bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Surgical Approaches for the Management of Tremor: Radiofrequency Thalamotomy, Gamma Knife Thalamotomy and Thalamic Stimulation
Authors: Niranjan Ajay , Jawahar Ajay , Kondziolka Douglas , Lunsford L. Dade 
Published: April 2003

<i>Objective:</i> Between April 1994 and January 1999, 39 stereotactic procedures for patients with intractable tremor were performed at the University of Pittsburgh Medical Center. A retrospective analysis of results of radiosurgical thalamotomy (n = 15), MR-guided stereotactic radiofrequency thalamotomy (n = 13), and deep brain thalamic stimulation (DBS; n = 11) was performed to study relative advantages and risks of these procedures. <i>Methods:</i> All options were discussed with the patients, but radiosurgery usually was performed in elderly patients with concurrent medical problems. Stereotactic thalamotomy and DBS was performed with MR guidance and macrostimulation. For radiosurgery, a median dose of 140 Gy (range 130–150 Gy) was delivered using a single 4-mm collimator. <i>Results:</i> Of the 13 patients who underwent radiofrequency thalamotomy, 5 had immediate complete arrest of tremor, 6 had a significant reduction and 2 had partial reduction. All 11 patients who underwent DBS had excellent control of tremor immediately after the procedure, and in longer-term follow-up 10/11 maintained excellent tremor control. Of the 12 evaluable radiosurgery patients, 10 noted excellent relief and 2 had partial relief. <i>Conclusion:</i> Stereotactic procedures for tremor control are safe and effective. Each procedure has specific advantages and disadvantages that are important for patient selection.
Fractionated Stereotactic Radiosurgery for Treatment of Acoustic Neuromas
Authors: Song Dan Y. , Williams Jeffery A. 
Published: April 2003

<i>Background:</i> Microsurgery and single-fraction radiosurgery for acoustic neuromas are associated with high rates of control, but can result in facial palsy and trigeminal neuropathy. To reduce the morbidity of treatment for acoustic neuromas while maintaining efficacy, we explored fractionated stereotactic radiosurgery (FSR). <i>Methods:</i> We reviewed data for 31 acoustic neuromas in 30 patients treated with 25 Gy (linear accelerator) given in 5 consecutive daily fractions. The minimum follow-up was 6 months (6–44 months). The mean tumor volume was 1.1 cm<sup>3</sup> (0.1–8.74 cm<sup>3</sup>). <i>Results:</i> All tumors remain controlled (9 smaller, 22 unchanged). No patient has experienced post-radiosurgery facial motor dysfunction. Two patients developed new trigeminal neuropathy; 2 patients with preexisting trigeminal nerve symptoms had improvement after FSR. Balance improved in 3 patients, was unchanged in 20 and worsened in 7 patients. Of the 12 patients with useful hearing (PTA ≤ 50 dB) prior to treatment, 9 patients retained useful hearing following FSR. Subjectively, of 25 patients with any hearing prior to treatment, 2 had improvement, 10 remained unchanged and 13 had worsening. <i>Conclusions:</i> Short course FSR for acoustic neuromas results in acceptable toxicity and may provide high control of tumors. Longer follow-up is needed to assess outcomes.
Effects of Diisopropylamine Dichloroacetate on Proliferation and Differentiation of Normal Human Keratinocytes in vitro
Authors: Kitamura Nobuo , Ota Yukiko , Mimura Kunio 
Published: April 2003

