bluuebunny/crossref_metadata_2025 huggingface dataset:
The Extent of Oral Fungal Flora in 353 Students and Possible Relationships with Dental Caries
Authors: Moalic E. , Gestalin A. , Quinio D. , Gest P.E. , Zerilli A. , Le Flohic A.M.
Published: April 2003

An epidemiological study was conducted on 353 students to determine the potential relationships between oral saprophytism with Candida albicans and dental status. For each student included, an interview, a dental examination, a mycological investigation and determination of oral pH were conducted. Various factors liable to affect the presence of oral fungus were investigated unsing the χ2 test. 58.6% of samples were positive when cultured, with C. albicans in 93.7% of cases. The mean DMF index was 7.6. C. albicans was more frequently isolated in men, smokers, when pH was lower than 7, when dental plaque was abundant and when the time since the teeth had last been brushed was more than 8 h. DMF and F indexes were greater when C. albicans was present but not when it was abundant, while decay was more often present in subjects with abundant C. albicans. Although the specific role of the various factors is difficult to establish, the results suggest that further research to elucidate the possible role of C. albicans in caries aetiology would be valuable.
Clinical Evaluation of Chemomechanical Caries Removal in Primary Molars and Its Acceptance by Patients
Authors: Maragakis G.M. , Hahn P. , Hellwig E.
Published: April 2003

The purpose of this study was to evaluate the clinical efficiency and patient acceptance of the chemomechanical caries removal agent Carisolv™ in deciduous teeth. Contralateral primary molars of sixteen 7– to 9–year–old patients (32 teeth) were treated with the air–motor and with Carisolv, respectively. Patients replied to a pre– and a postoperative questionnaire. Complete caries removal (CCR) was accomplished in all air–motor sessions. It was not achieved within the time limit of 15 min in 6 (37.5%) Carisolv sessions. Air–motor CCR time ranged between 6 and 18 s (mean: 11.81 s ). Carisolv CCR time, where accomplished within 15 min, ranged between 6 min 46 s and 13 min 57 s (mean: 6 min 51 s). Preoperatively, the majority of the children reported disliking the drilling, and that they would visit the dentist more often and prefer sitting in the chair longer if they could avoid it. Postoperatively, the majority of the children reported disliking the taste of Carisolv, estimated Carisolv to have taken longer, would not recommend it to their friends, and preferred the air–motor. In conclusion, Carisolv, although a step forward in terms of solution volume required, is not in a position to replace rotary instruments for caries removal: it did not remove decay completely in one third of our sample; it was much slower than the air–motor; it had a chlorine taste/odor our patients disliked.
Effect of a Solution with High Fluoride Concentration on Remineralization of Shallow and Deep Root Surface Caries in vitro
Authors: Mukai Y. , Lagerweij M.D. , ten Cate J.M.
Published: April 2003

A root dentin single–section model was developed to compare the efficacy of different fluoride treatments on the remineralization of lesions. Shallow (∼170 µm) and deep (∼400 µm) lesions were produced in acetic acid buffer solutions (pH 5.0) with 0.1– and 0.5–ppm fluoride for 3 days and 2 weeks, respectively. Next, the sections were pH–cycled for 4 weeks. Following the pH cycling, all sections were first remineralized for 5 weeks, then subjected to 10 days of demineralization. The treatments were (1) no treatment (control), (2) daily 1,450–ppm NaF toothpaste, (3) weekly 4,000–ppm fluoride solution, (4) a combination of treatments 2 and 3. In the shallow lesions, the 4,000–ppm fluoride solution and the combination treatment enhanced mineral deposition at the lesion front, producing a second, slightly hyperremineralized layer. Similarly, in the deep lesions a second remineralized layer was detected. In all lesions, the fluoride solution treatment showed significantly more remineralization compared to the control and the toothpaste treatment (p<0.05), most of which was formed during the pH cycling. In the demineralization period, the control showed significantly higher mineral loss than all other treatments. These results indicate that a 4,000–ppm fluoride solution might be effective for remineralization of root dentin lesions even over 400 µm depth.
Diffusion and Perfusion MRI, Measurements of Acute Stroke Events and Outcome: Present Practice and Future Hope
Authors: Berry Isabelle , Ranjeva Jean-Philippe , Duthil Pierre , Manelfe Claude
Published: April 2003

The morphological, metabolic and functional changes of brain ischaemia can be studied using various MRI methods. These are readily available should the early visualisation of affected territories be needed. Morphological changes include the depiction of oedema on T1- and T2-weighted images, and metabolic changes are reflected on magnetic resonance spectroscopy. Functional changes reflect haemodynamic failure seen on diffusion- and perfusion-weighted imaging. Modelling of behaviour of T2 and diffusion changes could predict the histological outcome of affected tissue regarding cell recovery or necrosis. In addition, the combination of diffusion and perfusion MRI offers a potential prognostic value.
Autonomic Nervous System Function in Patients with Acute Brainstem Stroke
Authors: Meglič Bernard , Kobal Jan , Osredkar Joško , Pogačnik Tomaž
Published: April 2003

