bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoxia induces hypersensitivity and hyperreactivity to thromboxane receptor agonist in neonatal pulmonary arterial myocytes
Authors: Hinton M. , Mellow L. , Halayko A. J. , Gutsol A. , Dakshinamurti S.
Published: October 2005

PPHN, caused by perinatal hypoxia or inflammation, is characterized by an increased thromboxane-prostacyclin ratio and pulmonary vasoconstriction. We examined effects of hypoxia on myocyte thromboxane responsiveness. Myocytes from 3rd–6th generation pulmonary arteries of newborn piglets were grown to confluence and synchronized in contractile phenotype by serum deprivation. On the final 3 days of culture, myocytes were exposed to 10% O2for 3 days; control myocytes from normoxic piglets were cultured in 21% O2. PPHN was induced in newborn piglets by 3-day hypoxic exposure (FiO20.10); pulmonary arterial myocytes from these animals were maintained in normoxia. Ca2+mobilization to thromboxane mimetic U-46619 and ATP was quantified using fura-2 AM. Three-day hypoxic exposure in vitro results in increased basal [Ca2+]i, faster and heightened peak Ca2+response, and decreased U-46619 EC50. These functional changes persist in myocytes exposed to hypoxia in vivo but cultured in 21% O2. Blockade of Ca2+entry and store refilling do not alter peak U-46619 Ca2+responses in hypoxic or normoxic myocytes. Blockade of ryanodine-sensitive or IP3-gated intracellular Ca2+channels inhibits hypoxic augmentation of peak U-46619 response. Ca2+response to ryanodine alone is undetectable; ATP-induced Ca2+mobilization is unaltered by hypoxia, suggesting no independent increase in ryanodine-sensitive or IP3-linked intracellular Ca2+pool mobilization. We conclude hypoxia has a priming effect on neonatal pulmonary arterial myocytes, resulting in increased resting Ca2+, thromboxane hypersensitivity, and hyperreactivity. We postulate that hypoxia increases agonist-induced TP-R-linked IP3pathway activation. Myocyte thromboxane hyperresponsiveness persists in culture after removal from the initiating hypoxic stimulus, suggesting altered gene expression.
Differential degradation of matrix proteoglycans and edema development in rabbit lung
Authors: Negrini Daniela , Tenstad Olav , Passi Alberto , Wiig Helge
Published: October 2005

The specific role of solid extracellular matrix components in opposing development of pulmonary interstitial edema was studied in adult anesthetized rabbits by challenging the lung parenchyma with an intravenous injection of a bolus of collagenase or heparanase. In 10 rabbits, pulmonary interstitial pressure (Pip) was measured by micropuncture in control and up to 3 h after collagenase or heparanase intravenous injection. With respect to control (Pip= −9.3 ± 1.5 cmH2O, n = 10), both treatments caused a significant increase of Pipand of the wet weight-to-dry weight lung ratio. However, while tissue matrix stiffness was maintained after 60 min of collagenase, as indicated by the attainment of a positive Pippeak (Pip= 4.5 ± 0.3 cmH2O, n = 5), this mechanical response was lost with heparanase (Pip= −0.6 ± 1.3 cmH2O, n = 5). Biochemical analysis performed on a separate rabbit group ( n = 15) showed an increased extraction of uronic acid with both enzymes, indicating a progressive matrix fragmentation. Gel chromatography analysis of the proteoglycan (PG) families showed that 60 min of both enzymatic treatments left the large-molecular-weight PGs (versican) essentially unaffected. However, the heparan-sulfate PG fraction was significantly cleaved, as indicated by a significant increase of the smaller PG fragments with heparanase, but not with collagenase. Hence, present data suggest that the integrity of the heparan-sulfate PGs is required to maintain the three-dimensional architecture of the pulmonary tissue matrix and in turn to counteract tissue fluid accumulation in situations of increased fluid filtration.
Tomato juice prevents senescence-accelerated mouse P1 strain from developing emphysema induced by chronic exposure to tobacco smoke
Authors: Kasagi Satoshi , Seyama Kuniaki , Mori Hiroaki , Souma Sanae , Sato Tadashi , Akiyoshi Taeko , Suganuma Hiroyuki , Fukuchi Yoshinosuke
Published: October 2005

The senescence-accelerated mouse (SAM) is a naturally occurring animal model for accelerated aging after normal development and maturation. SAMP1 strain was reported to show age-related structural and functional changes in lung and to be a murine model of senile lung. We postulated that aging of lung is an important intrinsic process for development of emphysema and even in a short period of tobacco smoke exposure may be able to generate emphysema. At age 12 wk, SAMP1 inhaled air or 1.5% tobacco smoke (total particulate matter 23.9 mg/m3) through the nose for 30 min/day, 5 days/wk, and for 8 wk. The mean linear intercepts (MLI) and destructive index (DI) of lung were significantly increased [air vs. smoke (means ± SE); MLI, 68.76 ± 0.69 vs. 75.34 ± 1.70 μm, P < 0.05 and DI, 8.61 ± 0.38 vs. 16.18 ± 1.54%, P < 0.05], whereas no significant changes were observed in SAMR1, control mice that show normal aging. In contrast, smoke-induced emphysema was completely prevented by concomitant ingestion of lycopene given as tomato juice [MLI: smoke with/without lycopene (mean ± SE), 62.87 ± 0.8 vs. 66.90 ± 1.33 μm, P < 0.05]. Smoke exposure increased apoptosis and active caspase-3 of airway and alveolar septal cells and reduced VEGF in lung tissues, but tomato juice ingestion significantly reduced apoptosis and increased tissue VEGF level. We conclude that SAMP1 is a useful model for tobacco smoke-induced emphysema and a valuable tool to explore both pathophysiological mechanisms and the effect of therapeutic intervention on smoke-induced emphysema.
Sympathoinhibition from ventrolateral periaqueductal gray mediated by the caudal midline medulla
Authors: Dean C.
Published: October 2005