We found that diisopropylamine dichloroacetate (DADA), known as a vasodilator, enhanced growth of keratinocytes in 4 days culture at 1–30 μg/ml, and such promoting effects of cell proliferation were reconfirmed by measuring DNA synthesis using [<sup>3</sup>H]thymidine incorporation. On the other hand, this substance enhanced synthesis of keratin K1, a potent marker of differentiation in keratinocytes, at 1–100 μg/ml in low calcium (0.1 m<i>M</i>) or high calcium medium (1.25 m<i>M</i>). Moreover, the formation of cornified envelope, another potent marker of differentiation in keratinocytes, was also promoted by DADA at a concentration of 0.1–10 m<i>M</i> which includes valid concentration of DADA for the enhancement of keratin K1 formation (1–100 μg/ml: 0.05–0.5 m<i>M</i> DADA). These results indicate that DADA has a double function, enhancement of both proliferation and differentiation of cells, which could be linked to the turnover of skin epidermis. Furthermore, in order to analyze the effect of DADA on keratinocytes, we examined the effects of each component of this substance, diisopropylamine (DIA) and dichloroacetate (DCA), on keratinocytes. As the result of these investigations, evidence was found that DCA was effective on enhancement of cell growth, but DIA was ineffective. Moreover, we found that DCA was effective on keratinocyte differentiation by evaluating the enhancement of a differentiation marker, formation of cornified envelopes, within 10 m<i>M</i>, while DIA was not effective. Therefore, we concluded that only DCA was an active component of the DADA molecule for the proliferation and the differentiation of keratinocytes in vitro.
Operative Course of Transurethral Resection of the Prostate and Progression of Prostate Cancer
Authors: Trygg Gunnar , Ekengren Jan , Farahmand Bahman Y. , Persson Per-Gunnar , Hahn Robert G. 
Published: April 2003

Surgery has the potential to disseminate cancer cells, and we therefore hypothesized that extensive transurethral resections of the prostate (TURP) would be followed by a worse prognosis than minor ones. For this purpose, the association between the extent of surgery, disease progression, and mortality was studied in 138 patients with prostatic cancer who had undergone TURP. The results show that a large bleed (≥275 ml) indicated a slightly increased relative risk of general progression of the cancer (relative risk (RR) = 1.9, 95% confidence interval (CI) = 0.9–4.1) and death (RR = 1.5, CI = 0.6–3.3). Other parameters of extensive surgery, such as the operating time and fluid absorption, were not associated with increased risk. Patients with a medical disease, however, such as hypertension and congestive heart failure, had a significantly higher relative risk of general progression (RR = 2.7, CI = 1.2–6.1) and death from prostatic cancer (RR = 4.6, CI = 2.0–10.7) in addition to an increased relative risk of death from other causes (RR = 3.7, CI = 1.3–10.5). We conclude that concurrent medical disease, but not an extensive TURP, worsened the prognosis of patients with prostatic cancer who underwent TURP.
Intravesical Instillation of Mitomycin-C in 242 Patients with Superficial Bladder Cancer at High Risk of Recurrence: Long-Term Results
Authors: Hurle R. , Manzetti A. , Losa A. , Micheli E. , Ranieri A. , Chinaglia D. , Lembo A. 
Published: April 2003

<b>Objective:</b> The present study evaluated the long-term results of intravesical mitomycin C (MMC) instillation after transurethral resection (TUR) in 242 consecutive patients with superficial bladder cancer at high risk of recurrence (stage Ta, grade 1–3, or stage T1, grade 1 and 2, primary multiple or recurrent tumor). <b>Materials and Methods:</b> 242 patients were treated with weekly instillations of 40 mg MMC for 8 weeks after TUR. Tumor-free patients then followed a maintenance course with monthly instillations for 3 months. <b>Results:</b> Median follow-up of disease-free patients is 43.5 (range 23–112) months. The incidence of first recurrence is 59.5% (144/242 patients) with a median time to first recurrence of 29 months. 95 patients (39.3%) remained disease-free. Three had disease progression as the first event. The risk of recurrence was significantly higher for multifocal tumors (p = 0.0023, hazard ratio 1.79, 95% CI 1.23–2.59). Overall, patients have been followed for a median time of 57 (range 10–114) months. During this period the recurrence rate was 4.9. Eleven more patients had disease progression. The progression rate is 5.8% (14/242), with a mean time to progression of 34 months. At present 209 patients are alive, 6 have died of bladder cancer, 16 of causes unrelated to the disease and 11 (4.5%) have been lost to follow-up. Thus the crude survival rate is 86.4%, disease-specific mortality 2.5%, and non-disease-specific mortality 6.6%. <b>Conclusions:</b> Patients with multiple tumors seem to benefit the least from MMC instillation. Probably recurrent disease could be better prevented with intravesical bacillus Calmette-Guérin.
Isolation of Large and Pure Samples of Human Erythroid Precursors at Different Stages of Maturation Using Immunomagnetic Separation of Cells from Liquid Cultures
Authors: Vaisman Boris , Konijn Abraham M. , Fibach Eitan 
Published: April 2003