Dysfunction of the autonomic nervous system (ANS) often complicates the clinical course in patients with acute stroke. The studies of the function of ANS in patients with brainstem stroke are scarce. The purpose of our study was to evaluate the function of ANS in the early period after acute brainstem stroke and to find out whether the location of stroke in brainstem influences the function of ANS. We studied heart rate variability (HRV) and plasma levels of catecholamines in 14 eligible patients with medullary (6 patients) and non-medullary (8 patients) brainstem stroke during the first 6 weeks after stroke. Integrals over the low- (LFB; 0.04–0.15 Hz) and high-frequency bands (HFB; 0.15–0.40 Hz) of power spectra were calculated. When compared to controls, the integrals over HFB in the hyperacute (p < 0.001) and over LFB in the hyperacute (p < 0.005) and in the acute (p < 0.05) phases were significantly smaller in patients with medullary strokes. Integrals over LFB and HFB in patients with non-medullary strokes did not differ significantly from controls, regardless of the phase of the disease. Plasma levels of epinephrine in patients with non-medullary stroke in the hyperacute and in the acute phases were significantly higher than in controls (p < 0.005). We conclude that there is transient dysfunction of ANS in patients with acute medullary stroke, in contrast to those with non-medullary brainstem stroke.
Prestroke Dementia
Authors: Barba Raquel , Castro María D. , del Mar Morín María , Rodriguez-Romero Rafael , Rodríguez-García Elena , Cantón Rafael , Del Ser Teodoro
Published: April 2003

Objective: To determine the frequency, associated factors and outcome of dementia previous to a stroke. Design: Cross-sectional study of a cohort of 324 consecutive unselected stroke patients (mean age 70.9 years, range 20–98; 255 ischaemic, 46 haemorrhagic and 25 indefinite). Methods: Cognitive and functional status prior to stroke were assessed by means of an interview to a relative, a short version of the Informant Questionnaire on Cognitive Decline in the Elderly and the Barthel Index. The DSM-III-R criteria were used to establish the diagnosis of prestroke dementia. Clinical and CT features of patients with and without prestroke dementia were compared. Results: Forty-nine patients (15%) were demented before stroke; they were significantly older, less well educated, they had more frequently female gender, prior cerebrovascular disease, cerebral and medial temporal lobe atrophy and leukoaraiosis in the CT scan, and they had a higher mortality rate. Female sex (OR 3.7, CI 95% 1.2–12), low education (OR 2.1, CI 95% 1.1–4.2), previous stroke (OR 3.6, CI 95% 1.2–11), and cerebral atrophy (OR 3.8, CI 95% 1.7–8.3) were independently associated with prestroke dementia in the logistic regression analysis. Conclusions: Fifteen percent of stroke patients have prestroke dementia and they have a worse outcome. Factors associated with prestroke dementia are reminiscent both of degenerative and vascular brain pathology.
Intracarotid Abciximab Injection to Abort Impending Ischemic Stroke during Carotid Angioplasty
Authors: Ho David Sai Wah , Wang Yan , Chui Michele , Wang Yiqing , Ho Shu Leong , Cheung Raymond Tak Fai
Published: April 2003

Background: Abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, prevents ischemic complications during percutaneous transluminal coronary angioplasty and was recently shown to open occluded vessels in patients with acute myocardial infarction when used alone or in combination with other thrombolytic agents. In an animal model of arterial thrombosis, abciximab was found to be safe and effective for the prevention of carotid artery thrombosis. However, the safety and efficacy of abciximab in the treatment of acute ischemic cerebrovascular events is unknown at present. Case Description: We describe 3 patients who experienced ischemic cerebrovascular events with symptoms involving the middle cerebral artery territory while undergoing percutaneous angioplasty and stenting to their internal carotid arteries. Abciximab was administered to each patient within 10 min of symptom onset as a bolus (0.25 mg/kg) into the ipsilateral common carotid artery followed by continuous intravenous infusion (9 µg/min) for 12 h. All patients’ symptoms resolved completely (by 25 min, 40 min and 5 h, respectively) with no further neurological complications. Conclusions: Our preliminary observation suggests that abciximab may improve neurological outcome following middle cerebral artery ischemic events associated with carotid angioplasty and stenting. Large prospective studies are warranted to establish the safety and efficacy of abciximab in acute ischemic stroke, either as a primary treatment modality or an adjunct to carotid angioplasty and stenting.
Prevalence of and Risk Factors Associated with Carotid Artery Stenosis: The Tromsø Study
Authors: Mathiesen Ellisiv B. , Joakimsen Oddmund , Bønaa Kaare H.
Published: April 2003

Background and Purpose: To assess prevalence, distribution, ultrasound characteristics and determinants of carotid artery stenosis in a large, population-based study of both women and men. Methods: A total of 6,727 persons aged 25–84 years were screened for extracranial stenosis with Duplex ultrasound of the right carotid artery. Risk factors were compared in 225 persons with stenosis and 5,514 persons without. Results: The prevalence of carotid stenosis was higher in men than in women, where 3.8% (95% CI, 3.2–4.6%) had carotid stenosis, compared to 2.7% (95% CI, 2.2–3.3%) in women (p = 0.001). The prevalence gradually increased by age in both genders. Cholesterol, HDL cholesterol, fibrinogen, systolic blood pressure levels and current smoking were independently associated with carotid artery stenosis in both women and men. The presence of carotid stenosis was significantly associated with a history of cerebrovascular disease, coronary heart disease and peripheral artery disease. For each 10% increase in the degree of carotid stenosis, the risk of having had a cerebrovascular event increased by 26%. Conclusions: The prevalence of carotid stenosis in the general population, as measured by ultrasound, is low. Age, male gender, smoking, total cholesterol, HDL cholesterol (inverse), fibrinogen and systolic blood pressure are all independent predictors of carotid artery stenosis.
Prevalence of Stroke Risk Factors and Their Outcomes
Authors: Manchev Ivan C. , Mineva Petya P. , Hadjiev Dimiter I.
Published: April 2003

