bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracellular localization of a lipid transfer protein in Vigna unguiculata seeds
Authors: De O. Carvalho André , De S. Teodoro Carlos Eduardo , Da Cunha Maura , Okorokova‐Façanha Anna L. , Okorokov Lev A. , Fernandes Kátia V. S. , Gomes Valdirene M.
Published: October 2004

Lipid transfer proteins (LTP) facilitate transfer of lipids between membranes in vitro. Up to now, they have been found to be localized basically in the plant cell wall and in compartments linked to lipid metabolism, such as glyoxysomes. Accordingly, LTP are considered to be involved in the plant defence against pathogen microbes and lipid metabolism. We herein show, by immunoelectron microscopy, that besides the cell wall, LTP are localized in the lumen of organelles which we suggest to be the protein storage vacuoles, as well as in vesicles similar to the lipid‐containing ones and in the extracellular space of Vigna unguiculata seeds. To further characterize these organelles, we performed subcellular fractionation of membranes isolated from imbibed seeds on a sucrose‐density gradient. The analysis of these fractions revealed that the lightest membrane vesicles, derived probably from PSV, contain LTP, α‐TIP and K+ independent PPiase, but not γ‐TIP and K+ stimulated PPiase. The presence of LTP and vicilins (typical storage protein) in the lumen of these vesicles was confirmed by immunoelectron microscopy. Taken together, the data suggest that the intracellular LTP in the V. unguiculata seeds are localized in protein storage vacuoles and in lipid‐containing vesicles.
Role of histidines in the binding of violaxanthin de‐epoxidase to the thylakoid membrane as studied by site‐directed mutagenesis
Authors: Gisselsson Anna , Szilágyi Anna , Åkerlund Hans‐Erik
Published: October 2004

Regulation of violaxanthin de‐epoxidase (VDE) involves a conformational change at low lumenal pH, followed by binding of the enzyme to the thylakoid membrane. The role of histidine residues in this process was studied by release of unbound enzyme from thylakoids upon sonication, on a pH scale from 4.7 to 7.1. The co‐operativity for binding of spinach VDE (four histidines) to the membrane was found to be 3.8, with respect to protons, and had an inflexion point at pH 6.6, whereas VDE from wheat (three histidines) showed a co‐operativity of 2.9 and had an inflexion point at pH 6.2. Mutant forms of VDE were constructed and probed for their binding to the outside of thylakoid membranes. With one or two histidines substituted for alanine or arginine, a lower co‐operativity (1.6–2.3) was found, compared with the wild type. Based on these findings, and that the pKa value for histidine is within the range where the VDE binding takes place, we propose that protonation of the histidine residues at low pH induces the conformational change of VDE, and hence indirectly regulates binding of the enzyme to the thylakoid membrane.
Proliferation of DU145 prostate cancer cells is inhibited by suppressing insulin‐like growth factor binding protein‐2
Authors: CHATTERJEE SHILLA , PARK EUN SUNG , SOLOFF MELVYN S.
Published: October 2004

Background:  Insulin‐like growth factor binding protein‐2 (IGFBP‐2) is expressed by all human prostate cancer cell lines and dramatically increases in the serum of prostate cancer patients. However, the role of IGFBP‐2 in prostatic tumorigenesis is not known. The aim of the present study was to investigate the effects of IGFBP‐2 on the proliferation of DU145 human prostate cancer cells in culture.

Methods:  Using cell proliferation assays, we examined the effects of exogenously administered and endogenously modulated levels of IGFBP‐2 on the proliferation of DU145 cells.

Result:  Cell growth was stimulated by exogenously administered IGFBP‐2, but significantly retarded (P < 0.05) by its neutralizing antibody. Overexpression of IGFBP‐2 by transfection also stimulated cell growth, which was significantly (P < 0.05) inhibited in transfectants expressing antisense mRNA to IGFBP‐2. Furthermore, the proliferation of IGFBP‐2 overexpressing cells was significantly dampened by exogenously administered IGFBP‐2 antibody.

Conclusions:  IGFBP‐2 is an autocrine growth factor for DU145 human prostate cancer cells and cell proliferation can be significantly retarded by neutralizing or inhibiting its synthesis. These findings provide a strong rationale for targeting IGFBP‐2 in the testing of novel strategies to treat prostate cancer.
Rupture of urachal diverticulum in radiation cystitis and neurogenic bladder dysfunction after radical hysterectomy
Authors: KAWAKAMI MASAKO , IGAWA YASUHIKO , INOUE HIROO , KOIZUMI KOUJI , NISHIZAWA OSAMU
Published: October 2004

Abstract  We experienced a rare case of the rupture of the urachal diverticulum in radiation cystitis and neurogenic bladder after radical hysterectomy. A 61‐year‐old woman presented with severe lower abdominal pain and urinary retention. Abdominal computed tomography revealed that the urachal remnant contained a large volume of urine that leaked to subcutaneous tissue. We excised the urachal diverticulum and bladder together and created a continent urinary diversion using transverse colon. Nine months after the operation, the patient could manage clean intermittent self‐catheterization 6 times a day through her umbilical stoma without any urinary complications.
Echinococcosis involving the liver, retrovesical and seminal vesicle presented with syncope
Authors: OZER TULAY , GUNDOGDU SADI , OZER YETKIN , MAHMUTYAZICIOGLU KAMRAN , SAVRANLAR AHMET , OZDEMIR HUSEYIN
Published: October 2004