The two-phase liquid culture, which supports the development of human erythroid progenitors into hemoglobin-containing orthochromatic normoblasts, provides high yield of erythroblasts with synchronized development. However, other cell types are also present in the culture. In the present report, we used immunomagnetic separation for the purification of the developing erythroid precursors. At different stages of the culture, aliquots of the cells were incubated with anti-glycophorin A, B monoclonal antibodies, followed by anti-mouse IgG-coated magnetic beads, and separated by a magnet. In mature cultures, all isolated glycophorin-positive cells contained hemoglobin, as indicated by their staining with benzidine. All glycophorin-negative cells were benzidine negative. In earlier cultures, morphological examination and measurements of hemoglobin content showed that the erythroid precursors could be isolated at different stages of maturation. Thus, the combination of the liquid culture procedure with the immunomagnetic separation thechnique permitted to obtain large samples of pure erythroid cells, which were synchronized at subsequent stages of maturation. The method enables comprehensive studies of developing erythroid cells from normal donors as well as from patients with various disorders of erythropoiesis.
Sickle-Cell Disease in Brazzaville, Congo: Genetical, Hematological, Biochemical and Clinical Aspects
Authors: Mouélé R. , Boukila V. , Fourcade V. , Feingold J. , Galactéros F. 
Published: April 2003

Clinical, hematological and molecular features of 116 unrelated sickle-cell anemia patients from Brazzaville were investigated. The mean age of the patients was 9.4 ± 5.3 years. 232 β<sup>s</sup>-chromosomes were haplotyped and almost all sickle cell anemia patients (91%) were homozygous for the Bantu haplotype. All hematological indices were similar for males and females. Mean hemoglobin (Hb) concentration was 6.6 ± 1.4 g/dl. Fetal Hb (HbF) levels were from 1 to 28%, with a mean of 8.8 ± 5.8%. There was a curvilinear relationship between %HbF and age suggesting that HbF level had a selective effect on the survival of patients. This effect was sex dependent. The (–α<sup>3.7</sup>) gene frequency was 0.45 and was not affected by stratification for age. Hematological characteristics of patients with (–α/αα, –α/–α) and without (αα/αα) the –α<sup>3.7</sup> α-thal-2 deletion showed trends similar to those reported in Jamaican and US sickle cell anemia patients. Hyperbilirubinemia (>38 μmol/l) was common and high lactic dehydrogenase (LDH) concentrations were recorded. Bilirubin concentrations for males and females were similar whereas those for LDH concentration were not. Hepatomegaly and splenomegaly were common. Splenomegaly was strongly associated with the –α<sup>3.7</sup> α-thal-2 deletion. These clinical and hematological observations indicate a more severe form of hemolytic disease in Congolese SS patients.
Comparative Nephritogenicity of Two Monoclonal Antibodies That Recognize Different Epitopes ofRat Thy-1.1 Molecule
Authors: Nakayama H. , Oite T. , Kawachi H. , Morioka T. , Kobayashi H. , Orikasa M. , Arakawa M. , Shimizu F. 
Published: April 2003