Activation of neurons in the ventrolateral region of the periaqueductal gray (vlPAG) can elicit a decrease in renal sympathetic nerve activity and blood pressure. The present study investigated whether the vlPAG-evoked sympathoinhibitory response depends on neurons in the caudal midline medulla (CMM). In pentobarbital-anesthetized rats, activation of neurons in the vlPAG evoked a decrease in renal sympathetic nerve activity to 29.4 ± 4.8% below baseline levels and arterial blood pressure fell 8.9 ± 1.6 mmHg ( n = 20). Microinjection of the GABA agonist muscimol into sympathoinhibitory regions of the CMM significantly attenuated the vlPAG-evoked sympathoinhibition to 17.9 ± 4.1% below baseline and the depressor response to 4.3 ± 1.2 mmHg. At 65% (13/20) of the sites examined, the vlPAG-evoked sympathoinhibition was responsive to CMM muscimol microinjection and attenuated from 34.2% to 11.5%, with the depressor response reduced from 14.8 to 3 mmHg. Microinjection of muscimol at the remaining 35% of the CMM sympathoinhibitory sites was ineffective on the vlPAG-evoked sympathoinhibition and depressor response. These data indicate that sympathoinhibitory and hypotensive responses elicited by activation of neurons in the vlPAG can be mediated by neurons in the sympathoinhibitory region of the CMM. The finding that the vlPAG-evoked response is not affected by muscimol at all CMM sympathoinhibitory sites also suggests that sympathoinhibitory sites in the CMM are not homogeneous and can mediate functionally different responses.
Evidence for Nr4a1 as a cold-induced effector of brown fat thermogenesis
Authors: Kanzleiter Timo , Schneider Tatjana , Walter Isabel , Bolze Florian , Eickhorst Christoph , Heldmaier Gerhard , Klaus Susanne , Klingenspor Martin
Published: October 2005

Acute cold exposure leads to norepinephrine release in brown adipose tissue (BAT) and activates uncoupling protein (UCP)1-mediated nonshivering thermogenesis. Chronic sympathetic stimulation is known to initiate mitochondrial biogenesis, UCP1 expression, hyperplasia of BAT, and recruitment of brown adipocytes in white adipose tissue (WAT) depots. Despite distinct functions of BAT and WAT in energy balance, only a few genes are exclusively expressed in either tissue. We identified NUR77 (Nr4a1), an orphan receptor, to be induced transiently in brown adipocytes in response to β-adrenergic stimulation and in BAT of cold-exposed mice. Subsequent reporter gene assays demonstrated an inhibitory action of NUR77 on basal and peroxisome proliferator-activated receptor (PPAR)γ/retinoid X receptor (RXR)α-mediated transactivation of the Ucp1 enhancer in heterologous cotransfection experiments. Despite this function of NUR77 in the control of Ucp1 gene expression, nonshivering thermogenesis was not affected in Nur77 knockout mice. However, we observed a superinduction of Nor1 in BAT of cold-exposed knockout mice. We conclude that NUR77 is a cold-induced negative regulator of Ucp1, but phenotypic consequences in knockout mice are compensated by functional redundancy of Nor1.
Stem Cell Relationships and the Origin of Gastrointestinal Cancer
Authors: Schier Stefanie , Wright Nicholas A.
Published: October 2005

Gastrointestinal stem cells have the capacity for long-term self-replication and the ability to give rise to all other epithelial cell lineages. These properties make them essential since they maintain tissue homeostasis by regulating cell turnover depending on the current demand. However, they are also important players in the earliest stages of gastric and colonic cancer, as they form a target for mutations to accumulate and lead to the development of the malignant phenotype. Due to the lack of reliable markers, gastrointestinal stem cells are difficult to define and characterise. This limits the knowledge about their number and position within the gastric gland and the intestinal crypt, respectively, and consequently about the clonal structure of these units. Therefore, the morphological events of early gastrointestinal carcinoma formation and expansion are hotly debated. In this review we summarize the properties of gastrointestinal stem cells and illuminate their role in the development of the earliest lesions in the gastric and colonic mucosa. We also resume current opinions about the morphological pathways and the clonality of these neoplasias and the subsequent mechanism of spread within the adjacent tissues.
Cancer Invasion and Metastasis
Authors: Wittekind Christian , Neid Matthias
Published: October 2005

Metastasis is the transfer of malignant tumors from one organ to a distant organ. It is the most common cause of death in cancer patients. Different molecular mechanisms enable tumor cells to infiltrate the surrounding tissue, invade blood vessels and leave the blood stream at a different site. Tumor cell interaction with extracellular matrix components and epithelial-mesenchymal transition as well as angiogenesis are important factors in invasion and metastasis. Gene expression profiles of metastatic cells in various organs are different and not every tumor cell has the capacity to metastasize. The microenvironment in the organ influences formation of metastasis. Only 1% of micrometastases progress into macrometastases.
Genes Involved in Invasion and Metastasis of Gastric Cancer Identified by Array-Based Hybridization and Serial Analysis of Gene Expression
Authors: Oue Naohide , Aung Phyu Phyu , Mitani Yoshitsugu , Kuniyasu Hiroki , Nakayama Hirofumi , Yasui Wataru
Published: October 2005

Gastric cancer (GC) is still a serious health problem and remains the second most common type of fatal cancer worldwide. Comprehensive gene expression analyses may be useful to identify genes associated with invasion/metastasis in GC. Among them, array-based hybridization and serial analysis of gene expression (SAGE) are currently the most common approaches. Over the past 3 years, several large-scale gene expression studies with array-based hybridization and SAGE have been performed and several genes have been identified. This review describes genes associated with invasion/metastasis in GC which have been identified by array-based hybridization and SAGE. We compared the expression levels of the genes identified by array-based hybridization with our SAGE data. In addition, expression of the candidate genes obtained by SAGE was further investigated by quantitative RT-PCR of 40 GC samples. MIA and GW112 were overexpressed in 10 (25%) and 22 (55%) of 40 GC samples, and the overexpression of these two genes was associated with tumor stage, respectively. We also discuss the significance of HMGB1/amphoterin in invasion and metastasis of GC.
Cyclooxygenase-2 Inhibition Prevents Colorectal Cancer: From the Bench to the Bed Side
Authors: Samoha Smadar , Arber Nadir
Published: October 2005