Abstract  Hydatid disease of the urogenital system, especially of the retroperitoneum and seminal vesicles, is a very rare condition. We report a case of hydatid disease located in the liver, retrovesical region and seminal vesicle that was diagnosed incidentally while investigating the etiology of syncope. Transabdominal and transrectal ultrasonography revealed hypoecoic multicystic masses which had thin septations and walls in the liver, retrovesical region and seminal vesicle. Abdominal computed tomography examination showed multicystic low attenuation masses in the same region. Pelvic magnetic resonance image findings revealed multiple cystic masses in the retrovesical region and the right seminal vesicle. In conclusion, the diagnosis of hydatid disease should be kept in mind with patients who have cystic lesions in seminal vesicle and retrovesical region.
Effect of treating lower urinary tract symptoms on anxiety, depression and psychiatric morbidity: A one‐year study
Authors: QUEK KIA FATT , RAZACK AZAD HASSAN , CHUA CHONG BENG , LOW WAH YUN , LOH CHIT SIN
Published: October 2004

Background:  The present study aimed to evaluate the effects of treating lower urinary tract symptoms (LUTS) on anxiety, depression and psychiatric morbidity following one year of follow‐up.

Methods:  A total of 297 patients were involved in this study. Patients were recruited into a surgical group (patients underwent transurethral resection of the prostate, n = 111), a medical group (underwent α‐blockers treatment, n = 116) and a control group (renal stones patients with no or mild symptoms of severity, n = 70). Patients were assessed on anxiety, depression and psychiatric morbidity levels before and after treatment and were followed at 3, 6 and 12 months.

Results:  The study showed that before treatment for LUTS, most of the patients, especially the surgical group compared to the medical and control groups, were more anxious, depressed and psychiatrically morbid. However, after treatment, most of the patients in the surgical group experienced a great improvement in their anxiety, depression and psychiatric morbidity level when compared to the medical and control groups. The reduction or improvement of their psychological profile was due to the reduction or total withdrawal of LUTS after treatment.

Conclusion:  Both medical and surgical treatment improved patient LUTS and thus improved their overall anxiety, depression and psychiatric morbidity.
Prostate‐specific antigen doubling time among Japanese men in an annual health screening program
Authors: TERAI AKITO , MATSUI YOSHIYUKI , ICHIOKA KENTARO , OHARA HIROKI , TERADA NAOKI , YOSHIMURA KOJI
Published: October 2004

Background:  Prostate‐specific antigen doubling time (PSA‐DT) has been studied as a parameter reflecting the biological doubling rate of clinically localized prostate cancer treated expectantly. With the use of PSA‐DT, we studied the natural history of PSA changes among Japanese men in a health screening program.

Methods:  Between July 1994 and December 2002, a cohort of 1995 men aged 40–79 years underwent a total of 5700 PSA measurements in an annual multiphasic health screening program. Prostate‐specific antigen doubling time was calculated using a log‐linear regression model for 994 (49.8%) men who had three or more serial PSA measurements with a mean follow‐up of 46.2 months.

Results:  Of the 994 men, 192 (19.3%) had a PSA‐DT of less than 10 years and 12 (1.2%) had a PSA‐DT of less than 2 years. Median PSA‐DT in 14 men with a subsequent diagnosis of prostate cancer was 41.6 months (range, 12.2 to stable). A log‐linear model statistically fitted 65 of 180 non‐cancer patients with a PSA‐DT of less than 10 years. The percentages of statistically fit cases increased with higher baseline PSA (5.3%, 7.7% and 8.7% among men with <1.0, 1.0–1.99 and 2.0–3.99 ng/mL, respectively) and older baseline age (3.7%, 8.5% and 6.9% among ages 40–49, 50–59 and 60 or older, respectively).

Conclusion:  In a small but significant portion of men, PSA increases exponentially when it is still less than 4.0 ng/mL, with a PSA‐DT of less than 10 years. The clinical significance of this finding should be evaluated by a prospective screening including biopsy.
Can normal saline be used to fill the balloon of a Foley catheter? The experience of a prospective randomized study in China
Authors: HUI JOSON , NG CHI‐FAI , CHAN LUNG‐WAI , CHAN PETER SIU‐FOON
Published: October 2004

Background:  Despite the lack of evidence, using normal saline for inflating the balloon of a Foley urethral catheter is frequently regarded as a cause for deflation failure. We have investigated the issue by comparing the rate of deflation failure of Foley catheter balloon, using either sterile water or normal saline as the filling solution.

Methods:  Four thousand latex Foley urethral catheters (14 Fr) were randomly assigned to one of two groups: sterile water or normal saline. Each of the catheter balloons would then be inflated with 10 mL of the corresponding fluid. They were subsequently put in water baths at 37°C for 4 weeks. At the end of 4 weeks, all the balloons were deflated by people who were blind to the assignment of fluid inflated. Failure of deflation was defined as the balloon not being able to be deflated completely. The number of deflation failures was recorded and the amount of fluid aspirated from each balloon was also noted.

Results:  Of the 4000 catheters, 17 (0.43%) were found to be defective and could not be used for the study. The remaining 3983 catheters were randomly allocated into the sterile water (2011) and normal saline (1972) groups. The failure rate of deflation for the sterile water group and normal saline group were 185 (9.2%) and 157 (8.0%), respectively, which was not statistically significant (P = 0.162).

Conclusion:  There was no difference in the rate of deflation failure of latex Foley balloons by using either sterile water or normal saline as the filling solution.
Non‐invasive estimation of intraurethral pressure profile from uroflowmetric curve
Authors: NISHIMOTO KEN‐ICHI , YASUDA KOSAKU , NISHIKAWA KEIICHIRO , YONEDA YUKIO , YAMANISHI TOMONORI , NAKATANI TATSUYA
Published: October 2004

Background:  An intraurethral pressure‐time profile as urodynamic information was obtained in a non‐invasive manner using an equivalent equation as a voiding model.