The pathophysiological role of the Thy-1.1 molecule expressed on rat mesangial cells with regard to mesangial cell dysfunction and injury remains unknown. The mechanism of Thy-1.1-associated injury has now been investigated with two monoclonal antibodies, 1-22-3 and OX7, that recognize different epitopes of Thy-1.1. Mesangiolysis and mesangial cell proliferation were more marked in rats injected with 1-22-3 than in those treated with OX7. Immunostaining for rat complement component C3 and also C9 was similar in the kidneys of rats 1 h after injection of either antibody. Alpha smooth muscle actin was first detected 3 days after injection of 1-22-3 and peaked on day 5; type I collagen staining showed a mesangial pattern on days 5 and 10. The staining for alpha smooth muscle actin and type I collagen was less intense in OX7-treated rats than in the 1-22-3-injected rats. The amounts of mRNAs encoding collagen types I and III peaked 5 days after injection of 1-22-3 and 10 days after injection of OX7. Rats injected with 1-22-3 developed proteinuria that was already marked on day 1 and peaked at 150 mg/day on day 3, whereas OX7 induced a low grade of proteinuria with large interindividual variability on day 3. Immunostaining for rat C3 in the normal rat kidneys, incubated in vitro with 1-22-3 or OX7 followed by incubation with normal rat fresh serum as a complement source, as well as the levels of serum complement activity, CH50, 30 min after injection of 1-22-3 or OX7 were similar, suggesting that the difference in the nephritogenicity of these two antibodies is not attributable to a difference in their complement-fixing activities, but rather may result from the difference in epitope specificities. The epitope recognized by 1-22-3 thus appears to be important in the initiation and progression of antibody-induced nephritis.
A High Glucose Concentration Stimulates the Expression of Monocyte Chemotactic Peptide 1 in Human Mesangial Cells
Authors: Ihm Chun-Gyoo , Park Jae-Kyung , Hong Seong-Pyo , Lee Tae-Won , Cho Byoung-Soo , Kim Myung-Jae , Cha Dae-Ryong , Ha Hunjoo 
Published: April 2003

The mechanism of glomerular infiltration of monocytes remains unknown in diabetic nephropathy. We examined the effect of a high glucose concentration on monocyte chemotactic peptide 1 (MCP-1) expression in human mesangial cells (MCs) by using enzyme-linked immunosorbent assay and reverse transcription coupled with polymerase chain reaction (PCR). More than a 50% increase in the MCP-1 protein production was observed in MCs cultured in high-glucose medium (450 mg/dl) as compared to normal glucose (100 mg/dl; 1,496 ± 75 vs. 966 ± 15 pg/ml after 24 h, 1,910 ± 93 vs. 1,250 ± 55 pg/ml after 48 h). Semiquantitative PCR showed that phorbol myristate acetate (100 n<i>M</i>) increased the ratio of PCR products for MCP-1 to housekeeping gene glyceraldehyde-3-phosphate dehydrogenase on densitometric results at 24 h by 2.7-fold, which was prevented by calphostin C (200 n<i>M</i>) pretreatment. High glucose increased the ratio by 3-fold as compared to normal glucose at 24 h (0.72 ± 0.11 vs. 0.24 ± 0.01). This was also suppressed by calphostin C pretreatment. These findings demonstrate that high glucose can directly increase MCP-1 expression in MCs, which may contribute to monocyte infiltration in diabetic nephropathy, and this is regulated by protein kinase C.
Multiple Electrolyte Abnormalities after Pamidronate Administration
Authors: Elisaf M. , Kalaitzidis R. , Siamopoulos K.C. 
Published: April 2003

Pamidronate constitutes a major advance in the treatment of tumor-associated hypercalcemia. However, transient electrolyte abnormalities have been reported after pamidronate administration. We describe here a patient with multiple myeloma and severe hypercalcemia who developed transient but significant electrolyte disturbances (mainly hypophosphatemia and hypomagnesemia) after a single dose of 90 mg of pamidronate, focusing on the underlying pathophysiological mechanisms.
Administration of Ascorbic Acid and an Aldose Reductase Inhibitor (Tolrestat) in Diabetes: Effect on Urinary Albumin Excretion
Authors: McAuliffe Aileen V. , Brooks Belinda A. , Fisher Elizabeth J. , Molyneaux Lynda M. , Yue Dennis K. 
Published: April 2003