Cancer is predicted to become the leading cause of death – surpassing heart disease – by the end of this decade. Colorectal cancer is a major health concern, with more than 1,000,000 new cases and 500,000 deaths expected worldwide per year. There is much evidence to suggest a link between the consumption of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevention of colorectal cancer (CRC). The consumption of NSAIDs is not problem free, and the number of deaths due to NSAIDs equals the number of deaths from AIDS or leukemia. Therefore, although chemoprevention of CRC is possible, drugs that have more acceptable side effect profiles than the currently available NSAIDs are required. Since up to 50% of polyps and 85% of colonic tumors in humans overexpress cyclooxygenase (COX-2), COX-2 inhibitors are an ideal drug candidate for CRC prevention or treatment
Cancer Prevention by Phytochemicals
Authors: Nishino Hoyoku , Murakoshi Michiaki , Mou Xiao Yang , Wada Saeri , Masuda Mitsuharu , Ohsaka Yasuhito , Satomi Yoshiko , Jinno Kenji
Published: October 2005

Information has been accumulated indicating that diets rich in vegetables and fruits can reduce the risk of a number of chronic diseases, including cancer, cardiovascular disease, diabetes and age-related macular degeneration. Phytochemicals (various factors in plant foods), such as carotenoids, antioxidative vitamins, phenolic compounds, terpenoids, steroids, indoles and fibers, have been considered responsible for the risk reduction. Among them, a mixture of natural carotenoids has been studied extensively and proven to show beneficial effects on human cancer prevention.
Biliary Tract Malignancy and Chronic Inflammation from the Perspective of Pancreaticobiliary Maljunction
Authors: Kimura Yasutoshi , Nishikawa Noriko , Okita Kenji , Furuhata Tomohisa , Mizuguchi Toru , Nobuoka Takayuki , Nishimori H. , Zenbutsu Hitoshi , Satoh Masaaki , Katsuramaki Tadashi , Hirata Koichi
Published: October 2005

This is a brief review of pancreaticobiliary maljunction. The basic treatment for this condition includes either cholecystectomy or extrahepatic bile duct resection. When the condition is accompanied by malignancies, a radical operation should be the first treatment option. Knowledge on molecular pathogenesis is gradually increasing. However, studies should be expanded to include larger patient cohorts, and other types of molecules should be carefully investigated and analyzed.
An Integrative Paradigm
Authors: Hammack Phillip L.
Published: October 2005

Through the application of life course theory to the study of sexual orientation, this paper specifies a new paradigm for research on human sexual orientation that seeks to reconcile divisions among biological, social science, and humanistic paradigms. Recognizing the historical, social, and cultural relativity of human development, this paradigm argues for a moderate stance between essentialism and constructionism, identifying (a) the history of sexual orientation as an identity category emerging from the medical model of homosexuality in the late 1800s; (b) the presence of same-sex desire across species, history, and cultures, revealing its normality; (c) an underlying affective motivational force which organizes sexual desire within individuals, and (d) the assumption of a sexual identity in response to the identity and behavioral possibilities of a culture. This framework considers the biology of sexual desire while simultaneously acknowledging the socially constructed nature of identity and the historical foundations of sexual orientation as a meaningful index of human identity.
Nodular Scleroderma: Increased Expression of Connective Tissue Growth Factor
Authors: Yamamoto Toshiyuki , Sawada Yasuyuki , Katayama Ichiro , Nishioka Kiyoshi
Published: October 2005

Background: Nodular scleroderma is a fibrosing reaction, presenting well-defined, firm, raised nodules, which resembles keloid. Recent studies suggest that connective tissue growth factor (CTGF) is involved in the fibrotic process, and its expression is increased in many fibrosing diseases. Objective: In this study, we report 3 cases of nodular scleroderma, and the expression of CTGF is also investigated. Methods: Three patients who developed nodular scleroderma are described. Expression of CTGF protein and transcripts in nodular scleroderma was examined by immunohistochemistry and in situ hybridization. Results: Patients were 1 female and 2 males, and all cases were associated with diffuse systemic sclerosis. Nodular lesions were found on the chest (2 cases), back (1 case), upper arm (1 case) and nape (1 case). Histology of the nodular lesions showed thickened collagen bundles in the dermis. Results of immunohistochemistry showed that expression of CTGF was detected on the sclerotic fibroblasts in the lesions of nodular scleroderma, while it was not detected in fibroblasts in normal skin. In situ expression of CTGF transcripts was abundantly detected on the fibroblastic cells in nodular scleroderma. Conclusion: Our data showed increased expression of CTGF in the sclerotic fibroblasts of nodular scleroderma, suggesting that CTGF plays an important role in its pathogenesis.
Plaque-Type Blue Nevus of the Oral Cavity
Authors: Fistarol Susanna K. , Itin Peter H.
Published: October 2005