Methods:  The reasonability of the voiding model was confirmed by applying it to an experimental flow curve likened to urinary flow. The flow curve was approximated and the pressure profile was estimated. From the uroflowmetric curves obtained in a normal subject and a patient with bladder outlet obstruction, the respective intraurethral pressure profiles were estimated.

Results:  The pressure profile estimated from the approximated flow curve was found consistent with the profile of the difference between the pressure actually measured at two different portions in the experimental system.

Conclusion:  Non‐invasive estimation of intraurethral pressure profile from uroflowmetric curves may be very useful to grasp intraurethral urodynamic information in clinical practice.
Expression of nitric oxide and inducible nitric oxide synthase in acute renal allograft rejection in the rat
Authors: SUZUKI AKIO , KUDOH SHIGEMASA , MORI KAZUYUKI , TAKAHASHI NOBUYOSHI , SUZUKI TADASHI
Published: October 2004

Background:  Recent studies have shown that nitric oxide (NO) synthases, particularly inducible nitric oxide synthase (i‐NOS), are induced in acute rejection episodes following heart, liver, pancreas and kidney allotransplantation. Furthermore, tissue and cellular injury has been demonstrated to be mediated by peroxynitrite (ONOO‐), a metabolite of NO as well as a potent oxidant. However, a detailed relationship between NO, i‐NOS and graft injury in transplantation remains elusive.

Methods:  The present study used the following models of renal transplantation in rats: allografts (n = 5, Brown–Norway to Lewis [LEW] rats), isografts (n = 5, LEW to LEW) and allografts treated with aminoguanidine (AG), an i‐NOS inhibitor (n = 5). Blood urea nitrogen (BUN), serum creatinine (SCr) and urinary and serum nitrosocompounds (NOx) were measured on days 2, 4 and 7 post‐transplant. Western blot analysis of i‐NOS protein expression and measurement of i‐NOS activity were carried out in grafts harvested on Day 7, along with immunohistochemical and histopathological examinations.

Results:  In the allograft group, both BUN and SCr levels increased markedly on Day 7, in parallel with a sharp increase in NOx. A band stained by anti‐i‐NOS antibody was detected at approximately 130 kDa, along with high levels of i‐NOS activity and diffusely distributed i‐NOS‐positive cells (macrophages). Histologically, an acute rejection episode was confirmed (Grade 3 according to Banff classifications). In the AG group, reduced renal function and graft injury were significantly less severe than in the allograft group.

Conclusions:  In rat renal allograft acute rejection, markedly increased levels of serum NOx were observed, along with enhanced tissue i‐NOS activity, together resulting in graft injury. AG administration suppressed the increase of serum NOx levels, with concomitant mitigation of tissue injury and renal function impairment.
Long‐term survival following radical prostatectomy in Japanese men with clinically localized prostate cancer: A single institutional study
Authors: HACHIYA TAKAHIKO , OKADA YASUHIRO , KAWATA NOZOMU , HIRANO DAISAKU , YOSHIDA TOSHIO , OKADA KIYOKI , TAKIMOTO YUKIE
Published: October 2004

Background:  We evaluated the outcome of radical prostatectomy to provide information about long‐term survival following this procedure.

Methods:  One hundred and twenty‐three otherwise healthy Japanese patients with clinically localized tumors underwent radical prostatectomy. Treatment outcomes were measured in terms of clinical progression‐free survival, prostate cancer‐specific survival and overall survival. Overall survival was compared with expected survival of age‐matched Japanese men.

Results:  For these 123 patients, clinical progression‐free survival and prostate cancer‐specific survival at 10 years were 72.5% and 86.4%, respectively. Results of Cox multivariate analysis showed that only pathological stage (P = 0.047) and tumor grade (P = 0.009) were independent predictors of clinical progression. Only tumor grade was a statistically significant independent predictor (P = 0.048) in terms of prostate cancer death. Both the 10 and 15‐year overall survival rates for these 123 patients were 58.6%, whereas the expected survival of age‐matched Japanese men was 65.0% at the 10‐year follow up, and 43.8% at the 15‐year follow up.

Conclusions:  The long‐term overall survival in this surgically treated group is comparable to the expected survival rate of age‐matched Japanese men. These results might be useful in counselling patients with clinically localized prostate cancer.
Progressive anemia following combination therapy with interferon‐α and interleukin‐2 in a patient with metastatic renal cell carcinoma
Authors: HOSOKAWA YUKINARI , KISHINO TATSUKI , ONO TAKAMASA , OYAMA NOBUO , HAYASHI KUNIO , MOMOSE HITOSHI
Published: October 2004

Abstract  Various toxicities have been observed during the treatment of advanced renal cell carcinoma with interferon‐α (IFN‐α) and/or interleukin‐2 (IL‐2). We report a case of severe anemia, which responded well to steroid therapy, in a patient receiving IL‐2 plus IFN‐α for metastatic renal cell carcinoma.
Influence of pretransplant dialysis modality on the change of lymphocyte subset populations and acute rejection rates after renal transplantation
Authors: SATOH SHIGERU , TSUCHIYA NORIHIKO , SATO KAZUNARI , OHTANI HIROSHI , KOMATSUDA ATSUSHI , HABUCHI TOMONORI , KATO TETSURO
Published: October 2004

Background:  The influence of dialysis modality on the acute rejection (AR) rate after renal transplantation is controversial. We investigated whether the pretransplant dialysis modality correlated with the lymphocyte subset populations and the incidence of AR after renal transplantation.

