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  • 1
    ISSN: 1279-8517
    Keywords: Larynx ; MRI ; Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The larynx is an organ with a complex anatomic structure. MRI allows the performance of sections in the three planes of space, so that this study of the soft parts of the larynx yields results superior to those of other imaging techniques. Together with laryngoscopy, MRI is most often used in assessing the extension of malignant laryngeal tumors. This assessment is fundamental in choosing the indications for surgery, but the published reports of MRI of the larynx are sometimes discordant. The visualization of certain important anatomic structures such as the conus elasticus is uncertain. Our aim was to study the MRI radio-anatomy of the larynx based on correlations between MRI and histologic sections. Eight anatomic specimens were studied four in the transverse plane, two in the sagittal plane, and two in the frontal plane. The MRI and histologic sections made at the same levels were compared. These comparisons allowed a description of the sectional radio-anatomy of the larynx and an assessment of the reliability and limitations of MRI. All the major anatomic structures could be identified. It was possible to demonstrate the conus elasticus. We were able to visualize the vocal process of the arytenoid cartilage, which has not to our knowledge been previously described in the literature.
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  • 2
    ISSN: 1279-8517
    Keywords: Anterior cruciate ligament ; Kinematics ; Knee ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this study is to suggest an anatomic study of the modifications of the length of the anterior cruciate ligament (ACL) and its bundles during flexion with the aid of a 3D computerized model of the knee in a living subject. The method of evaluation suggested is a 3D computerized reconstruction based on MRI sections, reproducing the movement of flexion of the knee from 0 to 75°. Twenty-one sections were made for each of the 13 positions of flexion. The reconstruction of Delaunay and the realignment of each position provided a 3D model which allowed monitoring of a bony point during the movement. By knowing the relative displacement of the ligamentous attachments it was possible to define the biometry of the ligament by calculating the length of the bundles of the ACL in each position and to demonstrate the variations in length during the movement. The mean length of the ligament was 3.4 mm. The anteromedial bundle was longer by 30% compared with the other two bundles. During flexion the anteromedial bundle was not much modified (this feature seems to provide a reference position for a ligamentoplasty), the posterolateral bundle became taut after 30°, and the intermediate bundle relaxed from the beginning of movement. Based on the data from the literature, this method allows an anatomic approach to the ACL, bundle by bundle, during flexion movement.
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  • 3
    ISSN: 1432-0568
    Keywords: Key words Mouse ; Gene expression ; Insulin-like growth factor (IGF) ; IGF binding protein (IGFBP) ; Hypodactyly (Hd) ; Limb bud ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Insulin-like growth factor-I (IGF-I) mediated signalling has been implicated to be of significant importance during vertebrate embryonic development. IGF-I signalling has also been shown to be modulated by a number of IGF binding proteins that are thought to act as either agonists or antagonists of IGF activity. IGF-I has been implicated in a number of cellular processes, including cell division and programmed cell death (apoptosis). We have used the mouse mutant Hypodactyly (Hd) as a tool to determine the role of IGF-I and two key IGF binding proteins (IGFBP-2 and IGFBP-5) during embryonic development. The Hd mutant is a good model with which to study developmental cascades, since it has a distinct phenotype in the limb where cellular and molecular circuits have been thoroughly investigated. The distinctive pointed limb buds observed in Hd mutant embryos have been shown to be the result of a massive increase in apoptosis. We show that all three genes, IGF-1, IGFBP-2 and IGFBP-5, display restricted expression patterns during limb development. Indeed, IGFBP-5 shows a remarkable similarity to the expression of Engrailed-1, which is the vertebrate homologue of the Drosophila selector gene Engrailed. We show that there is downregulation in the expression of IGFBP-2 in the entire apical ectodermal ridge (AER) in homozygous Hd/Hd limb buds, whereas IGFBP-5 is downregulated in specific regions in the mutant AER. IGF-I expression is downregulated in Hd limb buds in regions undergoing high levels of cell death, consistent with its proposed role as an anti-apoptotic factor, while IGFBP-5 is found at higher levels in regions of cell death, consistent with reports of its association with apoptosis in adult tissues. We propose that these three components of the IGF axis could be involved in the manifestation of the mutant phenotype in Hypodactyly, and that this is probably a result of their ability to regulate cell survival and cell death.
