bluuebunny/crossref_metadata_2025 huggingface dataset:
Testicular Sertoli Cell Tumours and Relative Sub-Types
Authors: Giglio Matteo , Medica Mauro , de Rose Aldo Franco , Germinale Francesco , Ravetti Jean Louis , Carmignani Giorgio
Published: April 2003

Introduction: Sertoli cell tumours have a rare (0.4–1.5% of all testicular neoplasms) and heterogeneous pathology. The aim of this paper is to analyse the histological classification of Sertoli cell tumours, in order to assess if the three different histotypes – classic type, large cell calcifying Sertoli cell tumour (LCCSCT) and sclerosing Sertoli cell tumour (SSCT) – really present distinctive clinical and prognostic features. Materials and Methods: The current literature was reviewed; Sertoli cell tumour clinical series and single case reports were searched and analysed. Hence, more than 200 classic Sertoli cell tumours, 48 LCCSCTs and only 12 SSCTs were found. The thirteenth SSCT has been found by us in a 34-year-old man. Results: Every single sub-type presents clinical specific characteristics regarding age of onset, bilaterality, focality, abnormal hormone production, correlated systemic symptoms. Ultrasonographic findings, size and – above all – malignant potential. Conclusions: The precise classification of these tumours is not important only histologically: the currently recognised variants really differ in clinical presentation and course. Moreover, LCCSCTs can be further divided in two subgroups with very different clinical behaviour, those in older patients and those associated with well-known syndromes. These clinical and prognostic variables are of great importance when deciding on the therapeutical approach.
Objective Measurement of the Alertness Level in Dementia
Authors: Edman Åke , Brunovsky Martin , Sjögren Magnus , Wallin Anders , Matousek Milos
Published: April 2003

The alertness level of 143 patients with dementia was investigated. The patients were examined clinically and electroencephalographically, and the results were compared with 21 healthy volunteers. Regional brain syndromes were determined clinically. For the assessment of the EEG, a method was employed that distinguishes alertness-related slow wave activity from abnormal slow activity. The shifts of the EEG power were monitored during the 5-min examination. The short-term variations were considered to be caused by changes in alertness, whereas the basal level was supposed to reflect the EEG abnormality. It was found that a decrease in alertness occurred more often in the demented patients than in the controls. The intensity of this decrease was proportional to the degree of the dementia. The alertness disturbance was found to be particularly associated with the parietal brain syndrome.
An Observational Clinical Study of the Efficacy and Tolerability of Donepezil in the Treatment of Alzheimer’s Disease
Authors: Hager Klaus , Calabrese Pasquale , Frölich Lutz , Göbel Claus , Berger Frank M.
Published: April 2003

An open-label, observational Post-Marketing Surveillance (PMS) study was undertaken in Germany to examine the efficacy and tolerability of donepezil in routine clinical practice. Alzheimer’s disease (AD) patients were treated with donepezil (5 or 10 mg once daily) and observed for a period of approximately 3 months. Study assessments included the Mini-Mental State Examination (MMSE), the Nurses’ Observation Scale for Geriatric Patients (NOSGER), and adverse events (AEs). A total of 2,092 patients (mean age 73.0 years; mean ± SD MMSE score 17.8 ± 5.8) were included in the efficacy assessments. MMSE and NOSGER scores showed statistically significant improvements in the total patient population and in the subpopulations with severe AD or AD with concomitant Parkinsonian symptoms (ADPS cohort). AEs were reported in a total of 12% of patients and were mostly due to peripheral cholinergic effects. In this observational PMS study, donepezil was shown to be an effective and well-tolerated therapy in the overall patient population, in patients with severe AD, and in the ADPS cohort.
Drug Consumption Rooms in Rotterdam: An Explorative Description
Authors: van der Poel Agnes , Barendregt Cas , van de Mheen Dike
Published: April 2003

The Rotterdam Drug Monitoring System used survey data, fieldnotes and interviews with staff to investigate the functioning of four (out of six) consumption rooms in Rotterdam. The results show that for most drug users, access to the drug consumption room results in less frequent drug use in public places and more time and rest. Pass holders value being able to use drugs safely inside, and make use of the additional services provided, such as refreshments, washing/showering facilities and talking with others about their personal problems. Two ‘weak points’ reported by the drug users are discussed in relation to their personal health situation and public nuisance reduction.
Transient Anton’s Syndrome: A Presenting Feature of Acute Epidural Hematoma at the Confluens sinuum
Authors: Yilmazlar Selcuk , Taskapilioglu Ozgur , Aksoy Kaya
Published: April 2003

Although unilateral epidural hematomas are well known, bilateral presentation, especially at the confluens sinuum, is uncommon, and its diagnosis may be delayed, thus causing morbidity. We report a case of acute posttraumatic cortical blindness due to epidural hematoma at the confluens sinuum caused by venous sinus tearing. The epidural hematoma was evacuated and the dural tear was repaired. The patient remained alert throughout the hospitalization. Examination of the visual field revealed recovery postoperatively, and the patient was discharged. We discuss the pathological mechanisms of transient blindness. The importance of anopsia as an early sign of epidural hematoma is emphasized.
Transient Cerebellar Eye Closure and Mutism after Cerebellar Tumor Surgery: Long-Term Clinical Follow-Up of Neurologic and Behavioral Disturbances in a 14-Year-Old Girl
Authors: Catsman-Berrevoets Coriene E. , van Dongen Hugo R. , Aarsen Femke K. , Paquier Philippe F.
Published: April 2003

