelial cell (EC) markers in different vascular beds in normal human tissues. We investigated by immunohistochemistry the expression of CD31, CD34, von Willebrand factor (vWF), and Fli-1 in EC of the major organs and large vessels. Tissue samples obtained from autopsies and biopsy specimens were routinely processed and stained immunohistochemically for CD31, CD34, and vWF. Biopsy material was also stained immunohistochemically for Fli-1, D2-40, and Lyve-1. The expression pattern of the markers was heterogeneous in some of the organs studied. In the kidney, fenestrated endothelium of the glomeruli strongly expressed CD31 and CD34 but was only focally positive or completely negative for vWF. Alveolar wall capillaries of the lung strongly stained for CD31 and CD34 but were usually negative for vWF. The staining intensity for vWF increased gradually with the vessel caliber in the lung. Sinusoids of the spleen and liver were diffusely positive for CD31. They were negative for CD34 in the spleen and only expressed CD34 in the periportal area in the liver. Fli-1 was expressed in all types of EC but also in lymphocytes. D2-40 stained lymphatic endothelium only. Lyve-1 immunostaining was too variable to be applied to routinely processed tissues. The expression of EC markers CD31, CD34, and vWF in the vascular tree is heterogeneous with a specific pattern for individual vessel types and different anatomic compartments of the same organ. D2-40 labels lymphatic EC only.
Cervical human papillomavirus screening by PCR: advantages of targeting the E6/E7 region
Authors: Morris Brian J.
Published: October 2005

PCR is a promising method for detection of human papillomavirus (HPV), the high-risk forms of which are responsible for cervical cancer. PCR primers that target the L1 or E1 region can be unreliable and may miss more advanced disease, whereas those directed at the E6 or E7 regions, which encode oncogenic products, are preferable because 1) the LI/E1 regions, but never the E6/E7 regions, are lost during integration of viral DNA into host genomic DNA, a process that can represent an integral component of progression from infection to tumorigenesis; and 2) the E6/E7 nucleotide sequence exhibits less nucleotide variation. The choice of region used for PCR has implications for HPV screening strategies in the clinical diagnosis and management of cervical cancer.
Isotretinoin therapy induces DNA oxidative damage
Authors: Georgala Sophia , Papassotiriou Ioannis , Georgala Catherina , Demetriou Elisabeth , Schulpis Kleopatra H.
Published: October 2005

Background: Isotretinoin (Iso) is currently indicated for the treatment of cystic acne (CA) and is related to marked teratogenicity.

Aim: The aim of the study was to evaluate the relationship between total antioxidant status (TAS) and a serum marker of DNA oxidative damage, 8-hydroxy-2-desoxyguanosine (8-OHdG), in patients on Iso treatment.

Patients and methods: Patients with CA (n=18) were evaluated before and 45days after Iso (0.5mg/kg per day) treatment and non-diseased controls (n=22) were tested only once. Plasma TAS levels and 8-OHdG were measured spectrophotometrically and with an immunoassay, respectively. Liver biochemical parameters and muscle enzymes were measured on a blood chemistry analyzer.

Results: TAS levels were significantly (p<0.0001) lower in patients before treatment (921±124μmol/L) compared with those after treatment (1335±93μmol/L) and in controls (1536±126μmol/L). In contrast, 8-OHdG serum levels were two-fold higher in patients after treatment (0.21±0.03ng/mL) than before treatment (0.11±0.02ng/mL) and three-fold higher than in controls (0.07±0.01ng/mL; p<0.0001). Negative correlations were found between TAS and 8-OHdG (r=−0.754, p<0.0001) in patients before therapy and positive correlations were found between creatine kinase (CK) and 8-OHdG (r=0.488, p<0.001) and liver enzymes after Iso treatment.

Conclusions: High serum levels of 8-OHdG in patients on Iso therapy may be due to a direct effect of Iso on liver, muscle and skin epidermal cells. Regular evaluation of 8-OHdG in sera of patients, especially of women of reproductive age, on Iso treatment could be a sensitive follow-up biomarker of DNA oxidation.
Specificity of the 3H-triolein assay for pancreatic lipase in blood plasma
Authors: Gewert Karin , Gregory Peter C. , Olivecrona Gunilla , Erlanson-Albertsson Charlotte , Pierzynowski Stefan G.
Published: October 2005

The aim of this study was to investigate the specificity of the
Effects of hemolysis and storage condition on neuron-specific enolase (NSE) in cerebrospinal fluid and serum: implications in clinical practice
Authors: Ramont Laurent , Thoannes Henri , Volondat Ariel , Chastang François , Millet Marie-Christine , Maquart François-Xavier
Published: October 2005

