bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mast cells in human allografted kidney: correlation with interstitial fibrosis
Authors: Goto Eizo , Honjo Soichiro , Yamashita Hideki , Shomori Kohei , Adachi Hironobu , Ito Hisao 
Published: March 2003

Abstract: Introduction: Chronic allograft nephropathy is the major cause of long‐term graft failure in human allografted kidney transplantation. In addition to macrophages and T lymphocytes, mast cells have been shown to increase in chronic allograft nephropathy. The present study examined tryptase‐positive mast cells and microvessels in the allografted kidney.Materials and methods:  We selected 131 biopsy specimens obtained from 100 allografted, 14 non‐grafted renal biopsy specimens and nine nephrectomy specimens due to renal cell carcinomas. Formalin‐fixed, paraffin‐ embedded specimens were immunostained using primary antibodies for mast cell tryptase, mast cell chymase and CD34. The number of the mast cells and microvessels was counted in at least 20 high‐power fields (10 × 40).Results:  Tryptase‐positive mast cells outnumbered chymase, toluidine blue or naphthol‐AS‐D choloacetate‐positive mast cells. The mean number of the tryptase‐positive mast cells was significantly higher in the 36 specimens with chronic allograft nephropathy (5.1 ± 3.5) among the grafted kidneys with other disease categories (P < 0.001). In the chronic allograft nephropathy, the mean numbers of mast cells was significantly higher in Ci 2 + Ci 3 (n = 20; 6.4 ± 3.89) than in Ci 1 (n = 16; 3.6 ± 2.65) (P < 0.01). In the non‐grafted kidney, the number of mast cells was highest in the four specimens with diabetic nephropathy. Mast cells and microvessels were analysed in the two representative cases, which subsequently developed chronic allograft nephropathy. Both of the cases showed the highest number of mast cells in chronic allograft nephropathy. In contrast, the mean number of microvessels tended to decrease along with interstitial fibrosis.Conclusions:  This study demonstrated clearly a close association between renal interstitial fibrosis and mast cells, which might play an important role in the development of chronic allograft nephropathy.
Nonoperative management of bile leaks following liver transplantation
Authors: Johnston Thomas D , Gates Robert , Reddy K Sudhakar , Nickl Nicholas J , Ranjan Dinesh 
Published: March 2003

The biliary anastomosis has been called ‘the Achilles heel’ of liver transplantation (Rabkin JM, Orloff SL, Reed MH. Transplantation 1998: 65 [2]: 193; Davidson BR, Rai R, Kurzawinski TR. Br J Surg 1999: 86 [4]: 447). Biliary complications after liver transplantation reportedly occur at an incidence of 20–30%, 10–15% as bile leaks. The management of bile leaks, especially early bile leaks, is controversial. In the present study, we report our experience with the management of bile leaks after liver transplantation.

In this retrospective study, we reviewed 85 liver transplants over a 3‐yr period. In 79, the biliary anastomosis was choledochocholedochostomy (CDCD) over a small‐caliber T‐tube, while choledochojejunostomy (CDJ) was used in 7. Over a mean follow up period of 13.5 months (median 10 months), 10 patients (12%) experienced a clinically significant bile leak within the first 3 months after liver transplantation.

The early leaks, occurring within 1 month of transplant, were successfully managed by observation (Davidson BR, Rai R, Kurzawinski TR. Br J Surg 1999: 86 [4]: 447) or endoscopic retrograde cholangiopancreatography (ERCP) and the placement of a biliary stent for a duration of 6–12 wk (Randall HB, Wachs ME, Somberg KA. Transplantation 1996: 61 [2]: 258). One of these resulted from accidental dislodgement of the T‐tube on postoperative day 1; one resulted from necrosis at the CDCD anastomosis and required CDJ; the remaining four resulted from leaks along the T‐tube track.

One of the late leaks occurred following the planned removal of the T‐tube at 3 months after liver transplantation; the other two were leaks along the T‐tube track. All were successfully treated by ERCP and stent placement, though in one case, ERCP was initially unsuccessful because of the inability to advance a guidewire, necessitating a fluoroscopically aided guide wire placement during a mini laparotomy. ERCP was then successfully performed with the placement of a stent.Table 1Conclusions: Our experience indicates that most bile leaks after liver transplantation, including early leaks, can be successfully managed nonoperatively. Most will require intervention, but ERCP and stent placement are usually sufficient.