Methods:  Thirty‐eight first living renal transplant recipients, consisting of 22 patients on pretransplant hemodialysis (HD) and 16 patients on pretransplant peritoneal dialysis (PD), were studied. Peripheral blood samples were taken on days ‐1 through 28 after transplantation, and the lymphocyte fractions were exposed to the monoclonal antibodies anti‐CD3, CD19, CD4, CD8 and CD28 for a flow cytometer analysis. Biopsy specimens were obtained at the time of presumed AR episodes and on day 28 after transplantation.

Results:  The PD patients had a higher frequency of AR (37.5% in PD vs 9.1% in HD patients, P = 0.034). In contrast, two HD patients showed graft loss at 18 and 30 months after transplantation. The increases of CD3, CD19, CD4 and CD4+ CD28+ cells in the PD patients occurred earlier than in the HD patients and the numbers of these cells in the PD group were higher than those in the HD between days 3–28 after transplantation, most significantly on day 7.

Conclusions:  These findings suggest that the PD patients with similar clinical characteristics could potentially have a higher immunocompetence and immune responsiveness associated with a higher rate of AR in the early stage of renal transplantation when compared with the HD patients.
Stones in anomalous kidneys: Results of treatment by shock wave lithotripsy in 150 patients
Authors: TUNC LUTFI , TOKGOZ HUSNU , TAN MUSTAFA OZGUR , KUPELI BORA. , KARAOGLAN USTUNOL , BOZKIRLI IBRAHIM
Published: October 2004

Objective:  To determine the efficacy of shock wave lithotripsy (SWL) in anomalous kidneys.

Methods:  From October 1990 to October 2002, 150 patients (93 men and 57 women) with anomalous urinary tracts, including 45 horseshoe kidneys, 57 duplex kidneys, 30 malrotated kidneys, 14 pelvic and four crossed ectopic kidneys were treated with SWL for urolithiasis at the Gazi University Faculty of Medicine. Shock wave lithotripsy was performed with Siemens Lithostar plus (Siemans, Erlanger, Germany) device and all procedures were carried under fluoroscopic control.

Results:  The mean shock wave number and intensity received by the patients was 3770 (range, 1380–4100) shocks and 18.4 (range, 16.1–19) kV per session, respectively. The minimum success rate was obtained in patients with lower calyceal (50%) followed by middle calyceal (60%) calculi. The stone‐free rate decreased and the number of sessions per patient increased with increasing stone diameter (dm). In patients with a stone dm > 30 mm, only 34% could be stone‐free, compared to a rate of 92% for calculi dm < 10 mm. The overall stone free rate at the third month was 68%. The best stone‐free rates were obtained in patients with ureteral duplication (80.7%). The stone‐free rates in horseshoe, malrotated, pelvic and crossed ectopic kidneys were found to be 66.7%, 56.7%, 57.2% and 25%, respectively.

Conclusion:  Shock wave lithotripsy might be an effective and minimally invasive treatment alternative in stone‐bearing anomalous kidneys. The type of anomaly, stone burden and localization seem to be the main parameters effecting the treatment success.
Bilingualism and systemic psychotherapy: some formulations and explorations
Authors: Karamat Ali Ramón
Published: October 2004

Bilingualism has risen dramatically due to increased migration patterns all over the world. This paper offers an overview of the current literature dealing specifically with bi‐ and multilingualism, and identifies a gap in systemic and family therapy literature about the subject of bilingualism. In the light of this, the author proposes a working definition of bilingual families. Some case examples illustrate different aspects of working systemically with a bilingual family and highlight potential challenges for a therapist, such as the assumption of more knowledge and expertise. The tools suggested relate to a rethinking of some modernist ideas regarding hypothesizing, and both the use of a social constructionist perspective and of self of the (bilingual) family therapist. A case is made for the exploration of meanings of difference including the lingua‐cultural one. The author ends with a plea to start including more specific cultural issues such as bilingualism in systemic therapy practice.
Power in relationships of women with depression
Authors: Byrne Michael , Carr Alan , Clark Marie
Published: October 2004

To identify marital power difficulties specifically associated with depression, twenty couples in which the female partner was depressed were compared on a range of interpersonal power variables with twenty healthy control couples and also with twenty couples in which the female partner had a disorder other than depression (specifically panic disorder with agoraphobia (PDA)). Couples in the depressed group had two features that distinguished them from couples in both the PDA and control groups and which were independent of relationship dissatisfaction. In the depressed group, both partners reported more physical assault in the year prior to the study and depressed women were more dissatisfied with their control of surplus spending money. Couples in the depressed group had a series of features that distinguished them from couples in both the PDA and control groups but which were due in part to relationship dissatisfaction. Depressed women were less committed to their relationships. Both partners in depressed couples reported more demand–withdraw transactions and less mutual constructive communication within their relationships. Depressed women reported more dissatisfaction with decision‐making and greater dissatisfaction in childcare task distribution.
Revelation, Scripture and Tradition: Some Comments on John Webster's Conception of ‘Holy Scripture’
Authors: D’Costa Gavin
Published: October 2004

Abstract:  John Webster's Holy Scripture: A Dogmatic Sketch (2003) is summarized, praised for its various strengths, and subjected to critical theological analysis. I argue that finally Webster's arguments fall short of what he wants to preserve: that in holy scripture we are confronted by God's Word, interpreted through his Spirit. It falls short precisely because the authoritative role of tradition is underplayed. Internal to Webster's argument the conceptual priority of sanctification to inspiration is called into question. I approach this criticism of Webster from a close inspection of his treatment of the Roman Catholic position on the matter.
A Unified Theory of the Atonement
Authors: Spence Alan
Published: October 2004