Transient cerebellar eye closure (TCES) is a complication of cerebellar tumor surgery in children and is almost exclusively observed in the context of the syndrome of mutism and subsequent dysarthria. As knowledge about the course of transient cerebellar eye closure is absent, we describe in detail the clinical picture in a 14-year-old girl. The process of improvement of TCES is characterized by four distinct phases, can last more than 1 month and may be associated with severe persistent cerebellar dysfunction.
Late Gestational Intrauterine Myelomeningocele Repair Does Not Improve Lower Extremity Function
Authors: Tubbs R. Shane , Chambers M. Renee , Smyth Matthew D. , Bartolucci Alfred A. , Bruner Joseph P. , Tulipan Noel , Oakes W. Jerry
Published: April 2003

Objective: To determine whether intrauterine myelomeningocele repair performed at between 20 and 28 weeks gestation improves lower extremity function (LEF). Methods: Thirty-seven consecutive patients who had undergone intrauterine repair of their myelomeningocele at Vanderbilt University Medical Center had their lower extremity function and radiographic level (first defective vertebral level) compared to these same parameters in 40 controls who had undergone traditional postgestational repair of their myelomeningocele at the Children’s Hospital in Birmingham, Ala., USA. Results: Of all 77 patients (controls and study group), 13 had a LEF that matched their radiographic level, 27 had a LEF that was rostral to their radiographic level, and 37 had a LEF that was caudal to their radiographic level. Further stratification revealed that for the intrauterine repaired myelomeningoceles, 11% had no difference between LEF and radiographic level, 43% had a LEF that was rostral to their radiographic level, and 46% had a LEF that was caudal to their radiographic level. For those closed in a traditional manner, LEF matched their radiographic level, was rostral to their radiographic level, and was caudal to their radiographic level in 22.5%, 27.5%, and 50% respectively. However, the overall mean differences between institutions produced a p-value of 0.2026 (paired t-test). Conclusions: Although the current timing of intrauterine myelomeningocele repair has been found to lessen the degree of herniation of the rhombencephalon and reduce the incidence of shunt-dependent hydrocephalus, it does not statistically improve LEF. Parents should be advised of these findings prior to surgical intervention so as to focus their expectations.
Infarct Volume on Apparent Diffusion Coefficient Maps Correlates with Length of Stay and Outcome after Middle Cerebral Artery Stroke
Authors: Engelter Stefan T. , Provenzale James M. , Petrella Jeffrey R. , DeLong David M. , Alberts Mark J.
Published: April 2003

Background: Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. Purpose: To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. Study Population: Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. Methods: Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≧95. Results: Infarct volume on ADC maps ranged from 0.2 to 187 cm3 and was significantly correlated with length of hospitalization (p < 0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p < 0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p < 0.05), but none for Canadian Neurological Scale score, age and gender (p >0.05 each). Conclusion: Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.
Towards the Genetic Analysis of Mulfactorial Diseases: The Estimation of Allele Frequency and Epistasis
Authors: Stewart John
Published: April 2003

Objectives: The general aim of this paper is to reactivate the original intention behind the Elston-Stewart algorithm: i.e. physiological characterisation of the effects of individual loci underlying quantitative variation. The specific aim is the estimation of allele frequency and epistasis in multifactorial genetic diseases. Methods: In a general genetic model, the probability of disease is a sigmoid function of the number of disease alleles summed over all loci. This model has just 4 parameters: the number of loci; the population frequency of disease alleles; a threshold expressed as a proportion of disease alleles; and the slope of the sigmoid curve. Assuming 10 loci, the remaining parameters can be estimated from empirical data: population frequency of the disease, monozygotic twin concordance rates, and disease frequency in sibs of affected probands. Results: For 10 typical multifactorial diseases, the estimates of allele frequency are generally high, of the order of 20%, with strong epistatic interactions between loci. It follows that the frequencies of subphenotypes specific for a single disease locus will also be high, and only about two-fold greater in affected individuals than in normal controls. Conclusions: Because of allelic heterogeneity, purely genomic approaches are unlikely to succeed in unravelling the genetics of multifactorial diseases; this will rather require articulation with physiology and the identification of biologically meaningful subphenotypes.
Management of Hepatobiliary Cystadenocarcinoma
Authors: Shrikhande Shailesh , Kleeff Jörg , Adyanthaya Kishor , Zimmermann Arthur , Shrikhande Vinayak
Published: April 2003

Primary biliary cystadenocarcinomas are rare malignant neoplasms of the liver. We report a case that was operated with a preoperative diagnosis of hydatid cyst of the liver. The patient underwent a wide surgical excision of the cyst. Histopathological examination revealed a hepatobiliary cystadenocarcinoma. The patient remains asymptomatic at 2 years following surgery. The importance of differentiating these rare tumors from hepatic hydatid cysts, especially in areas where the disease is endemic, is highlighted in this case report.
Pancreatic Arteriovenous Malformation
Authors: Rezende Marcelo B. , Bramhall Simon , Hayes Tim , Olliff Simon , Buckels J.A.C. , Candinas D. , Mirza D.F.
Published: April 2003