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  • 4
    ISSN: 1432-0533
    Keywords: Key words HSV ; Immunohistochemistry ; Apoptosis ; p53 ; Transcription factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To understand the mechanism of neuronal apoptosis induced by herpes simplex virus (HSV) infection in vivo, the distribution of viral antigen, the appearance of apoptotic bodies, and the expressions of the tumor suppressor gene p53 and several transcription factors such as c-fos, c-jun and NF-κB were examined immunohistochemically and histopathologically after corneal infection of mice with HSV type 2 strain 186. Five days after HSV infection, viral antigen was diffusely detected in the corneal epithelium, the trigeminal ganglion and the pars caudalis of the spinal trigeminal nucleus. Neuronal apoptosis was observed in the brain stem ipsilateral to the HSV-infected side with the immunoreactivities of c-fos, c-jun, NF-κB and p53. Dual-labeling immunohistochemical studies revealed that almost all of the viral antigen-positive neurons and glia in the brain stem also showed p53 immunoreactivity. On the other hand, no neuronal apoptosis but only with the expression of c-jun was found in the trigeminal ganglion. Our results suggest that the different expression of transcription factors between the brain stem and the trigeminal ganglion may influence the neuronal apoptosis induced by HSV infection.
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  • 5
    ISSN: 1432-0533
    Keywords: Key words Skeletal muscle ; Eccentric exercise ; Apoptosis ; Dystrophin ; Dystrophin-associated proteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study investigated the basis for the high severity of damage to skeletal muscle due to eccentric exercise, i.e., to muscles generating force while lengthened. Fast and slow rat leg muscles maintained in an extended position were examined after 2–24 h of continuous stimulation. The treatment caused the injury to some regions of both muscles. Within the better preserved parts of the muscles, i.e., those without signs of necrotic processes, dystrophin, spectrin, and some of the dystrophin-associated proteins (β-dystroglycan, α-sarcoglycan, and γ-sarcoglycan) disappeared from sarcolemma of many fibers. The reduction or loss of dystrophin from the sarcolemma was more evident than that of other proteins examined, with sarcoglycans apparently being the most preserved. Several muscle fibers devoid of dystrophin contained apoptotic nuclei. Simultaneously, Bax, Bcl-2 and caspase-3 proteins appeared in many fibers. Our results indicate that a normal muscle overworking in an extended position undergoes the loss of several membrane skeletal proteins because of the excessive stress to the membrane cytoskeleton, which can lead to fiber death by either apoptosis or necrosis. This experimental model may represent a good model for mimicking the pathogenetic events in several muscular dystrophies.
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  • 6
    ISSN: 1432-0533
    Keywords: Key words Alzheimer’s disease ; Apoptosis ; β-Amyloid load ; Astrocytes ; Microglia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The extent of DNA fragmentation analysed using the TUNEL technique was evaluated in post-mortem human brain tissue. Twenty-four patients with clinical and histopathological diagnosis of Alzheimer’s disease (AD) and a short post-mortem delay were analysed. We report an increase in the count of TUNEL-labelled cells as the pathology of AD intensifies. Our results point out a significant correlation between neurofibrillary tangle and senile/neuritic plaque score and TUNEL-labelled cells. Patients with two copies of apolipoprotein (Apo) E ɛ4 allele had highest number of histopathological hallmarks lesions of AD, whereas the ApoE genotype did not significantly influence the density of TUNEL-positive cells. No significant correlation was found between β-amyloid protein load and TUNEL-labelled cells. There was no relationship between the age at death, age at onset, extent of astrogliosis or microgliosis and TUNEL-labelled cells in our material.