Background: The blue nevus of the oral cavity is a rare lesion with important differential diagnoses. The plaque-type blue nevus is an uncommon variant of the blue nevus. Because of its particular clinical appearance, it can easily be confused with satellite metastases from malignant melanoma. The diagnosis usually requires a biopsy. Objectives: To describe the clinical and histological features of a plaque-type blue nevus of the buccal mucosa in a 20-year-old white woman, to review all intraoral blue nevi and all plaque-type blue nevi reported in the literature so far and to compare the criteria of blue nevi and nevus of Ota. Results: An intraoral blue nevus was described for the first time in 1959. Since then around 70 further cases have been documented. Our case is the first report of a plaque-type blue nevus of the oral cavity. Conclusions: The exceptional widespread intraoral blue nevus described herein can clinically be confused with an intraoral malignant melanoma, and it has a very similar clinical appearance as the intraoral part of nevus of Ota. Apart from the clinical resemblance, there is also some degree of histological overlap of the dermal melanocytoses. Transitional states between blue nevus and nevus of Ota may occur clinically and histologically.
Clinical and Dermoscopic Changes in Common Melanocytic Nevi in School Children: The Framingham School Nevus Study
Authors: LaVigne E.A. , Oliveria S.A. , Dusza S.W. , Geller A.C. , Halpern A.C. , Marghoob A.A.
Published: October 2005

Background: Nevi are potential precursors of malignant melanoma and are important risk factors for the development of the disease. Childhood may be a critical time for the formation and evolution of nevi. Objectives: To document the development of new nevi and to document the clinical and dermoscopic changes in index nevi in school children during a 1-year follow-up. Methods: Digital photographs and dermoscopic images of the back of subjects were compared at baseline and 1-year follow-up to assess changes in nevi counts and in clinical and dermoscopic features of index nevi. Results: Overall participation rate was 81% (42/52). 56.4% of study participants were found to have an increased number of nevi at 1-year follow-up. All nevi were small and clinically insignificant. Fifty percent of study participants were found to have dermoscopic changes in their index nevi at 1-year follow-up. Eighty-five percent of these changes were classified as subtle and 15.0% as obvious. Conclusions: A significant portion of students developed new nevi over the course of 1 year. Most index nevi remained stable in pattern and structure. Benign dermoscopic changes occurred in 50.0% of index nevi. However, none of the dermoscopically changed nevi revealed any major changes and the overall nevus pattern remained unchanged. The relevance of these changes is uncertain and further follow-up may elucidate their significance.
Deficient Production of Hexadecenoic Acid in the Skin Is Associated in Part with the Vulnerability of Atopic Dermatitis Patients to Colonization by Staphylococcus aureus
Authors: Takigawa Hirofumi , Nakagawa Hidemi , Kuzukawa Michiya , Mori Hajime , Imokawa Genji
Published: October 2005

Background and Objectives: As one of the major skin fatty acids, cis-6-hexadecenoic acid (C16:1Δ6) exhibits a specific antibacterial activity and might play a specific role in the defense mechanism against Staphylococcus aureus, in healthy subjects whereas S. aureus frequently colonizes the skin of patients with atopic dermatitis (AD). Methods: Fatty acid composition of sebum at the recovery level was analyzed by gas chromatography and S. aureus colonizing the skin was assessed by the ‘cup-scrub’ method (9 patients and 10 healthy controls). To evaluate in vivo effect of C16:1Δ6 on colonization, C16:1Δ6 was applied for 2 weeks on the upper arm skin of another group of AD patients (11 patients). Results: Analysis of sebum lipids revealed that there is a significant lower free C16:1Δ6 content in nonlesional skin from AD patients compared with healthy controls. This lower content is also accompanied by a significantly lower level of C16:1Δ6 in the total fatty acid composition of sebum (analyzed following hydrolysis). The lower level of free C16:1Δ6 correlated significantly (R2 = 0.41, p < 0.01) with the numbers of S. aureus colonizing nonlesional skin. Topical application of free C16:1Δ6 on the skin of AD patients for 2 weeks abolished the markedly increased bacterial count in 6 out of the 8 AD patients tested. Conclusions: Free C16:1Δ6 may be involved in the defense mechanism against S. aureus in healthy skin and this deficit triggers the susceptibility of the skin to colonization by S. aureus in AD.
Localization of IL-8 and Complement Components in Lesional Skin of Psoriasis vulgaris and Pustulosis palmaris et plantaris
Authors: Ozawa Maki , Terui Tadashi , Tagami Hachiro
Published: October 2005

Background: Munro’s microabscesses are a characteristic histopathologic feature of psoriasis vulgaris; however, the pathomechanisms underlying the migration of transepidermal leukocytes (PMNs) have not been fully elucidated yet. Objective and Methods: Since the lesional scale extracts contain potent chemoattractants, such as IL-8 and C5a fragments, we studied their location in the lesions of psoriasis vulgaris and PPP with immunohistochemical techniques. Results: Localization of IL-8 was not detected in the subcorneal keratinocytes but was demonstrated only in the basal keratinocytes together with migrating PMNs. In contrast, the presence of a complement fragment, C3b, was observed on the cell membranes of subcorneal keratinocytes, suggesting that these were the sites of complement activation. Conclusion: Such distinct localization of IL-8 and complement components suggests that the intraepidermal migration of PMNs takes place first according to the concentration gradient of IL-8, and thereafter they are guided by complement components to the final destination, the subcorneal portion of the lesional skin.
Alefacept in the Treatment of Psoriasis in Patients for Whom Conventional Therapies Are Inadequate
Authors: van de Kerkhof P. , Griffiths C.E.M. , Christophers E. , Lebwohl M. , Krueger G.G.
Published: October 2005