Time
Total (n)
Observed (n)
ERCP (n)
Surgery (n)
Follow‐up

Early (≤1 month after liver transplantation)
5
1
3
1
All doing well, median FU 12 months

Late (>1 month after liver transplantation)
5
1
4
1*
All doing well, median FU 5 months

*Managed by combined mini laparotomy and ECRP. FU, follow‐up.
A case of rapid progressive glomerulonephritis with IgA deposits after renal transplantation
Authors: Shimizu Tomokazu , Tanabe Kazunari , Tokumoto Tadahiko , Shimmura Hiroaki , Koga Shoji , Ishikawa Nobuo , Oshima Tadashi , Toma Hiroshi , Yamaguchi Yutaka 
Published: March 2003

Shimizu T, Tanabe K, Tokumoto T, Shimmura H, Koga S, Ishikawa N, Oshima T, Toma H, Yamaguchi Y. A case of rapid progressive glomerulonephritis with IgA deposits after renal transplantation. Clin Transplantation 2001: 15 (Supplement 5): 11–15. ©Munksgaard, 2001A 46‐yr‐old Japanese male who underwent a second cadaveric kidney transplantation on 31 October 1996 after suffering Type II diabetic mellitus for 25 yr was admitted to our institute on 23 January 1999, because of colicky abdominal pain and abdominal discomfort. Elevated levels of serum creatinine, severe proteinuria and microscopic haematuria were observed. The allograft biopsy specimen disclosed crescentic glomerulonephritis. Immunofluorescence showed granular deposits of mainly IgA and C3 along glomerular capillary walls and mesangial areas. Electron microscopy showed extensive subepithelial and mesangial electron dense deposits. Rapid and irreversible worsening of graft function led to resumption of haemodialysis on 31 May 1999. We speculated that this case was an atypical form of de novo Henoch–Schönlein purpura nephritis (HSPN) in transplanted kidney because of the histopathological findings of the allograft biopsy and clinical symptoms.
A case of tacrolimus nephrotoxicity appearing in a second renal transplantation patient
Authors: Oka Kazumasa , Moriyama Toshiki , Imai Enyu , Kyo Masahiro , Toki Kiyohide , Tanaka Toshiyuki , Hori Masatsugu , Kokado Yukito , Okuyama Akihiko , Takahara Shiro 
Published: March 2003

Oka K, Moriyama T, Imai E, Kyo M, Toki K, Tanaka T, Hori M, Kokado Y, Okuyama A, Takahara S. A case of tacrolimus toxicity appearing in a second renal transplantation patient. Clin Transplantation 2001: 15 (Supplement 5): 30–34. ©Munksgaard, 2001We experienced a case of a second renal trans‐ plantation patient. With the use of cyclosporin, he lost his first graft because of chronic rejection; with the use of tacrolimus, his second graft suffered from drug nephrotox‐ icity. On his second renal transplantation, his graft function deteriorated and required haemodialysis with the use of tacrolimus. Repeated biopsies did not reveal the typical characteristics of acute tacrolimus nephrotoxicity and acute rejection. His tacrolimus trough level was not high during the clinical course; however, by reducing tacrolimus dosage, his graft function eventually recovered to mild renal dys‐ function. This observation was helpful for clinical diagnosis of the functional toxicity of tacrolimus. The case is interest‐ ing in considering the functional toxicity of tacrolimus and the difference between tacrolimus and cyclosporin in terms of immunosuppressive and nephrotoxic actions.
Emotional issues after kidney transplantation: a prospective psychotherapeutic study
Authors: Baines Lyndsay S , Joseph John T , Jindal Rahul M 
Published: March 2003