This epidemiological study was performed to determine the prevalence of stroke risk factors and their outcomes among Bulgarian urban population. Volunteers, 200 men and 300 women, aged 50–79 years, without clinical signs and symptoms of vascular disease were enrolled in the study. A structured questionnaire, physical examination, ECG records and a battery of laboratory tests were employed. All volunteers underwent a carotid Duplex scan. High LDL-cholesterol levels, hypertension, obesity, cigarette smoking and cardiac diseases were the most prevalent risk factors. The annual incidence rate for TIA was 0.96% and for ischemic stroke –0.72%. Myocardial infarction incidence rate was 0.48%. Asymptomatic carotid stenosis (ACS) of 50% or greater was significantly related to the cerebral ischemic events (OR: 4.74; 95% CI 1.24–18.16). The aggregation of ACS and alcohol abuse was also significantly associated with cerebral ischemic events (OR: 5.04; 95% CI 1.29–19.63).
Unilateral Thalamic Edema in Internal Cerebral Venous Thrombosis: Is it Mostly Left?
Authors: Küker Wilhelm , Schmidt Friederike , Friese Sigrid , Block Frank , Weller Michael
Published: April 2003

Thrombotic occlusion of the internal cerebral veins is a particularly dangerous form of cerebral venous thrombosis (CVT) as it causes venous infarction of the thalami. Because both thalami drain into the vein of Galen and straight sinus, bilateral thalamic involvement is frequently encountered in internal CVT. However, unilateral thalamic edema may also occur, even if all internal cerebral veins are occluded. This suggests collateral venous drainage of the thalami, which is commonly insufficient in internal CVT. Patients with unilateral congestion of the thalamus, including 3 patients reported here, had mostly left-sided involvement, indicating that right-sided unilateral thalamic involvement in CVT may be clinically silent.
Stroke Related to Carotid Artery Dissection in a Young Patient with Takayasu Arteritis, Systemic Lupus erythematosus and Antiphospholipid Antibody Syndrome
Authors: Caso V. , Paciaroni M. , Parnetti L. , Cardaioli G. , Biscarini L. , Acciarini A.E. , Rubino S. , Gallai V.
Published: April 2003

Autoimmune diseases are rarely the cause of stroke even in the young age group in association with cervical artery dissection and collagen vascular diseases. Takayasu arteritis is a chronic, idiopathic, inflammatory disease that primarily affects large vessels, such as the aorta and its main branches. Takayasu arteritis rarely coexists with systemic lupus erythematosus, and only few cases have been reported in association with the presence of antiphospholipid antibodies. We describe a young patient with right internal carotid artery dissection and subsequent stroke who presented with all three syndromes. Although this patient met the diagnostic criteria for each syndrome, systemic lupus erythematosus, Takayasu arteritis and the antiphospholipid antibody syndrome, it remains unlikely that the three disorders are not related. We suggest a single disimmune disorder may have led to carotid artery dissection.
Antiphospholipid Antibodies in the Acute Phase of Cerebral Ischaemia in Young Adults: A Descriptive Study of 139 Patients
Authors: Blohorn A. , Guegan-Massardier E. , Triquenot A. , Onnient Y. , Tron F. , Borg J.Y. , Mihout B.
Published: April 2003

A total of 139 young stroke patients were consecutively examined and tested for antiphospholipid antibodies (APLA) to evaluate the role of these antibodies in cerebral ischaemia before the age of 45. APLA were found in 28.8% of patients. Two factors, hypertriglyceridaemia and alcohol abuse, were significantly more frequent in patients with a positive APLA test. The demographic characteristics, other risk factors, history of prior thrombotic events and distribution of aetiopathogenic types of cerebral ischaemia were not different in patients with or without APLA. Laboratory assays for APLA were highly positive for only two patients, who both had autoimmune diseases. These results suggest that with the exception of a clinical context of antiphospholipid syndrome or other autoimmune diseases, the usefulness of this diagnostic tool in the management of cerebral ischaemia remains limited.
In vitro Dedifferentiation of Fetal Porcine Pancreatic Tissue prior to Transplantation as Islet-Like Cell Clusters
Authors: Humphrey R.K. , Smith M.S. , Kwok J. , Si Z. , Tuch B.E. , Simpson A.M.
Published: April 2003

The fetal porcine pancreas under experimental conditions can be transplanted in the form of explants or islet-like cell clusters (ICCs) to normalize blood glucose levels in diabetic recipients. ICCs are released from the collagenase-digested pancreas and require a 4- to 5-day culture period for their complete formation. In order to maximize insulin producing β cell differentiation following transplantation, an understanding of ICC development is essential to utilize this alternative treatment for type 1 diabetes. In this study a role is proposed for exocrine cells in the generation of the multipotent pancreatic precursor cells during the culture period. Acinar cells undergo dedifferentiation during the initial stages of the cultureperiod into multipotent pancreatic precusor cells, previously called protodifferentiated cells. The progressive loss of exocrine differentiation appears to involve rapid degranulation of zymogen granules by exocytosis and loss of the prominent secretory apparatus. These processes occur in parallel with a significant reduction in the expression of lipase in the period from day 0 to day 5 and simultaneously there is an increase in the epithelioid/ductal cell marker, cytokeratin 20. Using proliferating cell nuclear antigen, cell proliferation during the culture period does not appear to account for the increase in epithelioid/ductal cells. Further the rates of apoptosis and necrosis which were identified using the TUNEL technique and propidium iodide, respectively, do not appear to account for the reduction in exocrine cell numbers. Exocrine cell dedifferentiation appears to increase the pool of protodifferentiated cells which have the potential to develop into the insulin-producing β-cell population following transplantation into the diabetic recipient
Immunohistochemical Detection of Myogenic Cells in Muscles of Fetal and Neonatal Lambs
Authors: McCoard S.A. , McNabb W.C. , Birtles M.J. , Harris P.M. , McCutcheon S.N. , Peterson S.W.
Published: April 2003