We report a case of a 57-year-old male with a pancreatic arteriovenous malformation (AVM). The diagnosis was made by CT scan and angiography. In the reported case, bleeding from AVM into the biliary tract caused haemobilia and bleeding into the pancreatic head caused abdominal pain. Pancreatic AVM has been only rarely reported as a cause of haemobilia.
Magnetic Resonance Cholangiopancreaticography as a Diagnostic Tool for Common Bile Duct Stones
Authors: Kats J. , Kraai M. , Dijkstra A.J. , Koster K. , ter Borg F. , Hazenberg H.J.A. , Eeftinck Schattenkerk M. , Ziedses des Plantes B.G. , Eddes E.H.
Published: April 2003

Background/Aims: The diagnostic potential of magnetic resonance cholangiopancreaticography (MRCP) has improved as a result of evolving technique. MRCP has the advantage of negligible morbidity and mortality in contrast to endoscopic retrograde cholangiopancreatography (ERCP). This study was performed to evaluate MRCP as a replacement for diagnostic ERCP for the suspicion of common bile duct (CBD) stones. Methods: From 1998 to 2001, MRCP was performed in 202 patients with a suspicion of CBD stones based on medical history (MH), cholestatic liver function tests (CL), both MH and CL or other reasons. ERCP was performed in all patients where MRCP indicated the presence of CBD stones and in those patients with a persistent strong clinical suspicion for CBD stones despite a negative MRCP. Results: In 25 patients, MRCP suggested CBD stones which were proven with ERCP in 24 patients. Despite a negative MRCP, 27 patients had a subsequent ERCP. None of these patients appeared to have CBD stones. In this group, MRCP resulted in 100% sensitivity and 96% specificity in detecting CBD stones. Follow-up of all patients revealed 5 more patients with persistent clinical suspicion or cholestatic liver function values. Assuming CBD stones in these patients, MRCP had a sensitivity of 83 % and a specificity of 99% for this diagnosis. Conclusion: In the case of CBD stone suspicion, MRCP should be the diagnostic procedure of choice.
Isolated Gastric Varices: Prevalence, Clinical Relevance and Natural History
Authors: Sarin S.K. , Jain A.K. , Lamba G.S. , Gupta R. , Chowdhary A.
Published: April 2003

Background: Isolated ectopic gastric varices (IGV2) are present either in the body or antrum of the stomach or upper duodenum. The prevalence, natural history and clinical significance of these varices has not been adequately described. Materials and Methods: Consecutive patients with portal hypertension, prospectively studied and diagnosed to have IGV2, were assessed for their time of appearance – primary (at first presentation) or secondary (after obliteration of oesophageal varices), association with other varices, portal hypertensive gastropathy and any overt bleeding. Results: Fifty-three of the 1,128 (4.7%) patients had IGV2. The IGV2 were commonly seen in the antrum (53%), duodenum (32%), or at both sites (11%) and rarely in body and fundus (4%). IGV2 were predominantly (84.9%) secondary in origin, developing after oesophageal variceal obliteration. The median time for emergence of secondary IGV2 was 8.2 months for patients with cirrhosis, 12.8 months for non-cirrhotic portal fibrosis and 10.8 months for extra-hepatic portal vein obstruction. Eight (15%) patients had primary IGV2, 6 of them had underlying portal vein obstruction. Portal gastropathy (p < 0.05) and UGI bleeding were more common in the secondary than in primary IGV2. Bleeding due to IGV2 was seen only in 3 (5.7%) patients during a mean follow-up of 36.3 ± 12.1 months, and could be successfully managed with endoscopic ligation or obliteration. Conclusions: Isolated ectopic gastric varices are not uncommon and generally develop following obliteration of main variceal columns. They rarely bleed and often can be managed with endoscopic interventions.
Video-Assisted Gasless Transanal Endoscopic Microsurgery: A Review of 217 Cases of Rectal Tumors over the Past 10 Years
Authors: Araki Y. , Isomoto H. , Shirouzu K.
Published: April 2003

Background: Transanal endoscopic microsurgery (TEM) has been suggested as a minimally invasive procedure of low morbidity for rectal tumor excision. However, the complicated setup of TEM instruments and the expensive cost are disadvantages to wider acceptance. The aims of this study are to introduce a new modality of modified video-assisted gasless TEM (V-TEM) using a video system and no CO2 insufflation of the rectum, and discuss our experience during past 10 years. Methods: 217 patients, with a mean follow-up of 61 months, underwent V-TEM for adenoma (n = 102), Tis (n = 83), T1 (n = 28) and T2 (n = 4) rectal tumors, located 3–20 cm from the dentate line. Results: The mean size of the tumor was 39 mm, and the mean duration of the operation was 63 min including setup time, and the mean duration of hospital stay was 5.8 days. Seven (3.2%) patients underwent conversion to radical surgery owing to T1 with massive invasion or T2 tumors histopathologically. Two (0.9%) patients had recurrent disease which was managed by repeat V-TEM. The postoperative course in all patients was free from any significant complications. Transient fecal soiling was present in 12 (5.5%) patients. The cost of V-TEM was decreased compared to that of conventional TEM (USD 40,000). Conclusion: V-TEM was a cheap, safe, simple and minimally invasive procedure for benign and early cancer in the proximal rectum.
Acute Fungal Pustulosis on a Bedridden Patient’s Back
Authors: Verneuil L. , Datry A. , Le Flour N. , Dompmartin A. , Derenne J.P. , Chosidow O.
Published: April 2003