Abstract: Background:  Negative emotional states are the single most influential factor in determining quality of life after a successful kidney transplant. We designed a prospective study using psychotherapeutic principles to understand and intervene in emotional issues in adult recipients of first cadaver kidney transplants.Methods:  Forty‐nine recipients of first cadaver kidney transplants were subjected to 12 sessions (at weekly intervals) of psychotherapy within 3 months of receiving their transplant. The Beck Depression Inventory (BDI) was utilized as a measure of change in emotional state, pretherapy, at 3, 6, 9 and 12 months. A higher score on BDI was suggestive of psychological dysfunction. In the first instance, data was analysed within a quantitative framework, by virtue of the BDI. In the second instance, data was considered in terms of recurring themes described by patients during psychotherapy and was analysed qualitatively. In the third instance, both qualitative and quantitative data was considered in terms of individual patient's ability to achieve some feeling of having implemented some social, relational and vocational equilibrium into their everyday life. Recipients of live kidneys, paediatric transplants and patients who received more than one transplant were excluded, as emotional issues are different in this cohort of patients. All patients have completed 1 yr of follow up. None of the patients were on antidepressant medication before or after therapy.Results:  This is an ongoing study in which we are comparing individual vs. group therapy vs. controls (who receive no therapy). The total number of patients recruited will be 120 and the final report will be available in 2003–04. The results reported in this paper form the 49 patients in the individual arm of the study. All the patients in our study happened to be white people. There was significant improvement in the BDI scores following therapy. The mean score was 26.3 ± 7.9 before and 20.5 ± 8.8 after therapy (p = 0.001); the lowering of the scores remained sustained at 12 months. Multivariate analysis of age, gender, employment status, duration of dialysis (if in dialysis for more than 3 yrs) and psychotherapy given before transplantation did not affect the results of our study. For the qualitative aspect of the study, we grouped the emotional problems as expressed by the patients into three recurring themes (i) fear of rejection, (ii) feelings of paradoxical loss post‐transplant despite having received a successful transplant and (iii) the psychological integration of the newly acquired kidney.Conclusions:  Psychotherapeutic intervention was an effective means of addressing emotional problems in recipients of kidney transplants. The recurring themes as identified above provided a baseline for psychotherapeutic exploration and resolution of these issues. Successful resolution of these issues was associated with lower BDI scores and the redefinition of normality in daily living post‐transplant.
Evaluation of neuroprotection by lithium and valproic acid against ouabain‐induced cell damage
Authors: Hennion JP , El‐Masri M Adnan , Huff Mary O , El‐Mallakh Rif S 
Published: March 2003

Background:
The pathophysiology of manic‐depression may be associated with dysregulation of ion homeostasis. Ouabain is a potent inhibitor of the sodium–potassium adenosine triphosphatase and has been purported to mimic abnormalities seen in acute mania. As manic episodes are believed to be neurotoxic and mood stabilizers have recently been implicated as neuroprotectants, it is of interest to determine if lithium and valproic acid antagonize ouabain‐induced neurotoxicity.
Methods:
Human neuroblastoma SH‐SY5Y cells were differentiated for 12 days then pretreated with lithium or valproic acid for 24 h and then challenged with a 10 μM ouabain insult. Cellular damage was assessed with lactate dehydrogenase (LDH) release, and apoptotic potential of ouabain was evaluated with DNA fragmentation.
Results:
Ouabain significantly increased LDH release after 72 h of treatment. Lithium pretreatment at 1 mM diminished ouabain‐induced LDH release. Valproic acid alone at 100 and 1000 μg/mL significantly increased LDH release from the cells. Furthermore, it significantly potentiated ouabain‐induced LDH release. DNA fragmentation suggests that ouabain induces apoptosis.
Conclusions:
Lithium at the therapeutic level of 1 mM limits the extent of cellular damage caused by 10 μM ouabain in SH‐SY5Y cells as measured by LDH release. Valproic acid alone at the therapeutic concentration of 100 μg/mL induces LDH release and does not prevent ouabain‐induced LDH release.
Olanzapine in diverse syndromal and subsyndromal exacerbations of bipolar disorders
Authors: Janenawasin Suttiporn , Wang Po W , Lembke Anna , Schumacher Matthew , Das Bibi , Santosa Claudia M , Mongkolcheep Jenny , Ketter Terence A 
Published: March 2003