Abstract:  Following Aulén, three broad, and competing, models of the atonement are outlined in this article, and an argument is offered to suggest that the mediatorial model should be considered normative. The argument proceeds through discussion with N.T. Wright's adoption of the victory model as normative in his expositions of Pauline theology. It is here suggested that the victory model is inherently unsuitable as a paradigm for the soteriology of Romans, and argued that the assertion that it can explain the process of reconciliation lacks foundation. Further, there is indication as to how the occasional language of victory in the New Testament can often be incorporated naturally within a mediation framework.
Assessment of tumor hemodynamics in small hepatocellular carcinoma: comparison of Doppler ultrasonography, angiography‐assisted computed tomography, and pathological findings
Authors: Kumada Takashi , Nakano Satoshi , Toyoda Hidenori , Hayashi Kazuhiko , Kiriyama Seiki , Sone Yasuhiro , Tanikawa Makoto , Hisanaga Yasuhiro , Yamamoto Akiko , Takeshima Kenji , Hibi Toshio , Yabashi Toshitake , Noda Takahiro , Sassa Toshi , Furukawa Masakazu , Ogawa Sadanobu
Published: October 2004

Abstract: Aim: We evaluated the usefulness of Doppler ultrasonography (DUS) for the analysis of tumor hemodynamics in small hepatocellular carcinoma (HCC).

Methods: We compared Doppler ultrasound (DUS) findings with angiography‐assisted computed tomography (Angio‐CT) such as CT during arterial portography and during hepatic arteriography in the evaluation of the intratumoral hemodynamics, and with pathologic findings in 45 small HCC nodules (≤3.0 cm in diameter) of 43 patients. DUS flow pattern of each nodule was categorized into three types: afferent continuous flow (Type 1), afferent pulsatile flow with afferent continuous flow (Type 2), and afferent pulsatile flow without afferent continuous flow (Type 3). Intratumoral blood supply was determined by Angio‐CT, and pathologic findings were evaluated on resected or biopsied specimen.

Results: Based on Angio‐CT findings, Type 1 nodules showed decreased arterial blood supply (ABS) without decreased portal blood supply (PBS). Type 2 nodules showed unchanged ABS but decreased PBS. Type 3 nodules showed both increased ABS and decreased PBS. DUS findings well represented blood supply of HCC evaluated by Angio‐CT. In addition, all Type 1 and 2 nodules were well‐differentiated HCC, and all Type 3 nodules were moderately or poorly differentiated HCC; DUS findings well reflected differentiation of HCC.

Conclusions: DUS is a non‐invasive imaging method and can be used for the evaluation of the stage of malignancy of small HCC.
The role of transcatheter arterial embolization in patients with resectable hepatocellular carcinoma: a nation‐wide, multicenter study
Authors: Huang Yi‐Hsiang , Chen Chien‐Hung , Chang Ting‐Tsung , Chen Shinn‐Cherng , Wang Shen‐Yung , Lee Pui‐Ching , Lee Hsuan‐Shu , Lin Pin‐Wen , Huang Guan‐Tarn , Sheu Jin‐Chuan , Tsai Hong‐Ming , Chau Gar‐Yang , Chiang Jen‐Huei , Lui Wing‐Yiu , Lee Shou‐Dong , Wu Jaw‐Ching
Published: October 2004

Abstract: Purpose:The role of transcatheter arterial embolization (TAE) for patients with resectable hepatocellular carcinoma (HCC) is controversial. Analyzing a cohort of nation‐wide data can delineate the beneficial effect of TAE for those patients.

Methods:From 1991 to 1995, 818 patients who had potentially resectable HCC from four medical centers in Taiwan were enrolled. Among them, 599 underwent curative resection, 157 received TAE and 62 received supportive treatment alone. The survivals among the three groups were compared.

Results:The 5‐year survival rates for patients who underwent surgery, TAE and supportive treatment were 43.6%, 25.6% and 3.7%, respectively. Surgery offered the best survival for those patients. TAE could also prolong survival as compared with supportive treatment (P=0.0001). However, among patients who were in advanced tumor stage (Cancer and the Liver Italian Program (CLIP) score ≥2), no statistical difference in survival was noted between patients who underwent TAE or supportive treatment. In multivariate analysis, single tumor, serum albumin ≥3.5 g/dl, tumor size less than 5 cm, early‐stage tumor (CLIP score=0–1) and aggressive treatment including surgery and TAE were independent factors associated with a better survival.

Conclusions:Surgery is superior to TAE for patients with resectable HCC. In patients who refuse surgery, TAE can be considered for selected patients whose tumors are in early stage.
Circulating endogenous cannabinoid anandamide and portal, systemic and renal hemodynamics in cirrhosis
Authors: Fernández‐Rodriguez Conrado M. , Romero Julian , Petros Timothy J. , Bradshaw Heather , Gasalla José M. , Luisa Gutiérrez Maria , Lledó José L. , Santander Cecilio , Pérez Fernández Teresa , Tomás Esperanza , Cacho Guillermo , Michael Walker J.
Published: October 2004

Abstract: Background: Endocannabinoids may participate in the homeostasis of arterial pressure. Recently, anandamide, the most extensively studied endocannabinoid, has been proposed as a key mediator in the peripheral arterial vasodilation of cirrhosis.