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  • 7
    ISSN: 1432-0738
    Keywords: Key words Acetaminophen ; Hepatotoxicity ; Apoptosis ; bcl-XL expression ; DNA fragmentation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The protein BCL-XL and protein product of proto-oncogene bcl-2 act as apoptosis antagonists, and BCL-XS serve as a dominant death promoter, including apoptosis following exposure to chemotherapeutic drugs. This investigation examined whether some aspects of the highly integrated process of acetaminophen (AAP)-induced hepatotoxicity involve down-regulation or upregulation of expression of BCL-2, BCL-XL and BCL-XS in mouse liver in vivo. Male ICR mice (CD-1; 35–45 g) were treated ip with a hepatotoxic dose of AAP (500 mg/kg) and sacrificed 0, 6, and 18 h later. Blood was collected upon sacrifice for determination of serum alanine aminotransferase (ALT) activity and the liver was sectioned for histopathological diagnosis of necrosis/apoptosis. Portions of liver tissues were also used for DNA extraction (for gel electrophoresis) and Western blot analysis. This study demonstrates that administration of a hepatotoxic dose of AAP to ICR mice results in severe liver injury (ALT leakage 〉200-fold at 6 h and 〉600-fold at 18 h) leading to massive cell death by apoptosis (diagnosed by nuclear ultrastructure, histopathology, and DNA ladder), in addition to necrosis coupled with spectacular changes in the BCL-XL expression (6 and 18 h after AAP administration). Western blot analysis of the liver proteins revealed that mouse liver expresses two proteins, BCL-XL and BCL-XS, and does not express BCL-2. As the toxicity progressed, during 6 and 18 h post-AAP administration, the BCL-XL protein band shifted to a slower mobility band which might represent a phosphorylated form of BCL-XL. Appearance of this higher molecular weight BCL-XL protein band correlated with massive apoptotic death of liver cells along with ladder-like DNA fragmentation. In the same time period, death inhibitory gene bcl-2 remained unexpressed, and the level of expression of BCL-XS remained unaltered. Whether the consistent level of expression of BCL-XS reflected inability of AAP to influence its expression remains unknown. Unaltered expression of BCL-XS in the near total absence of BCL-2 expression raises questions regarding the death promoting role of BCL-XS in vivo. The precise role of modified form of BCL-XL remains elusive. However, this study may have demonstrated for the first time drug-induced changes in the expression of anti-apoptotic gene BCL-XL, and a positive link between AAP-induced apoptotic death and modification of BCL-XL protein in vivo.
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  • 8
    ISSN: 1432-0738
    Keywords: Key words Fluoroacetate ; Apoptosis ; Testis ; Toxicity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fluoroacetate (FA), an inhibitor of aconitase, is known to lower the intracellular level of adenosine triphosphate (ATP), which recently has been suggested to be a possible determinant of the form of cell death, apoptosis or necrosis. To investigate which form of germ cell death occurs in FA-induced testicular toxicity, adult Sprague Dawley rats were given a single oral dose of FA (0.5 or 1.0 mg/kg) and euthanized at 3, 6, 12, 24, 48, and 72 h thereafter. Germ cell degeneration was histologically first found in early round spermatids at stage I and in spermatogonia at stages II-IV of seminiferous tubules 6 and 12 h, respectively, after dosing. Degenerating spermatogonia exhibited characteristic features of apoptosis as demonstrated by both electron microscopy and in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), whereas spermatids did not. At the 24 and 48 h time points, degenerating spermatids were continually present and subsequently formed multinucleated giant cells, while the number of degenerating spermatogonia and TUNEL-labeled spermatogonia was drastically and/or significantly decreased compared to those from the control group, indicating that spontaneous male germ cell apoptosis is inhibited. Coincident with these morphological changes, DNA laddering on gel electrophoresis was apparent only 12 h after dosing. The results demonstrate that FA induces either apoptosis or necrosis of male germ cells in the early stage after dosing and subsequently inhibits spontaneous apoptosis.
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  • 9
    ISSN: 1432-0738
    Keywords: Key words Fumonisin B1 ; C6 Glioma cells ; DNA fragmentation ; Comet assay ; Apoptosis ; Prevention by Vitamin E
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Fumonisin B1 (FB1), produced by the fungus Fusarium moniliforme, belongs to a class of sphingosine analogue mycotoxins that occur widely in the food chain. Epidemiological studies have associated consumption of Fusarium moniliforme-contaminated food with human oesophageal cancer in China and South Africa. FB1 also causes equine leucoencephalomalacia. Evidence for induction of apoptosis by FB1 was first obtained when C6 glioma cells were incubated with fumonisin B1 (3–27 μM) causing DNA fragmentation profiles showing DNA laddering in gel electrophoresis and apoptotic bodies revealed by chromatin staining with acridine orange and ethidium bromide. Further confirmation experiments and comet assays have been performed under similar conditions. The results of the comet test show that FB1 at 9 and 18 μM induces respectively 50 ± 2% and 40 ± 1% of cells with a comet with an increased tail length of 93 ± 9 μm and 102 ± 17 μm respectively. Under these concentrations, FB1 induced DNA fragmentation and laddering and many apoptotic bodies. Pre-incubation of the cells with vitamin E (25 μM) for 24 h before FB1 (18 μM) significantly reduced DNA fragmentation and apoptotic bodies induced by FB1.