Previous studies have implied that myonuclei accumulation in a muscle is more important than myofibre number in the determination of muscle size in fetal/neonatal lambs. However, due to the lack of a reliable marker, the role of myogenic precursor nuclei (satellite cells) in myofibre hypertrophy in late fetal and postnatal life is not well understood. In this study, MyoD was shown to be a useful marker for actively proliferating satellite cells in both fetal and neonatal lambs. MyoD was used to determine whether there were differences in the number of actively proliferating satellite cells between single and twin fetuses/neonates, which may explain at least some of the difference in myofibre size observed near birth. Eighteen single-bearing and 9 twin-bearing Coopworth ewes were randomly assigned to one of three slaughter groups (100, 120 and 140 days of gestation). The remaining ewes were kept on pasture until 20 days postpartum at which time 4 single and 4 twin lambs were sacrificed. Twin fetuses/neonates had lower body weights and muscle weights compared to singles. Lower muscle weights in the twins were associated with smaller myofibre cross-sectional areas and lower total nuclei numbers and myogenic precursor cell numbers per muscle in selected hind-limb muscles. These results indicate that myofibre hypertrophy in late gestation and early postnatal life is related to myogenic precursor cell number which may have important implications for growth potential of the growth-restricted fetus.
Optimization of Hepatocyte Spheroid Formation for Hepatic Tissue Engineering on Three-Dimensional Biodegradable Polymer within a Flow Bioreactor prior to Implantation
Authors: Török É. , Pollok J.-M. , Ma P.X. , Kaufmann P.M. , Dandri M. , Petersen J. , Burda M.-R. , Kluth D. , Perner F. , Rogiers X.
Published: April 2003

We hypothesize that in vitro conditioning of hepatocytes within biodegradable poly-L-lactic acid (PLLA) polymer matrices prior to implantation may increase hepatocyte survival and function after transplantation. The purpose of this study was to optimize the culture conditions of hepatocytes in a pulsatile flow bioreactor. PLLA discs were seeded with rat hepatocytes in a concentration of 2.5, 5, 10, 20 and 40 × 106 cells/ml. Seeded discs were exposed to recirculated perpendicular flow of 0, 7, 15, 24, 32, 52 ml/min of supplemented Williams’ Medium E and harvested after 6 days in flow culture. Only under flow conditions the hepatocytes formed spheroidal aggregates (SphA) of 50–260 µm in diameter with a liver-like morphology and active metabolic function. The number of SphA was examined by phase contrast microscopy and the reductive enzyme function of the hepatocytes was tested using MTT. Hematoxylin and eosin histology showed vital hepatocytes within the SphA less than 200 µm in diameter but central necrosis in the SphA exceeding this size. Immunohistochemical staining confirmed albumin production of hepatocytes within the SphA. The optimal cell seeding concentration was 10 × 106 cells/ml with a flow speed of 24 ml/min. SphA of hepatocytes cultured with this flow bioreactor method may prove useful as a functional unit for tissue engineering of an in vivo liver substitute.
Regulation of Embryonic Chick Insulin Cells: Effect of Retinoic Acid and Insulin-Like Growth Factor 1
Authors: Kramer Beverley , Penny Clem
Published: April 2003

We are interested in the regulation of early pancreatic differentiation, particularly with regard to factors that enhance insulin cell proliferation. Both retinoic acid and insulin-like growth factor 1 (IGF-1) are known to be important in the proliferation and differentiation of insulin cells. Individually, they have the ability to increase the proportion of insulin cells when added to cultures of chick dorsal pancreatic buds. The aim of this study was to define the action of retinoic acid (RA) in combination with IGF-1 on the proportion of insulin cells. The dorsal pancreatic bud of 5-day-old chick embryos was excised and the endodermal component, with minimal adherent mesenchyme, was explanted onto Matrigel. RA (10–6 M) and IGF-1 (50 ng/ml) were added to Ham’s F12 culture medium containing transferrin (5 µg/ml) and selenium (10–10 M) (F12.TS). Control explants were cultured in F12.TS alone or in F12.TS containing dimethyl sulphoxide (DMSO) [F12.TS (DMSO)]. After 7 days in culture, insulin and glucagon cells were localized immunocytochemically; numbers of insulin cells were expressed as a percentage of insulin plus glucagon cell counts. Addition of RA plus IGF-1 to the medium increased the proportion of insulin cells markedly (23.43%) compared with the proportions in control explants (11.3% with F12.TS (DMSO), 13.2% with F12.TS). This increase represents a more than twofold increase in the proportion of insulin cells over that of control explants.
Cerebellar Glia Cells Induce a Correct Laminar Organization in Chicken Retinal Reaggregates
Authors: Willbold Elmar , Rothermel Andrée , Huhn Jutta , Reinicke Michael , Layer Paul G.
Published: April 2003