The important role of ascorbic acid (AA) as an anti-oxidant is particularly relevant in diabetes mellitus where plasma concentrations of AA are reduced. This study was conducted to evaluate the effects of treatment with AA or an aldose reductase inhibitor, tolrestat, on AA metabolism and urinary albumin excretion in diabetes. Blood and urine samples were collected at 0, 3, 6, 9, and 12 months from 20 diabetic subjects who were randomized into two groups to receive either oral AA 500 mg twice daily or placebo. Systolic and diastolic blood pressures, HbA<sub>1c</sub>, plasma lipids, urinary albumin, and total glycosaminoglycan excretion were measured at all time points, and heparan sulphate (glycosaminoglycan) was measured at 0 and 12 months. The same parameters, as well as urinary AA excretion, were determined at 0 and 3 months for 16 diabetes subjects receiving 200 mg tolrestat/day. AA treatment increased plasma AA (ANOVA, F ratio = 12.1, p = 0.004) and reduced albumin excretion rate (AER) after 9 months (ANOVA, F ratio = 3.2, p = 0.03), but did not change the other parameters measured. Tolrestat lowered plasma AA (Wilcoxon’s signed-rank test, p < 0.05), but did not change AER or the other parameters measured. The ability of AA treatment to decrease AER may be related to changes in extracellular matrix or improvement in oxidative defence mechanism. Unlike the rat model of diabetes, inhibition of aldose reductase did not normalize plasma AA or AER in humans. In fact, tolrestat reduced the plasma AA concentration, a phenomenon which may be due to increased utilization of AA. Dietary supplementation of AA in diabetic subjects may have long-term benefits in attenuating the progression of diabetic complications.
Soluble Interleukin-6 Receptor, Interleukin-10 and Granulocyte Colony-Stimulating Factor in Acute Pyelonephritis: Relationship to Markers of Bacterial Virulence and Renal Function
Authors: Jacobson Stefan H. , Lu Ying , Brauner Annelie 
Published: April 2003

<b>Background:</b> Cytokines and cytokine receptors are involved in the systemic and local inflammatory response in patients with urinary tract infections. <b>Methods:</b> We examined urine and serum concentrations of soluble IL-6 receptor (sIL-6R), IL-10 and granulocyte colony-stimulating factor (G-CSF) in 29 women with acute pyelonephritis caused by <i>Escherichia coli</i> 2 weeks after the infection, during the subsequent episode of cystitis or asymptomatic bacteriuria and also later when the same patients were free from bacteriuria. Concentrations of sIL-6R, IL-10 and G-CSF were related to the expression of five virulence markers of <i>E. coli</i> and to glomerular filtration rate (GFR) after pyelonephritis. <b>Results:</b> On admission because of acute pyelonephritis the serum concentration of sIL-6R was similar to that of 12 healthy controls. Two weeks after the infection when all patients had received antibiotic treatment, the serum concentration of sIL-6R was significantly higher compared to that on admission (p < 0.001) and also higher compared to healthy controls (p = 0.001). Patients with increased concentrations of sIL-6R in serum 2 weeks after infection had significantly lower GFR at follow-up (p < 0.05). Patients with acute pyelonephritis had higher concentrations of G-CSF and IL-10 in serum compared to healthy subjects (p < 0.001 and p = 0.06, respectively). G-CSF in serum was higher in patients infected by <i>E. coli</i> producing cytotoxic necrotizing factor (p < 0.05). Patients infected by strains producing hemolysin had lower concentrations of sIL-6R (p < 0.001). Patients with detectable levels of the anti-inflammatory cytokine IL-10 in serum had significantly higher concentrations of IL-6 and the soluble tumor necrosis factor receptors I and II in serum as compared to patients in whom IL-10 was not detectable (p < 0.001, p = 0.001 and p < 0.05, respectively. <b>Conclusion:</b> These investigations, together with our previous findings summarized in this paper, contribute to an increased understanding of the local and systemic inflammatory response arising in response to acute pyelonephritis.
Deposition of Mannan Binding Protein and Mannan Binding Protein-Mediated Complement Activation in the Glomeruli of Patients with IgA Nephropathy
Authors: Matsuda Mitsuhiro , Shikata Kenichi , Wada Jun , Sugimoto Hikaru , Shikata Yasushi , Kawasaki Toshisuke , Makino Hirofumi 
Published: April 2003