Objectives: To determine if circulating levels of anandamide are related to the extent of the peripheral arterial vasodilation, the severity of portal hypertension and the degree of liver and renal dysfunction of patients with cirrhosis.

Methods: Plasma levels of anandamide and several systemic, portal and renal hemodynamic parameters were determined in 18 patients with cirrhosis and eight healthy subjects (control group).

Results: Plasma levels of anandamide were elevated in patients compared to the control group (P<0.05), nevertheless, no differences between patients with ascites and well‐compensated patients were found. There was no correlation between anandamide concentration and arterial pressure, cardiac output and systemic vascular resistance, Child–Pugh's score, portal pressure, renal vascular resistance, plasma renin activity or plasma aldosterone concentration.

Conclusions: Circulating levels of anandamide are increased in cirrhotic patients. However, this elevation was unrelated to the extent of arterial vasodilation, the severity of portal hypertension or the degree of hepatic and renal dysfunction. Although a local hormonal action cannot be excluded, our results do not support a relevant contribution of this system in the hemodynamic disturbance of cirrhosis.
Calcineurin inhibition and disease recurrence in the hepatitis C virus‐positive liver transplant recipient
Authors: Pollard Stephen
Published: October 2004

Abstract: Development of hepatitis C virus (HCV)‐related disease following liver transplantation is more aggressive than in non‐transplant individuals, and accounts for approximately 10% of liver allograft failures. HCV disease progression appears to have accelerated in recent years, possibly due to the aging donor population and/or changing immunosuppression regimens, and survival among HCV‐negative patients is falling. Various risk factors have been proposed for HCV disease recurrence, but choice of calcineurin inhibitor is one of the few that can potentially be modified by the physician. Cyclosporine (CsA) has been shown in vitro to suppress HCV replication as effectively as interferon alpha (IFN‐α), an effect that is separate from the immunosuppressive activity of CsA. Data from bone marrow patients and non‐transplant patient populations confirm that CsA inhibits HCV replication. This anti‐HCV effect is not seen with tacrolimus. Histologically, there is evidence that progression of fibrosis in HCV‐positive liver transplant patients may be slower with CsA than tacrolimus. The clinical implications of the anti‐HCV effect of CsA require evaluation versus tacrolimus in a large‐scale multicenter study.
Effects of venesections and restricted diet in patients with the insulin‐resistance hepatic iron overload syndrome
Authors: Piperno Alberto , Vergani Anna , Salvioni Alessandra , Trombini Paola , Viganò Mauro , Riva Alessia , Zoppo Adele , Boari Giuseppe , Mancia Giuseppe
Published: October 2004

Abstract: Goal: We evaluated the effect of venesections and restricted diet on iron and metabolic indices and liver function tests in patients with insulin‐resistance hepatic iron overload (IR‐HIO).

Materials and methods: Patients were divided in three groups: (a) patients without any therapy who were followed‐up for 36+28 months; (b) patients venesected; and (c) patients on dietary treatment. In each group baseline and end‐point levels of serum iron and metabolic indices, and liver function tests were compared by Student's paired t‐test and the relationship between serum ferritin and the other variables during treatment was evaluated by linear regression analysis.

Findings and conclusions: In the follow‐up group, iron and metabolic indices did not change over time. Serum alanine aminotransferase, γ‐glutamyl transferase, cholesterol and triglycerides significantly decreased after iron depletion. Serum glucose, cholesterol, triglyceride, ferritin and liver function tests significantly decreased after dietary treatment. Transferrin saturation decreased below 20% during phlebotomy treatment in 52% of the patients. In conclusion, our results show that IR‐HIO patients had relatively low amount of iron overload that seems not to increase even after a long follow‐up period. Both venesections and diet improved iron, metabolic and hepatic indices. Data suggest a relationship between hepatic iron overload and insulin resistance, and a role for both iron overload and insulin resistance in hepatocellular damage. The behaviour of iron indices during venesections suggests an impaired iron release from hepatic cells.
Early start on continuous hemodialysis therapy improves survival rate in patients with acute renal failure following coronary bypass surgery
Authors: Sugahara Souichi , Suzuki Hiromichi
Published: October 2004

Acute renal failure requiring dialysis therapy after cardiac surgery occurs in 1% to 5% of patients; however, the optimal timing for initiation of dialysis therapy still remains undetermined. To assess the validity of early start of dialysis therapy, we studied the comparative survival between 14 patients who started to receive dialysis therapy when urine volume decreased to less than 30 mL/hr and another group of 14 patients who waited to begin dialysis therapy until the level of urine volume was less than 20 mL/hr for 14 days following coronary bypass graft surgery. Twelve of 14 patients who received early intervention survived. In contrast, only 2 of 14 patients in the late‐dialysis group survived. There was a significant difference in survival between the two groups (p < 0.01). There were no significant differences between the two groups with respect to age, sex ratio, the APACHE (Acute Physiologic and Chronic Health Evaluation) II score, and the levels of serum creatinine at the start of dialysis therapy (2.9 ± 0.2 mg/dL vs. 3.1 ± 0.2 mg/dL), as well as the levels of serum creatinine at admission. We propose that the timing of the start for treatment of acute renal failure following cardiac surgery should be determined by the decrease of urine volume and not the levels of serum creatinine. Early start of dialysis therapy may help improve the survival of patients with acute renal failure following cardiac surgery.
Thrombotic events and markers of oxidation and inflammation in hemodialysis
Authors: Schwing William D , Erhard Penny , Holloman Cynthia K , Weigel Kelly A , Blankschaen Susan C , Anderson James M , Siegel Christopher T , Seaman David S , Valente John F , DeOreo Peter B , Weiss Miriam F
Published: October 2004