We investigated the functional role of glia cells during retinogenesis using the rotation culture system. Reaggregating cells from the embryonic chick retina have the unique capacity to reassemble into laminated cellular spheres. These spheres are composed of several compartments holding the constituents of many retinal layers in a topologically correct, yet inverse orientation. However, when these spheres are cultured in the presence of conditioned media derived from monolayers of cerebellar glia cells, the reassembling retinal cells behave totally differently. The anlage of the originally reversed lamina polarity is progressively transformed within a week into a sphere with a compound and correctly laminated orientation. Conditioned media from fibroblasts, other glia cells (except Müller cells) or a set of already characterized retinogenetic factors are not able to produce this dramatic transformation. Additionally, we were able to show that only retinal cells are able to respond with a reorganization process. Reaggregating cells from the chick cerebellum also form spheroids; however, neither in the presence of cerebellar glia cell-derived conditioned medium nor their control counterparts are they able to reassemble histotypically. This indicates that cerebellar glia cells produce diffusible factors to which retinal cells can respond and that these factors can act as important determinants for the correct establishment of the retinal polarity. Since all types of laminar disorganization are of great clinical significance, the knowledge of factors which determine and sustain the normal retinal architecture are biomedically highly relevant.
Chemically Defined Protein-Free in vitro Culture of Mammalian Embryo Does Not Restrict Its Developmental Potential for Differentiation of Skin Appendages
Authors: Bulić-Jakuš Floriana , Strahinić-Belovari Tatjana , Marić Svjetlana , Ježek Davor , Jurić-Lekić Gordana , Vlahović Maja , Šerman Draško
Published: April 2003

In a unique serum- and protein-free chemically defined in vitro culture model of postimplantation mammalian development the epidermis differentiates regularly, although the differentiation of other tissues is impaired due to the lack of the serum. The present study in that model was done to estimate more carefully the degree of epidermal differentiation in defined media supplemented with some growth- or differentiation-stimulating substances. The main objective was to discover by grafting in vivo to the richer environment whether simple protein-free culture conditions restrict an inherent embryonic potential for differentiation of skin appendages. Embryonic parts of E9.5 gastrulating Fischer rat embryos were cultivated for 2 weeks in the protein-free Eagle’s minimum essential medium supplemented with holotransferrin, apotransferrin, insulin and/or Na2SeO3 and in controls cultivated in protein-free medium or in serum-supplemented medium. In all experiments there was a high incidence of differentiation of the epidermis. A high level of epidermal differentiation was confirmed for the first time at the ultrastructural level. A well-differentiated cornified layer and cells connected with desmosomes containing keratohyaline masses and cytokeratin filaments were found. A strong immunohistochemical signal for the proliferating cell nuclear antigen was always detected in the basal layer of the epidermis showing that those cells were still able to proliferate. Finally, embryos precultivated for 1 or 2 weeks in the protein-free medium and media supplemented with apotransferrin or serum were grafted under the kidney capsule for an additional 2 weeks. It was discovered that even after spending 2 weeks in the simple protein-free medium in vitro, embryos retained their developmental potential for differentiation of skin appendages (hair and sebaceous glands).
Three-Dimensional Reconstruction of the Anal Striated Musculature in a Human Fetus
Authors: Fröber R. , Krebs U. , Haas A. , Fischer M.S. , Schier F. , Linss W.
Published: April 2003

Conflicting opinions in the recent literature indicate that the morphological organization and function of the anorectal continence organ has, up to now, not been clearly understood. But a clear imagination of the spatial arrangements of this compound muscle system is of clinical relevance for the pediatric surgeon performing reconstructive surgery. We analyzed 18-µm sections of the pelvic region of 4 human fetuses in order to describe the individual components of this muscle complex. A series of 630 Azan-stained sections was the base for the computer-assisted 3D reconstruction of the levator ani and the external sphincter complex in a male human fetus (14th week p.c.). In this context, special attention was paid to the intermediate muscle layer of the puborectalis which develops ventrally from the funnel-shaped levator ani and joins the tripartite ring system of the sphincter muscle dorsally. Our findings lead to a clear imagination of the spatial arrangement of this intermediate layer and characterize the anorectal muscle complex as an integrated ensemble in which the puborectalis holds a key position.
Properties of Sensory Neurons Innervating Synovial Joints
Authors: Grigg Peter
Published: April 2003

While it is clear that the TMJ joint has a sensory innervation like other synovial joints, there is little specific information about the function of the innervation of the TMJ. In order to provide a template upon which future studies might build, this article briefly reviews the function of sensory neurons in other synovial joints.
Immunohistochemical Expression of S-100 Protein in Human Embryonal Fat Cells
Authors: Atanassova P.
Published: April 2003

The aim of the present study was to investigate immunocytochemically the presence of S-100 protein in subcutaneous fat cells during early human embryogenesis (6–12 weeks of gestation). We found that preadipocytes in the subcutaneous tissue which were at different stages of differentiation were positive for S-100 protein. The other cells in the embryonal subcutis (mesenchymal cells differentiating into fibroblasts and fibrocytes and endothelial cells) showed a negative reaction for S-100. Our results imply that the S-100 protein is expressed from the beginning of lipidogenesis and possibly acts as a factor regulating lipid storage and body fat formation. It can be used as a reliable biochemical marker of human fat cell differentiation and for distinguishing them from the mesenchymal and the fibroblast cells in the human embryonal subcutis.
Developmental Morphological and Histological Studies on Structures of the Human Fetal Shoulder Joint
Authors: Aboul Mahasen Laila M. , Sadek Sohair A.
Published: April 2003