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  • 10
    ISSN: 1432-1084
    Keywords: Key words: Thorax ; Mediastinum ; Lymphangioma ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Adult mediastinal lymphangiomas are rare lesions the diagnosis of which is difficult based on imaging studies. A retrospective study of CT, MR, and pathologic findings of mediastinal lymphangioma was performed in order to correlate pathological and imaging findings. Nine cases of adult lymphangiomas were identified in the records of our institution over a 12-year period. The CT, MR, and pathologic findings were reviewed. Lesions were classified pathologically as unilocular, cavernous, and intermediate types. Pathologic examination identified six cases of unilocular lesion, two cases of cavernous type, and one intermediate type. The CT features (n = 9) included a smoothly marginated non-enhancing mass of water attenuation (n = 7), a non-enhancing mass of soft tissue attenuation (n = 1), and an enhancing multiseptated mass (n = 1). Lesions were located in the anterior mediastinum (n = 2), right paratracheal (n = 4), subcarinal (n = 1), aortopulmonic window (n = 1) areas, and below the left hilum extending into the posterior mediastinum (n = 1). The MR features (n = 3) were characterized by an enhancing multicystic and multiseptated appearance, evocative of a cavernous type in two cases. The CT appearance of mediastinal thoracic lymphangioma is variable depending on the pathologic type. The most common unilocular type is a non-enhancing thin-walled mass on CT. A less frequent cavernous type can be suggested based on a multiseptated and loculated mass on CT and/or MR examination.
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  • 11
    ISSN: 1432-1084
    Keywords: Key words: Ovarian cancer ; Lesion characterization ; Recurrence ; PET ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to compare prospectively the accuracy of whole-body positron emission tomography (PET), CT and MRI in diagnosing primary and recurrent ovarian cancer. Nineteen patients (age range 23–76 years) were recruited with suspicious ovarian lesions at presentation (n = 8) or follow-up for recurrence (n = 11). All patients were scheduled for laparotomy and histological confirmation. Whole-body PET with FDG, contrast-enhanced spiral CT of the abdomen, including the pelvis, and MRI of the entire abdomen were performed. Each imaging study was evaluated separately. Imaging findings were correlated with histopathological diagnosis. The sensitivity, specificity and accuracy for lesion characterization in patients with suspicious ovarian lesions (n = 7) were, respectively: 100, 67 and 86 % for PET; 100, 67 and 86 % for CT; and 100, 100 and 100 % for MRI. For the diagnosis of recurrent disease (n = 10), PET had a sensitivity of 100 %, specificity of 50 % and accuracy of 90 %. The PET technique was the only technique which correctly identified a single transverse colon metastasis. Results for CT were 40, 50 and 43 %, and for MRI 86, 100 and 89 %, respectively. No statistically significant difference was seen. Neither FDG PET nor CT nor MRI can replace surgery in the detection of microscopic peritoneal disease. No statistically significant difference was observed for the investigated imaging modalities with regard to lesion characterization or detection of recurrent disease; thus, the methods are permissible alternatives. The PET technique, however, has the drawback of less accurate spatial assignment of small lesions compared with CT and MRI.