We report a particular dermatophytosis due to Trichophyton rubrum. A 61-year-old woman presented an eruption which quickly evolved within 48 h, consisting of papular annular patches surrounded by creamy white pustules, which sometimes coalesced. The eruption was exclusively located on the back. The rest of the body and skin examination was normal, and the patient had no temperature. The mycological sample revealed mycelial filaments in the direct microscopic examination and T. rubrum in the mycological culture. Only a few cases of pustular lesions due to T. rubrum are reported in the literature. The extensive character, the site and the inflammatory aspect of the lesions were very surprising. This clinical presentation is more frequent with geophilic and zoophilic organisms than with anthropophilic dermatophytes such as T. rubrum.
Porphyria cutanea tarda, C282Y, H63D and S65C HFE Gene Mutations and Hepatitis C Infection: A Study from Southern France
Authors: Chiavérini Christine , Halimi Gilles , Ouzan Denis , Halfon Philippe , Ortonne Jean-Paul , Lacour Jean-Philippe
Published: April 2003

Background: To evaluate the role of genetic factors in the pathogenesis of porphyria cutanea tarda (PCT) and their association with chronic hepatitis C. Objective: To investigate the relations between hemochromatosis gene (HFE) mutations and PCT in the south of France and their links with chronic hepatitis C virus (HCV) infection. Methods: The genotype for the C282Y, H63D and S65C mutations of HFE was determined in 33 patients with PCT, 46 patients with HCV infection but without PCT and 58 controls. Iron status and HCV, HBV and HIV serologies were studied in all patients. Results: A statistically significant increase in the C282Y mutation was found in PCT patients. No difference was found for H63D or S65C mutations. The prevalence of HCV infection was higher in PCT patients than controls. Conclusions: C282Y mutations and HCV infection but not H63D or S65C mutations are PCT-triggering or associated factors in the south of France.
Incidental Control of Rosacea by Somatostatin
Authors: Piérard-Franchimont Claudine , Quatresooz Pascale , Piérard Gérald E.
Published: April 2003

Background: The precise pathomechanism of rosacea remains elusive. The disease commonly requires long-term treatments using topical or oral therapies. Objective: This report presents incidental findings about the possible modulatory role of somatostatin in the outcome of rosacea. Method: Four patients presenting long-standing recalcitrant facial rosacea were treated with octreotide for diabetic retinopathy. Results: Rosacea improved rapidly and even cleared without any recurrence in 3 of the patients. Conclusion: The beneficial effect might be attributed to inhibitory actions on the sebaceous gland, the neovascularization and/or on the inflammatory process.
Dehydroascorbic Acid in Urine as a Possible Indicator of Surgical Stress
Authors: Kubin Andreas , Kaudela Karl , Jindra Rudolf , Alth Gerhart , Grünberger Werner , Wierrani Franz , Ebermann Robert
Published: April 2003

Background/Aim:L-Ascorbic acid (AA) is the predominant circulating form of vitamin C found in human blood. It has been hypothesized that surgical stress increases the vitamin C metabolite dehydroascorbic acid (DHAA). Vitamin C is mainly excreted through the kidneys. In this study, the ratio of AA to DHAA excreted in urine was determined in patients who had undergone total hip joint endoprosthesis surgery (n = 12), and the results were compared with data obtained from healthy controls (n = 12). Methods: All subjects received 1,000 mg sodium ascorbate intravenously three times a day (every 8 h) for 8 days, starting 2 days prior to surgery. Total urine was collected daily while subsequent determinations of AA and DHAA were performed photometrically. Results: Administration of vitamin C led to average daily excretions of the combined products AA + DHAA of 2,343 ± 438 mg/day (mean value ± confidence intervals). The initial average ratio DHAA/AA of all 24 probands was 0.064 (6% DHAA; 153 ± 76 mg/day). One day after surgery, an increase in the DHAA/AA ratio to 0.165 (15% DHAA; 332 ± 107 mg/day) was measured in the patients. The ratio decreased 2 days after surgery and returned to normal within 5 days. Conclusion: Our data indicate that surgery increases the oxidation of AA and urinary excretion of DHAA, as a result of the enhanced formation of free radicals.
Metabolism of Long-Chain Polyunsaturated Fatty Acids in Rat Kidney Cells
Authors: Liabø Janne , Odden Nancy , Christiansen Erling N. , Hagve Tor-Arne
Published: April 2003