Background: Many patients with moderate to severe chronic plaque psoriasis fail to respond to or are not appropriate candidates for conventional systemic therapies and/or phototherapy. Objectives:To assess the efficacy, quality of life and safety of alefacept among the proportion of patients who participated in the phase III studies and who were not suitable candidates for conventional systemic psoriasis therapies or phototherapy. Methods: The patient’s historical responses at the baseline visit during the phase III studies of alefacept were used to identify a subpopulation in whom the use of methotrexate, ciclosporin, retinoids, ultraviolet B or psoralen plus ultraviolet A was ineffective or inappropriate. Endpoints included Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI) and adverse events. Results: Most patients (69%) who were treated with alefacept in the phase III programme were not candidates for ≧1 of the above-mentioned therapies, and 41 and 21% were not candidates for ≧2 and ≧3, respectively. A reduction in PASI of ≧75% was achieved by 27, 23 and 26% of alefacept-treated patients who were not candidates for ≧1, ≧2 and ≧3 conventional systemic psoriasis therapies or phototherapy, respectively (all p ≤ 0.001 vs. placebo). The corresponding results for PASI 50 were 53, 52 and 50% (all p ≤ 0.001 vs. placebo). At 2 weeks after the last dose of alefacept, mean DLQI overall scores were reduced by –4.2, –3.9 and –5.2, respectively (all p ≤ 0.001 vs. placebo). The incidence of adverse events was similar in the alefacept and placebo groups. Conclusions: The efficacy, quality of life effects and safety of alefacept in patients who were not candidates for conventional systemic psoriasis therapies or phototherapy were similar to those reported previously for the overall alefacept-treated population in the phase III studies.
Successful Treatment of Lymphadenosis benigna cutis with Topical Photodynamic Therapy with Delta-Aminolevulinic Acid
Authors: Takeda Hitoshi , Kaneko Takahide , Harada Ken , Matsuzaki Yasushi , Nakano Hajime , Hanada Katsumi
Published: October 2005

Background: Photodynamic therapy (PDT) using topical δ-aminolevulinic acid (ALA) has been used for nonmelanoma skin cancers, including malignant cutaneous T-cell lymphomas. Moreover, PDT has been tried for benign inflammatory or infectious skin lesions. Objective: To evaluate the effects of ALA-PDT on skin lesions of lymphadenosis benigna cutis (LABC). Patients and Methods: Two 16-year-old females with solitary and infiltrated nodules were treated 5 times with topical ALA-PDT. Results: Both patients responded well and showed dramatic clinical and histopathological improvement without visible scars. Conclusion: The results confirm that topical ALA-PDT is an effective and safe modality for the treatment of LABC, and that such treatment may be cosmetically beneficial.
Dystrophic Xanthomatosis in Primary CD30-Positive Cutaneous T-Cell Lymphoma
Authors: Giménez Sonia , Gallardo Fernando , Curcó Neus , Marcoval Joaquim , Romagosa Vicenç , Servitje Octavio , Pujol Ramon M.
Published: October 2005

The development of xanthomatous changes in lesions of primary cutaneous T-cell lymphomas (CTCL) is a rare event. It is usually observed in regressing skin tumours or plaques spontaneously or after a specific treatment. The pathogenetic mechanisms implicated in these changes are poorly understood. We are reporting 2 cases of extensive dystrophic xanthomatous changes, developing in regressing lesions of primary cutaneous CD30-positive T-cell lymphoproliferative disorders. Previously reported cases of primary CTCL developing secondary (dystrophic) xanthomata are reviewed.
Ciprofloxacin-Induced Acute Generalized Exanthematous Pustulosis Mimicking Bullous Drug Eruption Confirmed by a Positive Patch Test
Authors: Häusermann P. , Scherer K. , Weber M. , Bircher A.J.
Published: October 2005

We report the case of an 80-year-old woman presenting with ciprofloxacin-induced acute generalized exanthematous pustulosis (AGEP) confirmed by a positive patch test. Cutaneous morphology, course and histological findings were consistent with a definite diagnosis according to the AGEP validation score of the EuroSCAR study group. We point to the rarity of quinolone-induced AGEP and discuss immunological mechanisms, the value of in vivo and in vitro tests as well as the main differential diagnosis. Furthermore, we highlight in this particular case the challenging differentiation from bullous drug eruption.
Fatal CD8+ Epidermotropic Cytotoxic Primary Cutaneous T-Cell Lymphoma with Multiorgan Involvement
Authors: Marzano Angelo V. , Ghislanzoni Massimo , Gianelli Umberto , Caputo Ruggero , Alessi Elvio , Berti Emilio
Published: October 2005

A 70-year-old woman presented with a 3-month history of two ulcerated erythematous-violaceous nodular lesions over the nose and forehead, respectively. The patient’s history included a similar cutaneous nodule on the glabella diagnosed as pseudolymphoma 2 years ago.At that time, despite the diagnosis of a benign disease, an adequate staging was performed, ruling out any extracutaneous involvement. During hospitalization, multiple purpuric papules developed over the abdomen, and the disease spread to mediastinal lymph nodes, lungs and the central nervous system. Based on the histologic, immunophenotypic and molecular biology findings, a diagnosis of CD8+ epidermotropic cytotoxic primary cutaneous T-cell lymphoma was made. Secondary skin involvement by a CD8+ extracutaneous T-cell lymphoma could not be excluded with certainty, but seemed to be unlikely because of the negativity of the initial workup. The patient died from complications of right femoral artery thrombosis before starting specific polychemotherapy 21 months after onset of the disease. Among primary cutaneous T-cell lymphomas, the CD8+ epidermotropic cytotoxic subset comprises rare, highly aggressive forms characterized by metastatic spread to unusual sites such as the oral cavity, lungs, testis and the central nervous system but usually not to the lymph nodes. These cases seem to be distinct from mycosis fungoides with CD8+ phenotype, which shows a nonaggressive clinical behavior.
A Case of Lupus vulgaris Successfully Treated with Antituberculous Therapy despite Negative PCR and Culture
Authors: Akoglu Gulsen , Karaduman Aysen , Boztepe Gonca , Ozkaya Ozay , Sahin Sedef , Erkin Gul , Kolemen Fikret
Published: October 2005