Objective:  To evaluate effects of olanzapine in diverse exacerbations of bipolar disorders.Methods:  Twenty‐five evaluable bipolar disorder [14 bipolar I (BPI), 10 bipolar II (BPII) and one bipolar disorder not otherwise specified (BP NOS)] outpatients received open olanzapine (15 adjunctive, 10 monotherapy). Thirteen had elevated (11 syndromal, two subsyndromal) and 12 depressed (four syndromal, eight subsyndromal) mood symptoms of at least mild severity, with Clinical Global Impression‐Severity (CGI‐S) scores of at least 3. Only one had psychotic symptoms.Results:  With open olanzapine (15 adjunctive, 10 monotherapy), overall symptom severity (CGI‐S) as well as mood elevation (Young Mania Rating Scale), depression (Hamilton and Montgomery‐Asberg Depression Rating Scales), and anxiety (Hamilton Anxiety Rating Scale), rapidly decreased (significantly by days 2–3). Patients with the greatest baseline severity (CGI‐S) had the greatest improvement. Fifteen of 25 (60%) patients responded. Time to consistent response was bimodal, with five early (by 0.5 ± 0.3 weeks) and 10 late (by 7.0 ± 1.9 weeks) responders. Early compared with late responders had 51% lower final olanzapine doses. Olanzapine was generally well tolerated, with sedation and weight gain the most common adverse effects.Conclusions:  Olanzapine was effective in diverse exacerbations of bipolar disorders. The bimodal distribution of time to response and different final doses are consistent with differential mechanisms mediating early compared with late responses. Controlled studies are warranted to further explore these preliminary observations.
Is pelvic pain in pregnancy a welfare complaint?
Authors: BJÖRKLUND KENNETH , BERGSTRÖM STAFFAN 
Published: March 2003

Background. Pelvic pain in pregnancy has been suggested to be more common in Scandinavia than in the rest of the world, to be culturally specific for the region and to reflect a change in attitude among pregnant women. Little is known of the prevalence of pelvic pain in pregnancy in low‐income countries.Objective. To explore whether perceived pelvic pain among pregnant women differs between affluent and poor societies.Subjects and methods. Four observational studies, comprising a total of 752 women, were carried out in circumstances ranging from wealth to poverty, focusing on the reported prevalence, location and degree of pelvic pain in pregnancy. In Uppsala, Sweden, and in Rufiji, Tanzania, the women were interviewed in late pregnancy. In Jakobstad, Finland, and in Zanzibar Town, Zanzibar, the women were approached after delivery before discharge.Results. The reported prevalence of pelvic pain in pregnancy was 49% in Uppsala and 66% in Rufiji, 77% in Jakobstad and 81% in Zanzibar, with an overall similarity of location and degree of pain.Conclusion. No geographical differences were found in perceived pelvic pain among pregnant women, irrespective of the socio‐economy of the countries.
DNA strand breaks in human spermatozoa: Correlation with fertilization in vitro in oligozoospermic men and in men with unexplained infertility
Authors: HØST ERIK , LINDENBERG SVEND , SMIDT‐JENSEN STEEN 
Published: March 2003

Background. The purpose of this study was to examine the correlation between DNA strand breaks in human spermatozoa and semen quality, fertilization rate and IVF outcome.Methods. A total of 50 men suffering from unexplained infertility and 50 men with oligozoospermia undergoing IVF treatment entered a prospective study. Sperm samples were assessed according to the WHO manual and for the presence of DNA strand breaks in spermatozoa. The study was blinded for the technician involved in assessment of DNA strand breaks. IVF was carried out according to a long down regulation protocol using GnRH, FSH and hCG. The ova were inseminated with 200,000 spermatozoa/ml. Embryos were transferred on day 2 after fertilization with a maximum of three embryos.Results. This study demonstrates a negative correlation between the proportion of spermatozoa having DNA strand breaks and the proportion of oocytes fertilized after IVF.Conclusion. The number of human spermatozoa with DNA strand breaks is a good predictor for fertilization rate in couples suffering from unexplained infertility and undergoing IVF treatment.
Use of hormone replacement therapy among Danish nurses in 1993
Authors: ANDERSEN HUNDRUP YRSA , OBEL ERIK BERNHARD , RASMUSSEN NIELS KRISTIAN , PHILIP JOHN 
Published: March 2003