The metabolism of long-chain polyunsaturated fatty acids is characterized in tissues, such as liver and heart, especially from studies based on isolated cells incubated with radiolabelled fatty acid substrates. Differently, only little is known about the metabolism of fatty acids in the kidney. It is controversial whether the kidney possesses the ability to desaturate long-chain fatty acids or whether kidney cells are dependent on performed polyunsaturated fatty acids transported from the liver. In this study we used isolated rat kidney cells obtained by a perfusion technique. The cells were incubated with [1-14C]-labelled 18:3(n-3) or 20:3(n-6) fatty acids which were incorporated into complex lipids or desaturated/elongated. The lipids were separated by thin-layer chromatography and high-performance liquid chromatography. The present study shows that isolated kidney cells take up and esterify labelled long-chain polyunsaturated fatty acids in a time- and concentration-dependent manner. We have also demonstrated that isolated rat kidney cells only to a minor extent Δ6-desaturate labelled 18:3(n-3) to 18:4 (n-3). Conversely, the Δ 5-desaturation of 20:3(n-6) to 20:4(n-6) is far more active. It may thus be concluded that the kidney, at least in part, must obtain its C20 and C22 fatty acids from the circulation, while the active Δ5-desaturase suggests that preformed C20 fatty acids can be converted to more unsaturated homologues in the kidney.
Association of Histologic Chorioamnionitis, Increased Levels of Cord Blood Cytokines, and Intracerebral Hemorrhage in Preterm Neonates
Authors: Tauscher M.K. , Berg D. , Brockmann M. , Seidenspinner S. , Speer C.P. , Groneck P.
Published: April 2003

The objective of this study was to investigate in a prospectie study whether histological chorioamnionitis (ChA) is a risk factor predisposing for intracerebral hemorrhage (ICH), and whether ICH is associated with a systemic fetal inflammation in preterm neonates with a gestational age <32 weeks. 106 neonates were studied; 20 (18.9%) suffered from ICH. ChA occurred significantly more often in neonates with ICH compared to neonates without ICH (70.0 vs. 36.0%, p = 0.006). Neonates with ICH had significantly higher median levels of proinflammatory cytokines (IL-1β, IL-6 and IL-8) compared to neonates without ICH (p < 0.001 for all comparisons). We conclude that the development of ICH in preterm infants is associated with both ChA and high levels of proinflammatory cytokines at birth.
Mesoscopy and Scanning Electron Microscopy of the Trabecular Projections in the Superior Sagittal Sinus
Authors: Petroni S. , Tâmega O.J. , Tirapelli L.F. , Soares J.C.
Published: April 2003

The trabecular projections of the human superior sagittal sinus were classified into types and subtypes according to spatial arrangement and shape. The horizontal and vertical projections direct laminar blood flow, while the conic type, which is avalvular, protects the openings of the superior cerebral veins in the superior sagittal sinus.
Embryonic Development of the Pituitary Gland in the Chick
Authors: Sasaki Fumihiko , Doshita Ayumi , Matsumoto Yoshiki , Kuwahara Sachi , Tsukamoto Yasuhiro , Ogawa Kazushige
Published: April 2003

Pituitary glands of chicken, from stages 20 (70 ∼ 72 h of incubation) to 46 (20 days) of Hamburger and Hamilton (1951), were studied by immunocytochemical and histological stainings and India ink injection into blood vessels. Using the distribution pattern of 6 types of immunoreactive adenohypophyseal cells and the location of pituitary stalk as guideposts, we found how specific areas in the epithelium of Rathke’s pouch differentiate into specific regions of the adenohypophysis at 20 days. In the sagittal plane, the walls of Rathke’s pouch were tentatively divided into the upper part (A1 + A2) and lower part (A3) of the anterior wall, and the posterior wall (P1 + P2 + P3). The cephalic lobe was mainly assembled by the proliferation of parenchymal cells in the areas A2 + A3 + P2 of Rathke’s pouch epithelia at 3 days of incubation. The caudal lobe was derived from A1 + P1 + P3. The pars tuberalis was derived from A1 + A2. Thus, the avian adenohypophysis is established at 13 days, though the blood supply to the pars distalis is established at 20 days. Therefore, the cephalic lobe and caudal lobe of the pars distalis and the pars tuberalis of the chicken adenohypophysis are derived from specific areas of the cell cords of Rathke’s pouch at 3 days of incubation.
Morphological Characteristics of the Interpubic Joint (Symphysis pubica) of Rats, Guinea Pigs and Mice in Different Physiological Situations
Authors: Ortega Hugo H. , Muñoz-de-Toro Mónica M. , Luque Enrique H. , Montes Gregorio S.
Published: April 2003

The pubic joint of male and female rats, guinea pigs and mice was studied using the Picrosirius polarization method which selectively discloses the fibers of the collagenous system. Besides that, considerations were made regarding joint classification. In adult rats (both males and females, including intrapartum specimens), our results confirm those of earlier studies showing that the interpubic joint contains a central core of hyaline cartilage surrounded by fibrocartilaginous areas. Thus, in rats, the pubic joint should more properly be classified as a true synchondrosis. In virgin female guinea pigs and mice, the interpubic joint is formed of fibrocartilage (a true symphysis); whereas at term the bones are joined by a connective ligament, constituting a syndesmosis. Male mice have a similar (fibrocartilaginous) joint structure to virgin female mice, whereas male guinea pigs (like rats) have a hyaline cartilage joint. The foregoing observations indicate that the classification of the pubic joint depends upon the species, age, sex, and physiological reproductive stage studied. Species that are very similar in most other aspects (such as rats and mice) displayed different morphological features of the pubic joint to support the same reproductive processes. Together, the data reported here suggest that interspecies differences are likely to be found in other parameters and should be considered when choosing an appropriate animal model for research or teaching purposes.
Thiazolidinedione Inhibition of Peritoneal Inflammation
Authors: Hornung Daniela , Chao Victor A. , Vigne Jean-Louis , Wallwiener Diethelm , Taylor Robert N.
Published: April 2003