The concentration of neuron-specific enolase (NSE) in serum and cerebrospinal fluid (CSF) has been used as a biomarker in some cancers and, more recently, in neurodegenerative diseases. Pre-analytical conditions are very important for the quality of returned results. In this study, we evaluated the effects of storage conditions (temperature and duration of storage) and hemolysis on the concentration of NSE in serum and CSF. Our results demonstrate that samples for NSE measurement may be stored at −80°C for no more than 6 months in the case of CSF and 9months in the case of serum samples. Even invisible hemolysis may increase NSE levels in samples. Consequently, an index of hemolysis should be determined before deciding whether or not to perform NSE measurement.
Prevalence of abnormal thyroid stimulating hormone and thyroid peroxidase antibody-positive results in a population of pregnant women in the Samara region of the Russian Federation
Authors: Quinn Frank A. , Gridasov Gennady N. , Vdovenko Sergey A. , Krasnova Natalia A. , Vodopianova Nadezhda V. , Epiphanova Marina A. , Schulten Monika
Published: October 2005

Undiagnosed thyroid disease is a common problem with significant public health implications. This is especially true during pregnancy, when the health of both the mother and the developing child can be adversely affected by abnormal maternal thyroid function. Measurement of serum thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (TPO-Ab) are two common ways to assess maternal thyroid status. The objective of our study was to determine the prevalence of abnormal TSH and TPO-Ab tests in a population of pregnant women in the Samara region of the Russian Federation. Serum samples were obtained from 1588 pregnant women as part of their routine antenatal care. TSH and TPO-Ab were measured, and trimester-specific reference values for TSH (2.5–97.5 percentiles) were calculated using TPO-Ab-negative women. TSH results outside these ranges were considered abnormal; TPO-Ab levels outside the manufacturer's reference range (>12IU/mL) were considered abnormal. Overall, the prevalence of abnormal results was 6.3% for TSH and 10.7% for TPO-Ab. High TSH (>97.5 trimester-specific percentile) and TPO-Ab-positive results were most common in the first trimester (5.7% and 13.8%, respectively). TSH levels were associated with gestational age and TPO-Ab status, and with maternal age in TPO-Ab-negative women. TPO-Ab status was associated with both maternal and gestational age. Women with TSH >2.5mIU/L had a significantly increased risk of being TPO-Ab-positive, and this risk increased with age. Based on our data, we conclude that abnormal TSH and TPO-Ab are common in pregnant women of the Samara region. Given the association of thyroid dysfunction to adverse pregnancy outcomes, screening of this population for abnormal thyroid function should be considered.
Impact of standardized calibration on the inter-assay variation of 14 automated assays for the measurement of creatinine in human serum
Authors: Séronie-Vivien Sophie , Galteau Marie-Madeleine , Carlier Marie-Christine , Hadj-Aissa Aoumeur , Hanser Anne-Marie , Hym Bernadette , Marchal Alain , Michotey Odile , Pouteil-Noble Claire , Sternberg Michel , Perret-Liaudet Armand , Creatinine Working Group of the Société Française de Biologi
Published: October 2005

Purpose: The aim of our study was to measure the inter-assay variation and accuracy of serum creatinine assays and to assess the effect of standardized calibration procedures on this variability. Methods: We analyzed 30 human sera and three reference materials, using 17 creatinine assays (12 colorimetric, 4 enzymatic and 1 HPLC). We compared two standardized calibration procedures, using either a reference material or secondary standards, to that recommended by the manufacturers. Results: For assays calibrated according to the manufacturers' recommendations, the median inter-assay coefficient of variation (CV) was 14.2% for 20 low samples (45–150μM), and 7.7% for 10 high samples (250–350μM). The CV was significantly influenced by the calibration procedure, but none of the standardized calibration procedures significantly improved the inter-assay variability. However, a significant decrease in CV was noted within each type of assay method (colorimetric or enzymatic) when the standardized calibration used standards of level(s) close to the concentrations to be measured. Only the compensated Jaffe technique and the amido-hydrolase assay showed bias of less than 10%. Conclusions: Standardizing calibration procedures is unlikely to decrease the analytical variability of creatinine assays enough to allow uniform and reliable use of the equations for estimation of glomerular filtration rate.
Mean and variance quality control for multiple correlated levels of replicated control samples
Authors: Livesey John H.
Published: October 2005

Mean and variance rules for quality control are more powerful than rules based on individual values. An algorithm for applying such rules is described that controls type I errors (false alarms), while allowing for multiple levels of quality control samples, correlation between levels, small numbers of preliminary values, replication of samples and autocorrelation arising from random effects. Based on ANOVA and empirical approximations for small samples, the algorithm maintains a low per-batch probability of type I errors. Three statistics are computed,
Clinical evaluation of serodiagnosis of active tuberculosis by multiple-antigen ELISA using lipids from Mycobacterium bovis BCG Tokyo 172
Authors: Fujita Yukiko , Ogata Hideo , Yano Ikuya
Published: October 2005