The goal of this study was to determine whether antioxidant therapy with vitamin E would alter the rate of vascular access complications or other macrovascular complications in hemodialysis (HD) patients. A secondary goal of the study was to explore the relationship between baseline pretreatment markers of oxidative stress (the advanced glycation end product pentosidine and basal levels of vitamin Eα and γ) and the subsequent development of access failure. Thirty‐five stable patients treated by HD were recruited for the study. Patients were provided with vitamin E (800 IU) or placebo capsules to be taken daily. Clinical variables, vascular access function (flow meter access flow measurements), and circulating blood markers were obtained initially and every 3 months throughout the study. Vitamin Eα levels rose in treated patients from 12.7 ± 4.4 to 25.1 ± 15.1 µg/mL at 3 months and 28.6 ± 14.8 µg/mL at 6 months. Vitamin Eγ levels fell in treated patients from 3.9 ± 1.7 to 2.3 ± 1.5 µg/mL at 3 months and 1.7 µg/mL at 6 months. Patients who subsequently developed repeated thrombotic vascular access events were characterized by higher baseline pentosidine content of circulating proteins. Patients who developed a myocardial infarction had higher pentosidine, lower vitamin Eα, and much lower vitamin Eγ than patients who did not develop thrombotic events. These findings lead to the speculation that the anti‐inflammatory effects of vitamin Eγ may play a more important role in thrombotic vascular events than the antioxidant effects of vitamin Eα. Additional studies of these interactions are in progress.
Differences in cardiovascular mortality rates among hemodialysis patients in the United States and Japan: The importance of background cardiovascular mortality
Authors: Kuhlmann Martin K , Yoshino Maki , Levin Nathan W
Published: October 2004

Mortality rates among hemodialysis patients differ greatly among the United States, Europe, and Japan and it has been hypothesized that this is mainly due to differences in practice patterns. Results from the international DOPPS study, however, indicate that differences in practice patterns among the United States, Japan, and Europe are small and not alone explanatory for the differences in mortality rates. Ethnic variability in predisposition to atherosclerotic cardiovascular disease in the general population may lead to significant differences in background cardiovascular mortality in the United States, Japan, and Europe. It is our hypothesis that cardiovascular mortality in dialysis patients is to a great extent dependent on cardiovascular background mortality of the general population. We are currently studying the relationship between all‐cause and cardiovascular death rates in countries worldwide using the WHO database. Preliminary data from 35 countries show that all‐cause and cardiovascular death rates differ significantly among regions, with Eastern European countries reporting four‐ to sevenfold higher death rates than Asian countries. A strong linear relationship between cardiovascular and all‐cause death rates is observed among these countries. The next step of our study will be to compare country‐specific cardiovascular death rates of dialysis populations with those of the respective general populations. Ethnic differences in cardiovascular morbidity and mortality may be explained by genetic variability based upon polymorphism of genes involved in the pathogenesis of atherosclerosis and myocardial infarction.
Palæohydrology of the calcsilicate aureole of the Beinn an Dubhaich granite, Skye, Scotland: a stable isotopic study
Authors: HOLNESS M. B. , FALLICK A. E.
Published: October 2004

The contact aureole developed in siliceous carbonates surrounding the Beinn an Dubhaich granite, Skye, shows textural and stable isotope evidence for infiltration of aqueous fluids during both prograde and retrograde metamorphism. Strongly depleted isotope compositions of reaction‐product calcite correlate with high silica and fluorine contents, demonstrating a strong link between isotopic alteration and metasomatism by fluids with a significant magmatic component, even at the margins of the aureole. The oxygen and carbon isotope compositions of the carbonates form a linear cluster with a positive slope of about five, consistent with the depletion of isotope compositions by the infiltration of magmatic and/or meteoric fluids. Rayleigh fractionation during devolatilization played a minor role in determining the final isotope composition.

Stable isotope compositions of coexisting calcite–dolomite pairs show varying amounts of isotopic disequilibrium, which correlate with the inferred fluid infiltration mechanism. Much of the calcite in dolostones is the product of infiltration‐driven reactions along fractures, and is greatly depleted isotopically relative to the host dolomite, especially at talc grade. At higher grades the calcite–dolomite fractionation is smaller, probably due to both increased fluid–rock interaction and a greater tendency for fluid infiltration to be pervasive on the grain‐scale. Limestones generally show near‐equilibrium fractionation of oxygen and carbon owing to the overwhelming compositional influence of the host calcite. Veins formed during late‐stage hydrothermal circulation have strongly 18O‐depleted compositions relative to the host rock.

No small‐scale spatial patterns to the isotopic depletion were observed, but the extent of fluid infiltration was greatest in the west of the aureole. Fluid infiltration was clearly highly heterogeneous, with no evidence of a consistent flow direction. It is not possible to determine fluid fluxes or flow directions from one‐dimensional flow models based on continuum flow in the Beinn an Dubhaich aureole.
Three‐dimensional quantitative textural analysis of metamorphic rocks using high‐resolution computed X‐ray tomography: Part II. Application to natural samples
Authors: DENISON* C. , CARLSON† W. D.
Published: October 2004

Three‐dimensional quantitative textural analysis coupled with numerical modelling has been used to assess the dominant mechanisms governing crystallization of garnet porphyroblasts in rocks from diverse regional metamorphic environments. In every case, spatial dispositions, crystal size distributions, and compositional zoning patterns of porphyroblasts indicate the dominance of diffusion‐controlled nucleation and growth mechanisms.