Chemoattraction of macrophages into the peritoneal cavity is one of the important characteristics in patients with endometriosis. An inflammatory response is postulated to be responsible for infertility and pelvic pain associated with this syndrome. The present in vivo studies were designed to test if thiazolidinediones (TZDs), activators of peroxisome proliferator activated receptor gamma, could inhibit monocyte chemotaxis in a murine model. TZDs were first used as orally bioavailable insulin-sensitizing agents. They are currently under investigation in the treatment of inflammatory diseases, including arthritis or colitis. Intraperitoneal injection of thioglycollate was used to elicit high numbers of activated peritoneal macrophages in female mice. Concomitant peritoneal injection of ciglitazone, a member of the TZD family, significantly reduced the number of macrophages. When cultured and stimulated by tumor necrosis factor alpha, these peritoneal macrophages also secreted less RANTES and less IL-1β protein. This animal model suggests that treatment of endometriosis patients with TZDs may diminish symptoms associated with intraperitoneal inflammation.
Ultrasound Determination of Chorionicity and Perinatal Outcome in Twin Pregnancies Using Dividing Membrane Thickness
Authors: Bracero Luis A. , Byrne Daniel W.
Published: April 2003

Objective: To assess the value of ultrasound measurement of twin dividing membrane thickness in predicting chorionicity and perinatal outcome. To compare magnified with unmagnified images, and measurements taken with dividing membranes parallel and perpendicular to the ultrasound beam. Methods: This was a prospective, observational cohort study of twin-pregnancy ultrasound examinations during the second and third trimesters with chorionicity confirmed by a pathologist. Ultrasound measurements of the dividing membrane thickness were recorded in 44 twin pregnancies using unmagnified and magnified images. Measurements were taken at various membrane sites either horizontal or vertical to the ultrasound beam, depending on the orientation of the dividing membrane. We compared the mean membrane thickness between monochorionic and dichorionic pregnancies as well as between pregnancies with good and adverse perinatal outcome. Results: Membranes were significantly thicker in dichorionic pregnancies when compared with the monochorionic pregnancies (2.35 vs. 1.69 mm, p = 0.021). A cut-off point of ≧2.0 mm provided a sensitivity of 75.7%, a specificity of 85.7%, a positive predictive value of 96.6%, and a negative predictive value of 40.0%, for determining dichorionicity. Two of 7 monochorionic and 24 of 37 dichorionic pregnancies (59.1%) had good perinatal outcome. These pregnancies had significantly thicker membranes (2.44 vs. 1.96 mm, p = 0.022). Even among the dichorionic pregnancies, a membrane thicker than 2.2 mm was associated with a significantly higher proportion with good perinatal outcome (80.0 vs. 47.1%, relative risk 1.7, p = 0.036). Magnified images obtained with the ultrasound beam parallel to the membrane identified adverse outcome more accurately than unmagnified and perpendicular images. A cut-off point of >2.2 mm for membrane thickness was found to be the best predictor of good outcome. Conclusions: Membrane thickness can be used to identify chorionicity and adverse perinatal outcome, particularly if the ultrasound images are magnified and parallel to the ultrasound beam.
Deep Brain Stimulation for Parkinson’s Disease
Authors: Vitek Jerrold L.
Published: April 2003

Deep brain stimulation (DBS) in the subthalamic nucleus (STN) and the internal segment of the globus pallidus (GPi) is increasingly being used for the treatment of advanced Parkinson’s disease (PD). Although both targets have demonstrated clinical efficacy in the treatment of the cardinal motor signs of PD, the STN has gained greater popularity and is now considered the site of choice by most centers performing these procedures. This preference stems predominately from the belief that STN DBS provides greater improvement in reducing the motor manifestations of PD and allows a reduction in dopaminergic medication not permitted with GPi DBS. There are, however, a number of issues that must be considered before abandoning GPi in favor of STN as the surgical target of choice for DBS. The maximal benefit reported for GPi stimulation is not significantly different than that reported for the STN, 67 versus 71%, and while reductions in medication are required with STN stimulation to avoid inducing dyskinesia, GPi stimulation may directly suppress dyskinesia obviating any need to reduce medication. As such, many centers may not attempt to reduce antiparkinsonian medication with GPi DBS. In addition, there are significantly more reports of changes in mood, behavior and a higher incidence of adverse events reported for STN stimulation. Most studies of DBS are nonrandomized, assessment protocols are not standardized, and lead locations are not reported. Thus, before drawing conclusions regarding the optimal site for DBS for advanced PD we must take a critical eye to the present data and address the outstanding questions that remain with well-designed clinical trials that evaluate motor, nonmotor and adverse events and address the above clinical variables by randomizing patients, using standardized methods of assessment and defining the lead location.
Unoprostone Isopropyl Pretreatment Decreases Endothelin-1 Release and the Intra-Ocular Pressure Spike Induced by Laser Trabeculoplasty in the Rabbit
Authors: Holló Gábor , Visontai Zsuzsanna , Lakatos Péter , Vargha Péter
Published: April 2003