In the present work, morphological changes in the interior structures of the developing human shoulder joint were studied at different prenatal ages (9, 12, 16, 23 and 40 weeks) and were compared with the same structures in the adult joint. It was found that the shoulder joint had gone through important developmental changes during the 12th week of the prenatal life and it is assumed that genetic factors operative during this stage of development were more important than mechanical factors. A subsequent development of the intracapsular glenohumeral ligaments was present at the 16th week. The glenoid labrum, the biceps tendon and the three glenohumeral ligaments formed a complete ring around the glenoid fossa which constituted a functional unit, which seemed to have a role in stabilizing the joint. In the present work, histological prenatal studies were done on sagittal and radial sections from the glenoid fossa and its associated structures and the results were compared with the same structures in adults. At a crown-rump length of 30 mm (9 weeks), intermingling of the collagen fibres of the superior labrum and the biceps tendon was observed and the superior labrum could be considered as an extension of the biceps tendon. While the superior and inferior parts of the labrum appeared fibrous, the posterior labrum appeared as a primitive cellular condensation. At the 12th week, it became a fibrocellular structure and changed to a fibrocartilaginous structure at the 16th week. But until full term, no definitive fibrocartilage was found due to its hypercellularity compared to the adult. It was found that at all ages, the capsule was formed of cellular and fibrous elements, its collagenous content was progressively increased with age and at full term, it became generally fibrous but was still different compared to adults. In all stages of development, the synovial tissue of different regions of the same joint exhibited marked variations in thickness, vascularity, cellular density and collagenous content. It lined the capsule, surrounded the biceps tendon and reflected on the labrum. Its cell density as well as their vascular and collagenous contents were progressively increased with age. At full term, the synovial tissue was thickest at its inferior reflection and forming large folds. The synovial tissue lining the capsule was thinner than the synovial tissue at its reflection from the labrum, many villi and processes arising from it and projecting into the joint cavity.
The Ganoine Membrane of the Scales of Polypterus senegalus Includes a Labyrinth-Like Structure
Authors: Kogaya Yasutoku , Kubo Kin-ya , Iwaku Fumihiko
Published: April 2003

The ganoine membrane is a basement membrane-like structure appearing between the maturation stage inner ganoine epithelium (IGE) and mineralized ganoine of polypterids and lepisosteids. In the present study, further ultrastructural investigation of the ganoine membrane of Polypterus senegalus was made and it was confirmed that it possessed a specialized labyrinth-like structure. The complete ganoine membrane was composed of six distinct zones: (1) a filamentous zone facing the distal plasmalemma of IGE, (2) lamella zone I, (3) vertical striation zone, (4) lamella zone II, (5) electron-dense zone, (6) electron-lucent zone directly facing the maturing ganoine surface. The ganoine membrane sometimes partially lacked some of these zones, but the electron-dense zone was usually present. Oblique or horizontal sections of the membrane showed that the vertical striation zone was made up of a typical labyrinth-like structure. Certain sulfated glycoconjugates were localized at the filamentous zone, especially adjacent to the lamella zone I and over the electron-dense zones.
Adenosine Triphosphatase Expression Correlates with Ciliary Activity of Respiratory Epithelium in vitro
Authors: Schütz A. , von Foerster U. , Bücheler M.
Published: April 2003

In vitro culture of respiratory epithelium is of great utility for pharmacological investigations and tissue engineering. Up to now, the degree of differentiation of respiratory cells cultured in vitro has exclusively been estimated by measuring ciliary beat frequency (CBF). Ciliary motility is dependent on the function of the motor protein dynein that is composed of at least two heavy chains, sharing attributes of adenosine triphosphatases (ATPases). CBF is further dependent on medium conditions and does not allow to draw any accurate conclusion on the proportion of fully differentiated ciliated cells in culture. For this reason we introduced the immunohistochemical detection of a 100-kD ATPase subunit as a correlation with dynein activity in human respiratory cell tissue culture. Our results show that the amount of immunohistochemically detectable ATPase-subunit-positive cells strongly correlates with ciliary motility in vitro. Cultures without ciliary activity exhibited no ATPase staining, whereas in cell cultures with excessive ciliary beat, up to 15.1% of the cells were ATPase positive. Immunohistochemical detection of ATPase in respiratory cell cultures seems to be a sensitive and reproducible complement for the characterization of cultured ciliated epithelium.
A Longitudinal Cardiovascular Autonomic Function Study in Mild Guillain-Barré Syndrome
Authors: Lyu Rong-Kuo , Tang Lok-Ming , Hsu Wen-Chuin , Chen Sien-Tsong , Chang Hong-Shiu , Wu Yih-Ru
Published: April 2003