Nine samples from three geological areas were studied: a suite of semi‐pelitic rocks from the Picuris Mountains, New Mexico (USA); a suite of mafic samples from the Llano Uplift, Texas (USA); and a kyanite schist from Mica Dam, British Columbia (Canada). The semi‐pelitic suite exhibits post‐deformational garnet growth, whereas garnet in the mafic suite and in the kyanite schist grew synkinematically in rocks displaying weak and strong penetrative fabrics, respectively.

For each sample, the centres and radii of thousands of garnet crystals were located and measured in three dimensions, using images produced by high‐resolution computed X‐ray tomography. Statistical measures of the degree of ordering and clustering of nucleation sites, and estimates of crystal isolation for each porphyroblast, were then computed from the measured spatial dispositions. These measures can be reproduced in simple numerical models only by diffusion‐controlled nucleation and growth mechanisms. Normalized radius‐rate relations computed from compositional zoning patterns in the garnets require thermally accelerated diffusion‐controlled growth, providing independent confirmation of the conclusions based on textural analysis. The unexpected similarity of results from all samples indicates that diffusion‐controlled nucleation and growth mechanisms may govern porphyroblast crystallization in many metamorphic regimes.
TEM and XRD determination of crystallite size and lattice strain as a function of illite crystallinity in pelitic rocks
Authors: JIANG W.‐T. , PEACOR D. R. , ÁRKAI P. , TÓTH M. , KIM J. W.
Published: October 2004

Average crystallite size and mean‐square strain of illite in rock specimens and clay separates were measured independently in TEM images and by single‐line Fourier (Voigt method) profile analysis of thec. 1 nm peak of XRD patterns for a prograde sequence of pelitic rocks (illite crystallinity indices=0.17–0.58°Δ2θ) from the Gaspé Peninsula, Quebec. The TEM‐determined crystallite sizes in clay separates approximate those determined by Fourier profile analyses and those calculated from illite crystallinity indices by the Scherrer equation, with the exception of the diagenetic sample. The crystallite sizes and mean‐square strains of illite in rock samples exhibit a trend similar to that determined by profile analyses, but the average crystallite sizes are up to five times larger than those measured for clay separates.

TEM images show that all rock samples have a wide range of crystallite sizes, and the proportions of larger crystallites increase with metamorphic grade. The diagenetic illite is defect‐rich, fine‐grained (mean thickness by volume=c. 70 nm), 1Mdmaterial. Anchizonal illite tends to occur as separate aggregates of small 1Mdand larger 2M1crystals (c. 200 nm), comprising arrays of subparallel coalescing packets. The epizone sample has thick (c. 400 nm), defect‐free crystals of muscovite occurring in stacks of parallel layers, or subhedral crystals intergrown with large‐angle boundaries. Cleaved crystals that are free of intracrystalline layer terminations are dominant in clay separates of all samples, having ranges of smaller sizes with volume‐average thicknesses ofc. 43, 43, and 81 nm (c. 14, 28, 67 nm by the Voigt method), respectively, for the three zones.

The results suggest that illite crystallinity indices do not provide a direct measure of a single microstructural state of illite in rocks, although they yield consistent limits for average crystallite sizes for the anchizone (23 & 48 nm here). Therefore, they serve as a general parameter of the degree of recrystallization on a relative basis, in part because the contributions of all peak‐broadening variables (mixed layering, size and strain) decrease regularly with prograde regional metamorphism of pelites. The microstructural changes caused by rock disaggregation are probably a function of those variables as well. The data collectively demonstrate a trend from metastable, defect‐rich, small crystals towards a stable assemblage of larger, defect‐free crystals, through dissolution of strained crystals and neocrystallization, consistent with the Ostwald step rule.
Equilibration and reaction in Archaean quartz‐sapphirine granulite xenoliths from the Lace kimberlite pipe, South Africa
Authors: DAWSON J. B. , HARLEY S. L. , RUDNICK R. L. , IREL T. R.
Published: October 2004

Ultrahigh‐temperature quartz‐sapphirine granulite xenoliths in the post‐Karoo Lace kimberlite, South Africa, comprise mainly quartz, sapphirine, garnet and sillimanite, with rarer orthopyroxene, antiperthite, corundum and zinc‐bearing spinel; constant accessories are rutile, graphite and sulphides. Comparison with assemblages in the experimentally determined FMAS and KFMASH grids indicates initial equilibration at >1040 °C and 9–11 kbar. Corona assemblages involving garnet, sillimanite and minor cordierite developed on a near‐isobaric cooling P–T  path as both temperature and, to a lesser extent, pressures decreased. Garnet‐orthopyroxene Fe‐Mg exchange thermometers record temperatures of only 830–916 °C. These estimates do not indicate the peak metamorphic conditions but instead reflect the importance of post‐peak Fe‐Mg exchange during cooling. Correction of mineral Fe‐Mg compositions for this exhange using a convergence approach of Fitzsimons & Harley (1994) leads to retrieved P–T  estimates from garnet‐orthopyroxene thermobarometry (c. 1000 °C and 10.5±0.7 kbar) that are consistent with the petrogenetic grid constraints. U‐Pb dating of a single zircon grain gives an age of 2590±83 Ma, interpreted as the age of the metamorphic event. Protolith major and trace element chemistries of the xenoliths differ from sapphirine‐quartzites typical of the Napier Complex (Antarctica) but are comparable to less siliceous, high Cr and Ni, sapphirine granulites reported from several ultrahigh temperature granulite terranes.