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 832-840 
    ISSN: 1432-1084
    Keywords: Key words: Osteochondroma ; Complications ; Chondrosarcoma ; Bone tumors ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Osteochondromas can be complicated by mechanical irritation, compression or injury of adjacent structures, fracture, malignant transformation, and postoperative recurrence. Magnetic resonance imaging represents the most valuable imaging modality in symptomatic cases, because it can demonstrate typical features of associated soft tissue pathology, which can be differentiated from malignant transformation. Reactive bursae formation presents as an overlying fluid collection with peripheral contrast enhancement. Dislocation, deformation, and signal alterations of adjacent soft tissue structures can be observed in different impingement syndromes caused by osteochondromas. Magnetic resonance imaging provides excellent demonstration of arterial and venous compromise and represents the method of choice in cases with compression of spinal cord, nerve roots, or peripheral nerves, depicting changes in size, position, and signal intensity of the affected neural structures. Malignant transformation as the most worrisome complication occurs in approximately 1 % of solitary and 5–25 % of multiple osteochondromas. Magnetic resonance imaging is the most accurate method in measuring cartilage cap thickness, which represents an important criterion for differentiation of osteochondromas and exostotic (low-grade) chondrosarcomas. Cartilage cap thickness exceeding 2 cm in adults and 3 cm in children should raise the suspicion for malignant transformation. Finally, MR imaging can detect postoperative recurrence by depiction of a recurrent mass presenting typical morphological features of a cartilage-forming lesion.
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 780-782 
    ISSN: 1432-1084
    Keywords: Key words: Uterus ; Endometrial stromal sarcoma ; Uterine myometrium ; Uterine leiomyoma ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Two cases of uterine endometrial stromal sarcoma whose main mass was located in uterine myometrium are reported. They mimicked uterine leiomyoma with cystic degeneration or uterine leiomyosarcoma. Endometrial stromal sarcoma should be suggested in the differential diagnosis of mass lesion in uterine myometrium.
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 786-801 
    ISSN: 1432-1084
    Keywords: Key words: CT ; MRI ; Colon ; Colonography ; Virtual colonoscopy ; Colorectal polyp ; Screening
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. With the introduction of multidetector technology in CT and the moveable table with integrated coil modules in MRI, the concept of multiorgan screening has become realistic. CT colonography and MR colonography are new radiologic techniques that promise to be highly sensitive colorectal screening examinations. This article reviews the current status and research directions in CT colonography and MR colonography, and compares these methods.
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  • 15
    ISSN: 1432-1084
    Keywords: Key words:18FDG-PET ; Osteomyelitis ; Antigranulocyte antibody scintigraphy ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The purpose of this report is to discuss FDG-PET as a potentially new imaging tool in the diagnosis of infections of osteosynthetic material. We present a patient with a poly-trauma who developed a chronic osteomyelitis and ostitis after repeated osteosynthesis in a fibular transplant to the left femur. Work up included MRI, antigranulocyte antibody scintigraphy and positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG). Infection of the fibular transplant was demonstrated clearly by PET but not by the other methods. Positron emission tomography may become an important indication in the diagnosis and follow-up of bone infection.
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  • 16
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 1242-1244 
    ISSN: 1432-1084
    Keywords: Key words: Muscle anomalies ; Median nerve compression ; Wrist ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Muscle anomalies around the wrist, in particular the palmaris longus muscle, may cause effort-related median nerve compression. A search of the medical records at our university hospital between 1994 and 1999 revealed four patients with an effort-related median nerve compression due to a reversed palmaris longus muscle. Magnetic resonance imaging was used in the patient work-up and showed an anomalous muscle in each case that had been missed initially. All four patients were free of pain after simple excision of the anomalous muscle. Awareness of muscle anomalies at the wrist on MR imaging is essential in evaluating patients with nerve compressions at the wrist. The purpose of this article is to heighten this awareness in radiologists.
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    European journal of orthopaedic surgery & traumatology 10 (2000), S. 203-205 
    ISSN: 1432-1068
    Keywords: Cervical spondylotic myelopathy ; Syringomyelia ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of syringomyelia associated with cervical spondylotic myelopathy is presented. A decompressive cervical laminectomy was performed. The patient improved gradually after operation. It is concluded that the choice of surgical treatment in cases with syringomyelia associated with cervical spondylotic myelopathy requires a careful neurological and radiological examination based on the findings of magnetic resonance imaging (MRI) and cine-MRI.