A 14-year-old boy presented with a pink firm plaque with well-defined borders in the right infra-orbital skin area. On diascopy, the infiltrate exhibited a typical apple-jelly appearance. No acid-fast bacilli could be demonstrated. A polymerase chain reaction (PCR) assay did not reveal the presence of mycobacteria in a lesional biopsy sample. Culture of biopsied tissue on Loewenstein-Jensen medium was negative. Although the tuberculosis culture and PCR did not confirm tuberculosis, a diagnosis of lupus vulgaris was made considering the clinical and histopathological findings. After a 9-month antituberculous therapy, the lesion disappeared. We believe that a diagnosis of lupus vulgaris still depends more on clinical and histopathological findings than on tuberculosis culture or PCR.
Frühe Schwangerschaften – Ursachen und Möglichkeiten der ärztlichen Prävention
Authors: Gille Gisela
Published: October 2005

Die Zahlen minderjähriger Schwangerer steigen in der BRD seit Jahren kontinuierlich, parallel dazu steigen die Zahlen der Schwangerschaftsabbrüche bei Minderjährigen. Aus dem Trendvergleich wird deutlich, dass dies insbesondere und zunehmend die sehr jungen Mädchen betrifft. Auf den ersten Blick scheint das schwer verstehbar, weil die sexuelle Aufklärung ubiquitär verfügbar ist und weil nie zuvor eine Generation so unverstellten Zugang zu Kontrazeptiva hatte. Zur Klärung der Frage nach den Ursachen wird zunächst die körperliche und psychosexuelle Entwicklung von Mädchen in der Pubertät skizziert, um ableitend daraus die Defizite zu beschreiben, die die Gesellschaft im Umgang mit den tatsächlichen libidinösen Bedürfnissen junger Mädchen produziert: Mangelnde, sich an der Lebensrealität von Mädchen orientierende Aufklärung, Sexualisierung und massenmediale Stimulation, Pluralisierung von Lebensstilen, moralische Widersprüchlichkeiten, mangelnde Perspektiven am Arbeitsmarkt, Beziehungssehnsucht, Flucht in eine «heile Welt» einer eigenen kleinen Familie. Mädchen benötigen dringend kompetente, wertschätzende und praktisch umsetzbare Informationen zu den zyklischen Vorgängen im Mädchenkörper, zu Fruchtbarkeit und Schwangerschaft, mit denen ihre Fragen strukturiert und erklärbar werden und die sie wirklich handlungskompetent werden lassen – und das am besten im Vorfeld sexueller Beziehungen. Frauenärztinnen und Frauenärzte gelten hier als die idealen Ansprechpartner.
Kontrazeption bei Jugendlichen
Authors: Anthuber Sabine
Published: October 2005

Die Schwangerschafts- und Schwangerschaftsabbruchsraten bei Minderjährigen steigen in Deutschland trotz bester Verfügbarkeit von Verhütungsmittel ständig. Die entsprechenden Einrichtungen und Frauenärzte und -ärztinnen sind aufgefordert, eine bessere Beratung anzubieten und geeignete, complianceunabhängige Kontrazeptiva zu verordnen. Dazu ist es notwendig, die derzeit gültige Rechtssprechung zu beachten und die Ausführungen der AG Medizinrecht zur Verordnung von Kontrazeptiva an Minderjährige zu kennen. Orale Kontrazeptiva sind die am häufigsten verordneten Verhütungsmittel. Ihre Wirkung ist reversibel, sie sind verträglich und sicher. Neuere Entwicklungen sind Präparate mit sehr niedriger Dosierung oder mit neuen Gestagenen, die ovulationshemmmende reine Gestagenpille und die Anwendung von niedrigdosierten monophasischen Mikropillen im Langzyklus. Langzeitkontrazeptiva, wie subdermal implantierbare Stäbchen und hormonhaltige Intrauterinpessare, haben sich längst etabliert und stellen bei längerfristigem Verhütungswunsch auch bei Jugendlichen gute Alternativen zur oralen Kontrazeption dar. Das Spektrum der hormonfreisetzenden Systeme hat sich um den Vaginalring und das Verhütungspflaster erweitert. Dabei ist die Anwendung für die Frau einfach. Erwartet wird bessere Compliance und die Reduktion ungewollter Schwangerschaften durch Anwendungsfehler. Die Erweiterung des Angebotes an hoch effektiven, kontrazeptiven Systemen lässt hoffen, dass den individuellen Bedürfnissen noch besser Rechnung getragen wer den kann.
Kontrazeption des Mannes – Geeignet für Jugendliche?
Authors: Kamischke Axel , Nieschlag Eberhard
Published: October 2005

Obwohl effektive Verhütungsmethoden in Deutschland und anderen Industrienationen verfügbar sind, ist die Schwangerschaftsrate bei Teenagern weiterhin hoch. Ursächlich hierfür sind neben anderen Gründen insbesondere die Anwendung ineffektiver Methoden bzw. die fehlende Anwendung auch nur irgendeiner Verhütungsmethode. Existierende männliche Kontrazeptionsmethoden weisen entweder eine unbefriedigende Effektivität (Kondom, Koitus interruptus) auf oder sind nur bedingt reversibel (Vasektomie), was einer weiteren Verbreitung im Wege steht. Von den experimentellen Verhütungsmethoden beim Mann erscheint die hormonelle Kontrazeption zurzeit am weitesten entwickelt. Androgene sind elementarer Bestandteil der hormonellen Kontrazeptiva, da sie über eine Suppression der Gonadotropine zu einer Suppression der Spermatogenese führen und gleichzeitig den durch die Gonadotopinsuppression bedingten Androgenmangel ausgleichen. Wenn auch die Wirksamkeit einer hormonellen Methode bei Männern in klinischen Studien gezeigt werden konnte, so scheiterte die weitere Entwicklung zunächst an dem unpraktikablen Applikationsintervall bzw. an der mangelnden Effektivität der selbst anwendbaren Ansätze. Neuere effektive Ansätze in Phase II Studien konzentrieren sich daher auf die Verwendung von Androgen-Implantaten bzw. langwirksamen Testosterondepotinjektionen in Kombination mit den Gestagenen-Depots Medroxyprogesteron Azetat, Norethisteron, Desogestrel oder Etonogestrel, die zusätzlich zu den Androgenen die Gonadotropine supprimieren. Ob die hormonelle Kontrazeption beim Mann auch eine Alternative für Jugendliche darstellt bleibt nach der Markteinführung abzuwarten. Bedenken ergeben sich insbesondere hinsicht lich der Knochenreifung, da Androgene in den verwendeten Dosen einen vorzeitigen Schluss der Epiphysenfugen bewirken könnten.
Kontrazeption bei geistig und körperlich behinderten und chronisch kranken Jugendlichen
Authors: Navratil Francesca
Published: October 2005