Background. To describe the prevalence of women using systemic hormone replacement therapy in various age groups. To identify their reasons for choosing or not choosing the therapy, reasons for discontinuing the treatment, the prevalence of side effects among current users, and to estimate the duration of treatment.Methods. The study is based on postal questionnaires sent to 23,000 female Danish nurses above the age of 44 years. Out of these 19,953 (86%) responded. The questionnaire gave information on age, use of hormone replacement therapy, use of oral contraceptives, family predisposition and diseases. Duration of hormone replacement therapy was calculated by Cox regression analysis. Chi square tests were used to evaluate differences and 5% was used as the level of significance.Results. Overall, 6673 (33%) had ever used hormone replacement therapy. The prevalence was highest in the age group 55–59, where 29.3% were currently using hormones. The most cited reasons for choosing hormone replacement therapy were vasomotor symptoms (62%) and prevention of osteoporosis (44%). Among never users 43% had not experienced climacteric symptoms, 24% found the therapy unnatural, and 22% were afraid of side effects. It was estimated that 70% still were using hormones five years after the start of therapy, 57% after ten years, and 48% after fifteen years. Women with a family history of osteoporosis used hormones longer than women without this predisposition.Conclusions. One third of all the women had ever used hormone replacement therapy and more than half of ever users used the therapy for more than ten years.
Determinants of urinary incontinence in a population of young and middle‐aged women
Authors: SAMUELSSON EVA , VICTOR ARNE , SVÄRDSUDD KURT 
Published: March 2003

Background. Urinary incontinence and genital prolapse are prevalent conditions in the female population. The aim of this study was to study possible determinants of female urinary incontinence in a population‐based sample of young and middle‐aged women.Methods. Of 641 eligible women aged 20–59 years in a primary health care district, 487 (76%) responded to a questionnaire and accepted an invitation to a gynecological examination. The examination included digital assessment of the pelvic floor muscle strength (PFMS). Genital prolapse presence (cystocele, rectocele, uterine prolapse or absence of the urethrovesical crease) was graded in relation to the vaginal introitus.Results. The prevalence of urinary incontinence was 28%, 3.5% having daily leakage. Stress urinary incontinence was the dominant type. The odds ratio (OR) of having incontinence increased from 1 to 3.5 with increasing age and from 1 to 2.7 with increasing parity. The OR also increased with decreasing PFMS; from 1 in the group with the best PFMS to 3.4 in the group unable to contract their pelvic musculature. In addition, women with cystocele and/or absence of the urethrovesical crease had a 2.5‐fold increased OR of incontinence (95% CI 1.5‐4.2), smoking increased the OR 1.9 times (95% CI 1.1‐3.2) and estrogen replacement therapy (ERT) increased the OR 2.9 times (95% CI 1.4‐5.9). There were no significant correlations with the presence of chronic disease, episiotomy or the birth weights of children but small non‐significant correlations with performed hysterectomy and the woman's weight.Conclusions. Urinary incontinence is a frequent symptom in the female general population and related to age, pelvic floor muscle strength, genital prolapse, smoking, parity and estrogen replacement therapy.
Prognostic significance of serous and clear cell adenocarcinoma in surgically staged endometrial carcinoma
Authors: SAKURAGI NORIAKI , HAREYAMA HITOSHI , TODO YUKIHARU , YAMADA HIDETO , YAMAMOTO RITSU , FUJINO TAKAFUMI , SAGAWA TADASHI , FUJIMOTO SEIICHIRO 
Published: March 2003

Background. The serous adenocarcinoma (SA) and clear cell adenocarcinoma (CCA) of endometrium have been shown to be associated with high relapse rate and poor survival. It is not clear whether prognostic significance of these specific cell types of tumor is independent of retroperitoneal lymph node metastasis and other histopathologic prognostic factors in endometrial carcinoma.Methods. We examined 240 consecutive patients with clinical stage I to stage III endometrial carcinoma who were treated prospectively with radical surgery and/or platinum‐based chemotherapy. Surgery included extended hysterectomy, bilateral salpingo‐oophorectomy, and systematic pelvic and paraaortic lymph node dissection. Prognostic significance of various histopathologic factors was determined by Cox regression analysis.Results. SA/CCA were more frequently associated with deep myometrial invasion, high nuclear grade (G3), lymph‐vascular space invasion (LVSI), and pelvic lymph node metastasis when compared to endometrioid adenocarcinoma (EMA). Of 216 clinically staged stage I or II disease, seven of 12 cases of SA/CCA had extrauterine disease. This incidence was much higher than that for EMA (46/204) (p<0.01). A multivariate Cox regression analysis revealed that cell type, grade, LVSI, and paraaortic node metastasis (PANM) were independent prognosticators.Conclusions. Prognosis of patients with endometrial carcinoma depends on cell type, grade, LVSI, and PANM. Poor prognosis for patients with SA/CCA is independent of lymph node metastasis and other histopathologic prognostic factors. The SA/CCA should be strictly discriminated from EMA.