The humoral immune responses of 69 active tuberculosis (TB) patients against three major mycobacterial lipid antigens, monoacyl phosphatidylinositol dimannoside (Ac-PIM
Mixed Blessings Reactions of Two Japanese NRMs to Postwar Media Portrayals
Authors: Dorman Benjamin
Published: October 2005

This article concerns print media reporting in Japan surrounding the first NRMs—Jiu and Tenshô Kôtai Jingû Kyô—to be covered in the postwar period. First, I discuss the media from a historical perspective, arguing that images of NRMs formed pre-1945 were applied to these groups during the postwar period of religious freedom. Second, I examine their reactions to the media attention, and explore reasons why Jiu's growth was hampered substantially after its leaders were arrested in a highly publicized incident, while Tenshô Kôtai Jingû Kyô grew to become a prominent NRM despite facing strong press criticism. While Jiu attempted unsuccessfully to utilize its celebrity members to gain credence with the media and the public and displayed a lack of awareness of the social arrangements, Tenshô Kôtai Jingû Kyô used press criticism to its advantage and averted the commonly held perception about NRMs that it was involved in criminal activity.
Good Works and the Question of Self-Presentation in Tenrikyo
Authors: Morishita Saburo
Published: October 2005

As one of the older "new" religious movements in Japan, Tenrikyo has often struggled with its self-presentation to the public. This was especially so in its quest for legal recognition at certain times in its long history, but also in response to broader public suspicions. However, work by Tenrikyo members to benefit society should not be seen as public relations efforts to create a positive image for institutional growth and acceptance. A case in point is social welfare work undertaken quite early in the movement's history. Drawing on in-progress research and interviews focusing on Tenrikyo members' work with people suffering from Hansen's Disease (leprosy) in Japan, this essay makes the case that good works are not carried out to create a positive public image, but rather are pursued for the betterment of society and personal spiritual development.
Professional Practitioners and Contact Persons Explicating Special Types of Falun Gong Practitioners
Authors: Porter Noah
Published: October 2005

This study, based on ethnographic fieldwork in the United States with Falun Gong practitioners, explores the role of "contact persons" and "professional practitioners." The role of contact persons has been misinterpreted by some scholars as being more authoritative than my fieldwork suggests; in instances in which contact persons overstep their authority, other practitioners speak up to contradict them. Professional practitioners are the only practitioners who are relatively isolated from society by living in temples. By showing the non-hierarchical nature of these social roles, I demonstrate how Falun Gong is able to organize regular events despite being a decentralized network of peers. This case study provides a model for understanding the kind of globally dispersed, technologically aware religious movements that are likely to become more common in the future.
Perspective Chronologies, Commonalities and Alternative Status in Japanese New Religious Movements Defining NRMs outside the Western Cul-de-sac
Authors: Reader Ian
Published: October 2005

Through the example of the Japanese new religious movements (NRMs), this essay argues that studies of NRMs must move beyond their current Western-oriented framework if they are to have any validity in a global context. It argues that neither the perspective of Eileen Barker, in focusing on chronological newness, nor of J. Gordon Melton, in centering on outsider status, alone suffices to provide a framing definition of NRMs in Japan. One needs to combine the concept of newness (which should not be limited to mere first-generation notions) with the idea of being alternative. There is much value in extending a definition of NRMs to movements several generations old, for this enables the development of more nuanced understandings of NRM processes. The Japanese example indicates that one can identify a number of shared characteristics that enable discussion of a coherent category of movements known as NRMs. Such shared characteristics are more important than any links NRMs might have to older traditions with which they identify. NRMs are associated not only with newness, but also can be seen as possessing enduring themes shared by movements a century or more old and those of very recent origin.
Field Notes Breakthrough Conference on Law and Religion in China
Authors: Richardson James T.
Published: October 2005

Through the example of the Japanese new religious movements (NRMs), this essay argues that studies of NRMs must move beyond their current Western-oriented framework if they are to have any validity in a global context. It argues that neither the perspective of Eileen Barker, in focusing on chronological newness, nor of J. Gordon Melton, in centering on outsider status, alone suffices to provide a framing definition of NRMs in Japan. One needs to combine the concept of newness (which should not be limited to mere first-generation notions) with the idea of being alternative. There is much value in extending a definition of NRMs to movements several generations old, for this enables the development of more nuanced understandings of NRM processes. The Japanese example indicates that one can identify a number of shared characteristics that enable discussion of a coherent category of movements known as NRMs. Such shared characteristics are more important than any links NRMs might have to older traditions with which they identify. NRMs are associated not only with newness, but also can be seen as possessing enduring themes shared by movements a century or more old and those of very recent origin.