Zunehmend viele Kinder mit Behinderungen oder chronischen Erkrankungen erreichen das Adoleszentenalter. Sie sind öfters durch Eltern, Bezugspersonen und betreuende Ärzte nicht ausreichend und adäquat über normale Pubertätsentwicklung, Sexualität, Sexualverhalten, sexuelle Aktivität, über Risikoverhalten und Eigenverantwortung sowie über mögliche sexuelle Gewalt informiert. Bei der Wahl der Kontrazeptionsmethode sollten immer sowohl die individuelle Situation und die intellektuellen und körperlichen Fähigkeiten als auch die Urteils- und Einwilligungsfähigkeit berücksichtigt werden.
Ist die frühe Kohabitarche ein Risikofaktor des Zervixkarzinoms?
Authors: Reich O.
Published: October 2005

Seit vielen Jahrzehnten gilt das Sexualverhalten als Risikofaktor des Zervixkarzinoms. Alle damit assoziierten Faktoren sind nur bei chronischer Infektion der zervikalen Transformationszone mit humanen Papillomaviren (HPV) des Hochrisikotyps von Relevanz. Mehrere retrospektive Analysen machen eine frühe Kohabitarche als krankheitsfördernden Umstand für das spätere Auftreten eines Zervixkarzinoms wahrscheinlich. Da verschiedene Risikofaktoren miteinander zusammenhängen können, ist die Frage nach dem Einzelbeitrag einer frühen Kohabitarche zur Entstehung des Zervixkarzinoms umstritten. Umsichtig geplante prospektive Studien fehlen zu diesem Thema. Vieles spricht dafür, dass die zervikale Transformation zwischen der Menarche und etwa dem 16. Lebensjahr besonders vulnerabel für HPV ist. In diesem Alter liegen während der Metaplasie eine grosse Anzahl sich umdifferenzierender Zellen an der Oberfläche der Zervix. Dies begünstigt offensichtlich stark das Angehen einer HPV-Infektion. Auch gibt es Hinweise, dass bei früher Kohabitarche oft noch keine sekundäre Immunantwort gegen HPV besteht. Dies macht die Immunantwort gegen das Virus weniger effizient. Neben einer genetischen Prädisposition sind weiterhin verschiedene Variablen des täglichen Lebens wie einseitige Ernährung, Rauchen, Entzündungen mit Chlamydien oder HSV-2, langjährige orale Kontrazeption, Drogenabusus, Immunsuppression und frühe erste Schwangerschaft als HPV-assoziierte Kofaktoren der zervikalen Karzinogenese von Bedeutung. Eine adäquate Aufklärung junger Menschen sollte deren İberzeugung fördern, dass sie aktive Gestalter ihres eigenen Lebens sind, was neben der Akzeptanz ihres sexuell reifen Körpers wesentlich auch Verantwortlichkeit im Freiraum der eigenen Lebensgestaltung bedeutet.
Theoretisch-mathematische Modelle zur Kräftewirkung bei alloplastischen Bandsystemen in der Inkontinenztherapie
Authors: Jürgens Jan , Steller Joachim
Published: October 2005

Die verschiedenen alloplastischen Bandsysteme unterscheiden sich sowohl hinsichtlich der Applikatoren, der unterschiedlichen Gewebsdichte der Prolenebänder als auch im Wesentlichen durch die verschiedenen anatomischen Verankerungspunkte. Die retropubischen Bänder werden durch das Cavum retzii, die Transobturatorbänder durch das Foramen obturatum angelegt. Eines der möglichen Komplikationsrisiken bei der Bandanlage ist das einer Überkorrektur. Die bei der Anlage und der Feinkorrektur wirkenden Kräfte der unterschiedlichen Bandsysteme werden anhand eines mathematischen Modells dargestellt. Je flacher der suburethrale Winkel bei der Bandanlage wird, umso grösser wird die anzuwendende Kraft für eine weitere Bandstraffung. Aufgrund der wirkenden Kraftvektoren erscheint bei den Transobturatorbändern eine Überkorrektur als wenig wahrscheinlich.
Plaster of Paris Mould for Stereotactic Frame Fixation
Authors: Muzumdar D.P. , Bhatjiwale M.G. , Goel A.
Published: October 2005

Stereotactic procedures have been prevalent in neurosurgical practice for a prolonged time period. With the advent of new custom-made frames designed for morphologic and functional neurosurgical procedures, its extended use in the pediatric population is becoming increasingly popular. However, there is still a need for sophistication in design and instrumentation. We describe a novel method of a plaster of Paris mould for stereotactic frame fixation, which can be a useful adjunct during frame fixation. It primarily accounts for a remarkable variation in skull shapes and sizes seen in the pediatric population undergoing stereotaxy besides many other advantages.
Superior Sagittal Sinus Thrombosis Associated with Raised Intracranial Pressure in Closed Head Injury with Depressed Skull Fracture
Authors: Tamimi A. , Abu-Elrub M. , Shudifat A. , Saleh Q. , Kharazi K. , Tamimi I.
Published: October 2005

A case of delayed signs of intracranial hypertension following closed head injury with a depressed cranial fracture and superior sagittal sinus thrombosis is reported. Conservative treatment of intracranial hypertension, including just repeated lumbar puncture and oral acetazolamide, was performed. Spontaneous recanalization of the superior sagittal sinus was observed. Pathogenesis and different modalities of treatment are discussed.
A Rare Case of Shunt Malfunction Attributable to a Broken Codman-Hakim Programmable Shunt Valve after a Blow to the Head
Authors: Okazaki T. , Oki S. , Migita K. , Kurisu K.
Published: October 2005