Purpose: We have previously shown that the intra-ocular pressure (IOP) spike due to argon laser trabeculoplasty (ALT) is caused by an acute endothelin-1 (ET-1) release from the uveal tissue into the aqueous humour of rabbit eyes. In this study we investigated whether pretreatment with topical unoprostone isopropyl, a functional antagonist of ET-1, protects against the pressure spike due to ALT in the rabbit model. Methods: IOP of both eyes of 17 pigmented rabbits was measured with a TonoPen XL tonometer under general anaesthesia (baseline measurement). Then the right eyes were treated with topical unoprostone isopropyl 0.12% BID for 6 days, and the left eyes similarly received balanced salt solution (BSS) twice daily. After the last morning instillation, IOP for both eyes was measured under general anaesthesia after 2 h in group 1 and after 3 h in group 2 animals. Then, for both groups, ALT was performed on both eyes. Thirty minutes after laser treatment (and still under general anaesthesia), IOP was measured again. Then the aqueous humour was aspirated for measurement of ET-1 concentration. Results: Baselineindividual IOP differences (left eye minus right eye) were not significant in both groups: mean ± SD 0.25 ± 1.16 and –0.33 ± 0.71 mm Hg, respectively (paired t test, p > 0.05 for both groups). On day 6, 2 h (group 1) and 3 h (group 2) after the last instillation but before laser trabeculoplasty, the difference (BSS-pretreated left eye minus unoprostone-pretreated right eye) increased to 2.13 ± 2.10 mm Hg (p = 0.024) and 1.33 ± 0.71 mm Hg (p = 0.0005), respectively. Thirty minutes after ALT, the IOP difference was 2.63 ± 2.67 mm Hg in group 1 (p = 0.027), but no difference was seen in group 2 (0.67 ± 1.94 mm Hg, p = 0.332). In group 1, postoperative aqueous humour ET-1 concentration for the unoprostone-pretreated right eye was significantly lower than that for the BSS-pretreated left eye (paired t test, p = 0.01); but in group 2 no inter-ocular difference in ET-1 concentration was found (p = 0.976). Conclusion: Topical unoprostone pretreatment decreases laser-induced ET-1 release and diminishes the IOP spike caused by ALT in vivo within 2 h after instillation, when the concentration of unoprostone in the aqueous humour is high.
Comparison of Deep Sclerectomy with Implant and Combined Glaucoma Surgery
Authors: D’Eliseo Domenico , Pastena Bruno , Longanesi Lora , Grisanti Filippo , Negrini Valeria
Published: April 2003

To evaluate the efficacy of combined glaucoma surgery, 42 glaucomatous patients were randomly divided into two groups: deep sclerectomy with implant (DS) alone was performed in 21 patients, and combined deep sclerectomy and phacoemulsification (PDS) was performed in the other 21 patients. Follow-up was carried out at regular intervals for 12 months. A comparative study on intraocular pressure (IOP) was designed. Although further study is needed, PDS appears to have better postoperative long-term results in IOP control than DS alone.
The Neonate Has a Temporary Conductive Hearing Loss due to Fluid in the Middle Ear
Authors: Priner Ronit , Freeman Sharon , Perez Ronen , Sohmer Haim
Published: April 2003

Postnatal functional changes in the activity of the ear and auditory pathway in neonatal guinea pigs [from day of birth (postnatal day, PND = 0), PNDs 1–4, 7 and then weekly up to 7 weeks] were studied as a model of maturation of hearing in human neonates. On the day of birth there were signs of a conductive hearing loss: negative middle ear pressure, auditory nerve brainstem evoked response (ABR) threshold elevation, ABR wave 1 latency prolongation and low amplitude otoacoustic emissions. The conductive hearing loss is probably a result of the (amniotic) fluid found in the neonatal middle-ear cavity. Over the next PNDs, this conductive hearing loss was resolved. In order to confirm this neonatal conductive hearing loss and its resolution, saline was instilled into the middle ear of guinea pigs. This induced signs of a conductive hearing loss similar to those seen in the neonatal guinea pigs which disappeared with clearance of this fluid. Therefore it may be concluded that most of the changes in auditory function seen over the first PNDs are due to absorption of amniotic fluid from the middle-ear cavity.
Synaptophysin Immunohistochemistry during Vestibular Hair Cell Recovery after Gentamicin Treatment
Authors: Lopez Ivan , Ayala Carlos , Honrubia Vicente
Published: April 2003

In the present study, morphometric and immunohistochemical techniques were used to evaluate the degree of synaptic recovery in the chinchilla crista sensory epithelia during various post-gentamicin-treatment periods of hair cell loss and recovery. For this purpose, two groups of animals were treated with Gelfoam® pellets impregnated with 50 µg of gentamicin implanted in the perilymphatic space within the otic capsule of the superior semicircular canal. Animals were sacrificed 1, 2 and 4 weeks after treatment. The degree of synaptic reinnervation was evaluated in the horizontal crista of the first group of animals using immunohistochemical techniques and antibodies against synaptophysin, a marker for synaptic reinnervation and synaptogenesis. Quantification of immunoreactivity in this group was made in the mid-region of the crista using the NIH ‘Image’ program. The second group of animals was used for quantification of the number of hair cells and supporting cells in the horizontal crista. In the normal sensory epithelium, synaptophysin immunoreactivity was found in the areas corresponding to the known distribution of afferent and efferent nerve terminals. Immunoreactivity was predominantly located within the afferent calyces of type I hair cells. No immunoreactivity was found in the supporting cells. Seven days after treatment there was a significant loss of hair cells and synaptophysin-stained area (SSA). In the mid-region of the crista the loss of synaptophysin immunoreactivity was quantitatively the greatest within the central zone of this region (93%) while the loss of hair cells was the smallest. These results suggest that afferent and efferent nerve terminals were also severely affected by the ototoxic treatment. Four weeks after treatment corresponding to the end of the recovery phase of gentamicin ototoxicity, there was a proportional increase in the number of hair cells and of the degree of SSA in the mid-region of the crista. The number of hair cells recovered to 58% with a recovery of SSA to 54% of normal. These results suggest that a greater fraction of synaptophysin expression within the sensory epithelium depends on the presence of afferent calyceal endings, which are greatly affected by gentamicin. Also, these results demonstrate a significant level of reinnervation of the newly regenerated hair cells, forecasting the potential for functionality of the regenerated hair cells.
Oral Immunization with a Recombinant Major Grass Pollen Allergen Induces Blocking Antibodies in Mice
Authors: de Weerd Nicole , Bhalla Prem L. , Singh Mohan B.
Published: April 2003