To identify subclinical autonomic dysfunction in mild Guillain-Barré syndrome (GBS), a set of autonomic function tests was serially performed for up to 6 months in 5 GBS patients with mild disability at the nadir. Parasympathetic autonomic function tests consisted of Valsalva ratio and R-R interval variation during rest and deep breathing. Sympathetic autonomic function was evaluated by blood pressure responses to sustained handgrip, hand immersion in ice water, and active standing. The results showed that abnormal parasympathetic and sympathetic function was frequently encountered in all 5 patients during the acute stage of the illness. Autonomic dysfunction occurred both in axonal and demyelinating types of GBS. There was a trend of improvement in most autonomic function tests after 3 months, comparable to the recovery of motor function. In conclusion, subclinical autonomic dysfunction was present in mild GBS. It was temporary and would resolve spontaneously.
Diagnostic and Therapeutic Dilemma with Large Prenatally Detected Cystic Adrenal Masses
Authors: de Luca J.L. , Rousseau T. , Durand C. , Sagot P. , Sapin E.
Published: April 2003

Objectives: The prenatal finding of a large cystic adrenal mass raises the dilemma of the differential diagnosis between adrenal hemorrhage and cystic neuroblastoma. The possibility of a neuroblastoma usually leads to surgical excision of such tumors. Nevertheless, an adrenal hemorrhage has to be recognized, so that unnecessary surgery may be avoided. Methods: Three cases of large prenatally detected adrenal masses managed nonoperatively are reported. Data studied were: age at the diagnosis, prenatal and postnatal ultrasonographic consistency, and tumor marker levels. Size and sonographic evolution were also studied. Results: In all 3 cases, a cystic mass, measuring more than 40 mm in size, was detected during the 3rd trimester of pregnancy. The sonographic appearance evolved from a sonolucent tumor to a heterogeneous mass with hyperechoic areas. The tumor marker levels were normal. All infants had a documented decrease in mass size at birth and were managed nonoperatively. All these tumors were considered adrenal hemorrhages. Conclusions: Prenatal ultrasonography rarely permits to distinguish an adrenal hemorrhage from a cystic neuroblastoma. The differential diagnosis, even in large masses, is based on close postnatal follow-up with serial sonography. Surgery is not mandatory, unless the size does not decrease. However, without pathologic proof, it is not possible to differentiate an adrenal hemorrhage from a spontaneously resolved neuroblastoma.
The Influence of Smoking and Parity on Serum Markers for Down’s Syndrome Screening
Authors: Tišlarić Dubravka , Brajenović-Milić Bojana , Ristić Smiljana , Latin Višnja , Žuvić-Butorac Marta , Bačić Josip , Petek Marijan , Kapović Miljenko
Published: April 2003

Objective: To evaluate the impact of smoking and number of previous births on maternal serum levels of α-fetoprotein and free β-subunit of human chorionic gonadotropin (free β-hCG). Methods: The study included 3,252 completed unaffected singleton pregnancies that proceeded beyond 37 weeks’ gestation and resulted with a birth of healthy child. Smoking status of mothers and data concerning gravidity and parity were collected at the sampling date. Serum markers were measured between 13 and 22 gestational weeks, corrected for maternal weight, and converted to multiples of median (MoM) for unaffected pregnancy of the corresponding gestational age. Median MoM values for both markers were examined in relation to both: smoking habits and number of previous births. Results: Smokers had significantly decreased free β-hCG MoM values compared to nonsmokers (p < 0.001). The median levels showed a negative relationship with the number of previous births. The significance of a decreasing trend was proved, both in smokers (p < 0.001) and nonsmokers (p < 0.001). The median maternal serum α-fetoprotein MoM values did not show any significant dependence, neither with regard to smoking (p = 0.65) nor with regard to parity (p = 0.07). Conclusions: The recommendable adjustment of serum markers to smoking habits, especially concerning the free β-hCG levels, would be worthwhile. The evidence of the coexisting influence of parity on serum levels of free β-hCG, both in smokers and nonsmokers, should perhaps be a stimulus for reconsideration of which corrections the screening performance is dependent on.
Prenatal Diagnosis of Lissencephaly (Type II) by Ultrasound and Fast Magnetic Resonance Imaging
Authors: Kojima Kazuhisa , Suzuki Yoshikatsu , Seki Koichiro , Yamamoto Tamao , Sato Takeshi , Tanaka Taihei , Suzumori Kaoru
Published: April 2003

We report a case of lissencephaly which could be diagnosed by detailed examination during pregnancy. We first found bilateral enlarged ventricles in the fetus by routine abdominal ultrasonography at mid-pregnancy. Fast scanning MRI subsequently allowed confirmation of a diagnosis of lissencephaly during pregnancy.
Inability to Clonally Expand Fetal Progenitors from Maternal Blood
Authors: Zimmermann Bernhard , Holzgreve Wolfgang , Zhong Xiao Yan , Hahn Sinuhe
Published: April 2003

Objectives: To confirm the recent report of the culture of single clones of fetal progenitor cells from maternal blood. Methods: Hemopoietic progenitor cells were cultured from 16 blood samples obtained from women pregnant with a male singleton fetus. Single colonies were isolated by micro-manipulation and examined by multiplex real-time PCR. Results: Of a total of 1,674 colonies examined, 1,648 were identified as being maternal. No colonies were detected of fetal origin. Conclusions: The clonal expansion of single fetal colonies from the maternal circulation is not feasible by current methods.
Myomectomy as a Pregnancy-Preserving Option in the Carefully Selected Patient
Authors: Hasbargen U. , Strauss A. , Summerer-Moustaki M. , Baretton G. , Roth U. , Kimmig R. , Hepp H.
Published: April 2003