We report a rare case of shunt malfunction resulting from breakage of the Codman-Hakim programmable shunt valve system following a blow to the head. Originally, the patient had suffered intraventricular hemorrhage a month after birth; ventriculoperitoneal shunt was performed at 7 months. After that, the shunt valve functioned well for 7 years. The patient presented with headaches after receiving a blow behind the right ear. The headache became exacerbated with activity and improved with rest. Damage to the shunt valve was identified during surgery, with a crack at the top of the valve housing. Symptoms resolved following a change of the complete shunt system. The possibility of damage to the shunt valve following a blow should be considered in shunt patients presenting with headaches.
Spinal Seeding of a Pilocytic Astrocytoma following Multiple Subtotal Resections
Authors: Zorlu Faruk , Selek Ugur , Akyuz Canan , Ozturk Arzu , Soylemezoglu Figen , Akalan Nejat
Published: October 2005

We report the case of a 4-year-old girl presenting with spinal and leptomeningeal dissemination following several subtotal resections of cerebellar pilocytic astrocytomas.
Benign Fibrous Histiocytoma of the Sacrum – Diagnostic Difficulties Facing This Rare Bone Tumor
Authors: Balasubramanian Chandramouli , Rajaraman G. , Singh C.S. , Baliga Dilip Kumar
Published: October 2005

Benign fibrous histiocytoma of bone is rare, and this is the first report of the tumor arising from the sacrum. The descriptive histopathological picture makes the diagnosis more difficult as it resembles many benign and malignant myxoid tumors. In this case report, the diagnostic difficulties involved and a review of the literature in order to describe the optimal management of this condition, have been presented. The clinical presentation of this 18-year-old girl was that of low back ache, radiating along the right posterior leg, of 1 month’s duration. On the straight leg raising test, right-sided sciatic nerve compression was detected. Magnetic resonance imaging revealed a large tumor involving and destroying sacral segments S3–S4, homogeneous in intensity and extending into the vertebral canal and the presacral space. There was no enhancement with gadolinium contrast. Core needle biopsy revealed fibrous histiocytoma. Excision through a posterior midline incision was performed taking care to preserve the S1–S2 sacral segments and also the sacral nerves. Additional cauterization with phenol was performed. Postoperatively, the patient had significant improvement in pain with no major residual neurological deficit.
Endoscopic, Single-Catheter Treatment of Dandy-Walker Syndrome Hydrocephalus: Technical Case Report and Review of Treatment Options
Authors: Sikorski Christian W. , Curry Daniel J.
Published: October 2005

Optimal treatment for hydrocephalus related to Dandy-Walker syndrome (DWS) remains elusive. Patients with DWS-related hydrocephalus often require combinations of shunting systems to effectively drain both the supratentorial ventricles and posterior fossa cyst. We describe an endoscopic technique, whereby a frontally placed, single-catheter shunting system effectively drained the supratentorial and infratentorial compartments. This reduces the complexity and potential risk associated with the combined shunting systems required by so many with DWS-related hydrocephalus.
Endoscopic Transtentorial Ventriculocystostomy and Cystoventriculoperitoneal Shunt in a Neonate with Dandy-Walker Malformation and Associated Aqueductal Obstruction
Authors: Weinzierl Martin R. , Coenen Volker A. , Korinth Marcus C. , Gilsbach Joachim M. , Rohde Veit
Published: October 2005

Objective: Shunting of the lateral ventricle and the posterior fossa cyst is the advocated surgical therapy for children with Dandy-Walker malformation (DWM) and associated aqueductal obstruction. The high rate of complications of combined shunting stimulated the authors to search for an alternative surgical solution. Clinical Presentation/Intervention: After transtentorial endoscopic ventriculocystostomy, a cystoventricular catheter, connected to a peritoneal shunt, was placed in a neonate with DWM and associated aqueductal obstruction. Immediately prior to ventriculocystostomy, the presence of a blocked third ventricular outflow was reconfirmed by contrast medium injection. Neuronavigation was required to define the surgical path from the lateral ventricle through the tentorium and the overlying small rim of brain parenchyma into the posterior fossa cyst. The postoperative clinical course was uneventful with radiologically proven reduction of the size of the ventricular system and the cyst. Conclusion: Cystoventriculoperitoneal shunt placement after transtentorial endoscopic ventriculostomy is a surgical alternative in very young children with DWM and associated aqueductal obstruction.
Neonatal Chronic Lung Disease in the Post-Surfactant Era
Authors: Bland Richard D.
Published: October 2005

This is a brief review of neonatal chronic lung disease, sometimes called the ‘new bronchopulmonary dysplasia (BPD)’. The clinical, radiographic and pathological features of this condition have changed considerably in recent years because of major advances in perinatal care, including widespread use of antenatal glucocorticoid therapy, postnatal surfactant replacement and improved respiratory and nutritional support. Authentic animal models, featuring lengthy mechanical ventilation of surfactant-treated, premature neonatal baboons and lambs, have provided important insights on the pathophysiology and treatment of this disease. Lung histopathology after 2–4 weeks of positive-pressure ventilation with oxygen-rich gas results in failed formation of alveoli and lung capillaries, excess disordered elastin accumulation, smooth muscle overgrowth in small pulmonary arteries and airways, chronic inflammation and interstitial edema. Treatment interventions that have been tested in these animal models include nasal application of continuous positive airway pressure, high-frequency mechanical ventilation, inhaled nitric oxide and retinol. The challenge now is to improve understanding of the molecular mechanisms that regulate normal lung growth and development, and to clarify the dysregulation of lung structure and function that occurs with injury and subsequent repair so that effective treatment or prevention strategies can be devised and implemented.