Mannan binding protein (MBP) is a C-type lectin and has a high affinity to mannose and N-acetyl glucosamine. It is also known to activate C4 and C2 without C1 component, which is called ‘lectin pathway’. We now report the presence of MBP and MBP-mediated complement activation in renal glomeruli of IgA nephropathy patients using an immunohistochemical method. In 7 of 42 cases with IgA nephropathy, MBP was detected in the glomerular mesangial area and colocalized with IgA1. In 19 cases with other types of IC-mediated glomerulonephritis including lupus nephritis and membranous nephropathy or without nephritis, MBP was not detected in the glomerulus. The C2- and/or C4-positive rate was 87.5% in the MBP-positive group and 20% in the MBP-negative group of IgA nephropathy. In addition, MBP-positive cases showed marked mesangial cell proliferation, lower creatinine clearance (53.4 ± 10.0 vs. 77.8 ± 4.7 ml/min) and higher urinary protein excretion (2.5 ± 0.9 vs. 0.9 ± 0.2 g/day) compared with MBP-negative cases. These findings suggested that MBP was involved in glomerular complement activation through the lectin pathway and thus induced glomerular injury of IgA nephropathy. Since oligosaccharide chain alterations such as reduced sialic acid and galactose of IgA1 molecule have been reported in IgA nephropathy patients, MBP might bind to the IgA1 molecule via interaction between MBP and sugar chain.
Effect of a Hemodialysis Session on Plasma Levels of Endothelin-1 in Hypertensive and Normotensive Subjects with End-Stage Renal Failure
Authors: Surdacki Andrzej , Sułowicz Władysław , Wieczorek-Surdacka Ewa , Herman ZbigniewS. 
Published: April 2003

<i>Background:</i> Elevated plasma endothelin-1 (ET-1) was found in end-stage renal failure (ESRF). However, there are discordant reports on the influence of hypertension on plasma ET-1 in ESRF and on the effect of hemodialysis on ET-1 concentrations. <i>Aim:</i> To compare the time course of plasma ET-1 during hemodialysis in hypertensive (HT) and normotensive (NT) ESRF patients. <i>Methods:</i> Plasma ET-1 and mean blood pressure (MP) were measured in 12 HT patients and 11 matched NT patients on maintenance hemodialysis at baseline (B), after a 2.5–3.5 h hemodialysis with ultrafiltration (P1) and after a subsequent 1 h isovolumic dialysis (P2). <i>Results:</i> In HT patients, plasma ET-1 increased at P1 with no further change after P2 (B vs. P1 and P2, p < 0.05). In NT patients, ET-1 levels were similar at B, P1 and P2. In HT, but not in NT subjects, volume loss correlated with change of ET-1 at P1. In HT patients, MP fell during P1 and tended to return towards baseline at P2. In NT patients, MP dropped after P1 and remained lower also at P2. <i>Conclusion:</i> Hypertensive ESRF subjects exhibit potentiated ET-1 release on hemodialysis, possibly stimulated by volume depletion with sympathetic activation, which may attenuate hypotensive hemodialysis effects thus contributing to hypertension in ESRF.