Background: Immunotherapy for the treatment of pollen allergies traditionally involves a series of parenteral injections of a crude pollen extract. Successful application of this treatment results in the development of systemic tolerance to the sensitizing allergens, including the induction of blocking antibodies. Objective: We sought to investigate whether oral immunization with a recombinant pollen allergen could induce a systemic immune response, and the production of systemic blocking antibodies in mice. Methods: C57BL/10 mice were orally administered rLol p 5 or sodium chloride solution via gavage. Results: We report that the oral administration of rLol p 5 induced a systemic immune response, including the induction of both blocking and interspecific cross-reactive antibodies. Conclusion: Our results suggest that oral administration of a major grass pollen allergen can induce the development of a systemic immune response including the production of systemic blocking and cross-reactive antibodies, a response that may offer immunological protection upon subsequent allergen exposure.
Characteristics and Immunobiology of Grass Pollen Allergens
Authors: Andersson Kerstin , Lidholm Jonas
Published: April 2003

Grass pollens are one of the most important airborne allergen sources worldwide. About 20 species from five subfamilies are considered to be the most frequent causes of grass pollen allergy, and the allergenic relationships among them closely follow their phylogenetic relationships. The allergic immune response to pollen of several grass species has been studied extensively over more than three decades. Eleven groups of allergens have been identified and described, in most cases from more than one species. The allergens range from 6 to 60 kD in apparent molecular weight and display a variety of physicochemical properties and structures. The most complete set of allergens has so far been isolated and cloned from Phleum pratense (timothy grass) pollen. Based on the prevalence of IgE antibody recognition among grass pollen-sensitized individuals, several allergens qualify as major, but members of two groups, groups 1 and 5, have been shown to dominate the immune response to grass pollen extract. Isoform variation has been detected in members of several of the allergen groups, which in some cases can be linked to observed genetic differences. N-linked glycosylation occurs in members of at least three groups. Carbohydrate- reactive IgE antibodies have been attributed to grass pollen sensitization and found to cross-react with glycan structures from other allergen sources, particularly vegetable foods. Another cause of extensive cross-reactivity are the group 12 allergens (profilins), which belong to a family of proteins highly conserved throughout the plant kingdom and present in all tissues. Members of eight allergen groups have been cloned and expressed as recombinant proteins capable of specific IgE binding. This development now allows diagnostic dissection of the immune response to grass pollen with potential benefits for specific immunotherapy.
Neuroprotection of Creatine Supplementation in Neonatal Rats with Transient Cerebral Hypoxia-Ischemia
Authors: Adcock Kathryn H. , Nedelcu Johann , Loenneker Thomas , Martin Ernst , Wallimann Theo , Wagner Bendicht P.
Published: April 2003

We hypothesized that creatine (Cr) supplementation would preserve energy metabolism and thus ameliorate the energy failure and the extent of brain edema seen after severe but transient cerebral hypoxia-ischemia (HI) in the neonatal rat model. Six-day-old (P6) rats received subcutaneous Cr monohydrate injections for 3 consecutive days (3 g/kg body weight/day), followed by 31P-magnetic resonance spectroscopy (MRS) at P9. In a second group, P4 rats received the same Cr dose as above for 3 days prior to unilateral common carotid artery ligation followed 1 h later by 100 min of hypoxia (8% O2) at P7. Rats were maintained at 37°C rectal temperature until magnetic resonance imaging was performed 24 h after HI. Cr supplementation for 3 days significantly increased the energy potential, i.e. the ratio of phosphocreatine to β-nucleotide triphosphate (PCr/βNTP) and PCr/inorganic phosphate (PCr/Pi) as measured by 31P-MRS. Rats with hemispheric cerebral hypoxic-ischemic insult that had received Cr showed a significant reduction (25%) of the volume of edemic brain tissue compared with controls as calculated from diffusion-weighted images (DWI). Thus, prophylactic Cr supplementation demonstrated a significant neuroprotective effect 24 h after transient cerebral HI. We hypothesize that neuroprotection is probably due to the availability of a larger metabolic substrate pool leading to a reduction of the secondary energy failure because DWI has been reported to correlate with the PCr/Pi ratio in the acute phase of injury. Additional protection by Cr may be related to prevention of calcium overload, prevention of mitochondrial permeability transition pore opening and direct antioxidant effects.