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  • 18
    ISSN: 1437-7772
    Keywords: Key words Endometrial carcinoma ; MRI ; Diagnosis ; Minimally invasive therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Magnetic resonance imaging (MRI) provides precise staging of endometrial carcinoma. However, we have sometimes experienced patients with microscopic extrauterine extension in whom MRI showed the disease as being limited to the uterus. We studied indirect MRI signs for microscopic extrauterine spread of endometrial carcinoma which outwardly seemed to be limited to within the uterus. Methods. MRI studies and the clinical records of 100 patients with surgically proven endometrial carcinoma were retrospectively reviewed. We evaluated: (1) MRI staging, (2) tumor growing at the orifices of the fallopian tube in the uterine fundus, (3) hydrosalpinx, and (4) ascites, in each MRI study. Results. Surgical specimens showed that 12 of the 100 patients had extrauterine spread, with 1 patient showing both ovarian extension and omental metastasis; there ovarian extension in 3, extension to the fallopian tubes in 3, omental metastasis in 1, and positive peritoneal cytology in 4. Tumor growing at the orifices of the fallopian tubes with deep myometrial invasion showed higher accuracy for predicting microscopic intrauterine spread (82.0%) although it was not significantly different from the accuracy of deep myometrial invasion anywhere within the uterus (75.0%). However, tumor growing at the orifices of the fallopian tubes in a patients with stage Ia disease showed a high negative predictive value (89.7%). Hydrosalpinx had the highest specificity (98.9%) and accuracy (88.0%); however, it did not seem to be practical because it was observed in only 2 patients. Ascites in postmenopausal patients showed higher specificity (93.5%), although it was not considered to be useful in the premenopausal patients. Conclusion. Tumor extension at the orifices of the fallopian tubes in patients with stage Ia disease, and ascites in postmenopausal patients on MRI seemed to be predictive factors for microscopic extrauterine spread.
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    International journal of clinical oncology 5 (2000), S. 200-203 
    ISSN: 1437-7772
    Keywords: Key words Small cell carcinoma of the ovary ; Pregnancy Paclitaxel ; MRI ; Facial palsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Small cell carcinoma of the ovary (SCCO) is a highly aggressive malignancy that affects young females. The disease is fatal in nearly all patients with disease categorized as higher than stage IA. A 30-year-old Japanese woman was diagnosed, while pregnant, as having bilateral small cell carcinoma, pulmonary type, a rare finding. She received three courses of JP chemotherapy (carboplatin, 525 mg; cisplatin, 120 mg) and three courses of PVP chemotherapy (peplomycin, 30 mg; vinblastin, 12 mg; cisplatin, 120 mg). Computed tomography scans were taken during and after the period in which she received chemotherapy showed growing multiple metastatic tumors and massive ascites. Third-line chemotherapy with paclitaxel (225 mg) was then initiated. Although the lymphadenopathy and massive ascites were alleviated, bone marrow suppression intervened. The patient died 18 months after being diagnosed. To our knowledge, this is third reported case of SCCO to be diagnosed during pregnancy, and the first reported case of bilateral disease diagnosed during pregnancy.
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  • 20
    ISSN: 1437-9813
    Keywords: Key words Adriamycin ; Apoptosis ; Embryogenesis ; Esophageal atresia ; Notochord ; VATER association
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The adriamycin-induced rat model of the VATER association has provided a means of studying the morphogenesis of a variety of major congenital structural abnormalities similar to those seen in humans with the VATER association. Most interest has been centered on the foregut, where the model has clarified some aspects of the development of esophageal atresia (EA), tracheal agenesis, and other communicating bronchopulmonary foregut malformations. It has demonstrated aberrations in the nerve supply to the esophagus in EA and allowed the study of tracheomalacia. A relationship between an abnormal notochord, foregut abnormalities, and vertebral defects has been shown, and the model has reignited interest in the role of the notochord as a regional organizer of axial development. The normal temporospatial characteristics of apoptosis during fore- and hindgut development is disturbed in this model, resulting in abnormal morphology. The indications are that this model will continue to clarify the processes that lead to many of the structural congenital abnormalities that are seen in infants born with the VATER association.