Objectives: To present the indications for myomectomy during pregnancy and to discuss complications possibly related and unrelated to the procedure. Method and Results: A 33-year-old patient at 18 weeks of gestation underwent removal of a 1,570-gram symptomatic fundic myoma. Histologically the patient had a leiomyomatous neoplasm of uncertain malignant potential. The pregnancy was continued under sequential observation with magnetic resonance imaging and ultrasound. At 36 weeks of gestation a healthy girl with an upper extremity limb defect was born via cesarean section. Follow-up of the mother and the child was uneventful. Conclusions: Certain known risk factors in pregnant women with myomas can predispose to complications during pregnancy. Women with such risk factors or women who have failed medical therapy should be offered the option of undergoing myomectomy as a pregnancy-preserving procedure.
Sepsis due to Clostridium perfringens after Pregnancy Termination with Feticide by Cordocentesis: A Case Report
Authors: Li Kim Mui S.V. , Chitrit Y. , Boulanger M.C. , Maisonneuve L. , Choudat L. , de Bièvre P.
Published: April 2003

We report a case of sepsis due to Clostridium perfringens after termination of pregnancy at 22 weeks with feticide by cordocentesis. Three weeks earlier, the 41-year-old patient had undergone an amniocentesis and a full trisomy 13 karyotype had been discovered. Feticide was performed by injection of thiopental and potassium chloride after percutaneous umbilical foetal blood sampling through the same needle. The patient delivered vaginally with signs of chorioamnionitis and septicaemia. She recovered under broad-spectrum antibiotherapy. C. perfringens was present in maternal blood cultures, placental smears and foetal organs. We discuss the possible mechanisms of infection by C. perfringens, including inoculation of intestinal germs.
Second-Trimester Maternal Pregnancy-Associated Plasma Protein A and Inhibin A Levels in Fetal Trisomies
Authors: Watanabe Hideki , Hamada Hiromi , Yamada Naoki , Ogura Tsuyoshi , Yasuoka Mana Obata , Okuno Suzuka , Fujiki Yutaka , Sohda Satoshi , Kubo Takeshi
Published: April 2003

Objective: The aim of this study was to determine whether fetal trisomy is associated with altered levels of second-trimester maternal pregnancy-associated plasma protein A (PAPP-A) and inhibin A. Methods: Maternal serum PAPP-A and inhibin A concentrations were measured at 15–17 weeks of gestation in 14 singleton pregnancies with fetal trisomy and in 56 matched pregnant controls. Results: PAPP-A levels in the trisomy group were significantly lower than in controls. The inhibin A level with fetal trisomy 21 was slightly higher than the control group, but levels were not different between trisomies 18 and 13 and controls. Conclusion: Fetal trisomies 21, 18, and 13 are associated with a reduction in second-trimester maternal PAPP-A levels; trisomies 18 and 13 are not associated with increased inhibin A levels, unlike trisomy 21.
Systemic Diffusion Including Germ Cells after Plasmidic in utero Gene Transfer in the Rat
Authors: Gallot D. , Seifer I. , Lemery D. , Bignon Y.J.
Published: April 2003

Objectives: The integration of a proviral plasmid into the host genome could be a good approach for fetal somatic gene transfer. The goal of this study was to assess the integration and transcription of a proviral marker gene injected intraperitoneally into rat fetuses as well as the risks of maternal contamination and germ-line transmission. Methods: On day 17 post-coitus, each fetus was injected intraperitoneally with 10 µg plasmid DNA through the uterine wall. Twenty-one days after spontaneous delivery, integration and transcription of the plasmid in gonad, gut, liver, spleen, lung and brain tissue from 10 pups were determined by PCR and RT-PCR. Results: 14 of 60 organs exhibited integration of the plasmid. Four samples of gut (40%), 3 samples of liver and spleen (30%), 2 samples of brain (20%) and no sample of lung were transfected. Two testicular samples were transfected and study of F1 rats from 2 brothers of one of the positive rats revealed transgenic pups from 1 of these 2 animals. No transfection of maternal tissues was detected. Conclusion: Integration and transcription of a marker gene injected intraperitoneally into rat fetuses appear efficient, especially in intraperitoneal organs. The risk of maternal contamination appears very low when using a naked DNA plasmid injected directly into fetuses. However, germ-line contamination can occasionally occur even with injection late during pregnancy, suggesting further studies are necessary to assess this risk in direct gene transfer experiments.
Linear Insertion of Atrioventricular Valves without Septal Defect: A New Anatomical Landmark for Down’s Syndrome?
Authors: Fredouille C. , Piercecchi-Marti M.-D. , Liprandi A. , Duyme M. , Gonzales M. , Bigi N. , Rouault F. , Pellissier J.F.
Published: April 2003

Our objective was to explore whether minor anatomical abnormalities of the septal insertion of tricuspid and mitral valves could be a feature of trisomy 21 in fetuses with an otherwise normal heart. Postmortem examinations were performed in 41 fetuses affected by Down’s syndrome and in 52 controls. Adjoining the standard postmortem procedure, an apex-to-base section of the crux of the heart was made on a plane corresponding to the sonographic four-chamber view. This allowed gross and histological examination of the hinge points of tricuspid and mitral leaflets, showing the usual apical displacement of the tricuspid valve in all controls. Of 41 fetuses affected by Down’s syndrome, 18 had a structural heart defect. Of the 23 Down syndrome fetuses without a patent heart defect, 16 (i.e., 69% of those considered as having ‘normal hearts’) had nevertheless a linear insertion of atrioventricular valves at autopsy. Prospective clinical studies are required to evaluate if these postmortem findings can be transposed to the clinical setting of 2nd-trimester sonographic screening.