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  • 21
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 16 (2000), S. 485-487 
    ISSN: 1437-9813
    Keywords: Key words Duodenum ; Apoptosis ; Fetus ; Rat ; Duodenal atresia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Duodenum is thought to go through a solid-core stage followed by recanalization during its development. This study investigates the role of apoptosis in normal duodenal development, especially during widening of the lumen, and hence, the possible role of apoptosis in duodenal atresia (DA). Twenty-four time-mated Sprague-Dawley rats were killed from day 13 to day 20 of gestation. Duodenums of 3 fetuses were chosen randomly from each rat and processed. Apoptosis was determined by the terminal deoxytransferase-mediated biotin dUTP nick-end labeling (TUNEL) technique (ApopTag). Apoptosis count and cross-sectional areas were measured with an image analyzer (MetaMorph). The number of apoptotic cells per unit area duodenum peaked on day 15 for the mucosal/submucosal layer and on day 14 for the muscular/mesenchymal layer. The maximal number of apoptotic cells per cross-section of duodenum was between 7 and 8. The cross-sectional areas of the duodenal wall and lumen increased exponentially between day 17 and day 19 while duodenal-wall thickness remained relatively constant throughout duodenal development. The localization, timing, and intensity of apoptosis do not suggest that apoptosis is responsible for the widening of the duodenal lumen; enlargement of the lumen is related to the increase in duodenal circumference. Apoptosis thus may not be involved in the pathogenesis of DA.
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  • 22
    ISSN: 1437-7772
    Keywords: Key words BAK cells ; T24 cells ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. We previously reported the basic characteristics of BCG (bacille Calmette-Guérin)-activated killer (BAK) cells, which exhibited antitumor effects against the bladder cancer cell line T24. Our study suggested that both BCG and BAK cells were responsible for the inhibition of tumor cell proliferation; however, the basic mechanism of BCG or BAK cells in this inhibition was not clear. We here report the antitumor effects of BAK cells, which correlated with the induction of apoptosis in T24 cells. Methods. Lymphocytes were cultured with BCG to examine 3H-thymidine uptake, and the subpopulation was evaluated by immunocytometry. T24 cells were then cultured with BAK cells for the analysis of 3H-thymidine uptake and apoptosis induction by DNA electrophoresis; pathology study, and cell-cycle analysis were also done. Culture supernatants of BAK and T24 cells were also investigated to detect interferon-γ (IFN-γ), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Results. The 3H-thymidine uptake study of lymphocytes showed that BCG activated the lymphocytes. Evaluation by immunocytometry revealed that CD4+ and CD8+ T cells were induced by BCG. The 3H-thymidine uptake study of T24 cells revealed that BAK cells inhibited tumor cell proliferation. DNA electrophoresis, the morphological study, and cell-cycle analysis by immunocytometry demonstrated that apoptosis in T24 cells was induced when they were cultured with BAK cells. IFN-γ, IL-6, and TNF-α were detected in the culture supernatants of BAK and T24 cells. Conclusions. Cytokine production and the induction of apoptosis may, together, be the major mechanisms of the antitumor action seen when BAK cells were employed against T24 cells; BAK cells could be employed as clinical effectors against bladder cancer.
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  • 23
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    Clinical and experimental nephrology 4 (2000), S. 24-28 
    ISSN: 1437-7799
    Keywords: Key words Uranyl acetate ; ARF ; Glycine ; Apoptosis ; Tubular damage
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Although uranyl acetate (UA) is known to induce apoptosis in renal tubular cells, the pathophysiological role of apoptotic cell death in UA-induced acute renal failure (ARF) is not clear. In this study, we examined whether glycine, which is known to provide protection against nephrotoxic acute renal failure, attenuated tubular damage in UA-induced ARF in rats, and, if so, whether the attenuation of tubular damage was associated with reduced apoptotic cell death. Methods. Sprague-Dawley rats were allocated to three groups; normal controls, UA-treated, and UA plus glycine-treated. Acute renal failure was induced by the intravenous injection of UA (5 mg/kg). UA plus glycine-treated rats were given glycine at 1 g/kg, i.v. over 3 min at the same time as the UA injection. Serum creatinine concentration (Scr) and tubular damage score were examined 5 days after UA administration. Apoptosis was evaluated by counting the number of terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)-positive cells in the outer stripe of the outer medulla. Results. Glycine significantly decreased the UA-induced increases in Scr (3.73 ± 0.31 vs 2.74 ± 0.11 mg/dl; P 〈 0.05) and the tubular damage score (3.83 ± 0.13 vs 2.58 ± 0.01; P 〈 0.01). UA significantly increased the number of TUNEL-positive cells in the outer stripe of the outer medulla (0.16 ± 0.04 vs 7.45 ± 0.46/high power field at ×400 magnification; P 〈 0.01 vs normal control value). Glycine infusion significantly lessened the number of TUNEL-positive cells (5.84 ± 0.31/ high power field at ×400 magnification; P 〈 0.01 vs UA-treated rats). A significant correlation was found between the number of TUNEL-positive cells and the tubular damage score (r = 0.93; P 〈 0.01). Conclusion. Glycine ameliorated the severity of UA-induced ARF and the degree of apoptotic cell death. This finding suggested that the protective effect of glycine in UA-induced ARF may be mediated, at least in part, through a reduction of apoptosis.
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  • 24
    ISSN: 1437-7772
    Keywords: Key words Photodynamic therapy ; Cervical cancer ; Apoptosis ; MnSOD ; Gene induction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Photodynamic therapy (PDT) is a cancer treatment modality in which systemic administration of a tumor-localizing photosensitizer is followed by irradiation of the tumor with visible light. Although PDT is undergoing clinical trials for various cancers, the mechanisms of its action are not fully understood. To investigate the mechanism of cell death by PDT, we performed in-vitro PDT, using Photofrin II as a photosensitizer, in two human cervical carcinoma cell lines, HeLa and CaSki. Methods. Cells were incubated with Photofrin II for 24 h, followed by illumination, using a YAG-OPO laser. Cell survivability after PDT was evaluated by an MTT assay. Cytotoxicity was assayed by measuring the release of lactate dehydrogenase (LDH) into the supernatant. DNA of the PDT-treated cells was electrophoresed in an agarose gel to determine fragmentation. In situ detection of apoptosis in the PDT-treated cells was performed by identification of the 3′-OH ends of DNA. In addition, induction of manganese superoxide dismutase mRNA (MnSOD) was analyzed in the PDT-treated cells. Results. The CaSki cells were more sensitive to this PDT treatment than were the HeLa cells. DNA fragmentation was observed with less than 5 μg/ml of Photofrin II in both cell lines, whereas PDT-induced cell membrane destruction, determined by LDH release, was observed only at 10 μg/ml. The MnSOD mRNA was induced in the HeLa cells in the early hours after PDT with a non-lethal dose of Photofrin II, but was reduced with a high dose, whereas the CaSki cells did not show any induction of the MnSOD gene by PDT. Conclusion. The present results suggest that PDT induces cell death by a mechanism involving membrane destruction and apoptosis. Differences in cell susceptibilities to PDT may depend upon a protective mechanism, such as MnSOD gene induction.
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  • 25
    ISSN: 1437-7780
    Keywords: Key words Gastric cancer ; Low-dose FP ; Pharmacokinetics ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To analyze the clinical efficacy of a protracted infusion of low-dose 5-fluorouracil (5-FU) and cisplatin (CDDP), a phase II study was performed in 36 patients with advanced gastric cancer. The treatment schedule of the low-dose administration of 5-FU and CDDP (FP) was a continuous infusion of 5-FU (250 mg/m2) for 28 consecu-tive days and a drip infusion of CDDP (3.5 mg/m2) for 5 consecutive days, followed by a 2-day interval each week in one cycle. The overall response rate was 47.2%. Of importance, the improvement in quality of life assessed by performance status (PS) and oral intake was 13.9% and 33.3%, respectively. The toxicity in low-dose FP treatment was less than grade 2, including gastrointestinal toxicities and bone marrow suppression, and this was tolerable during the treatment. The median survival time (MST) and 1-year survival rate were 8 months and 36.2%, respectively. In a pharmacokinetic analysis following the protracted infusion of low-dose FP, the plasma concentrations of 5-FU and CDDP were increased to about 120–130 ng/ml and 0.3–0.5 μg/ml on day 21 after the treatment, respectively. The plasma concentrations of 5-FU and CDDP were not significantly different between responders and non-responders. The tumor response to low-dose FP treatment was associated with the induction of apoptotic cell death and with the overexpression of apoptosis-related genes, such as Bax and Bcl-Xs, in cancer cells. These results indicate that the protracted infusion of low-dose FP could be a useful regimen for patients with advanced gastric cancer, in terms of the high response rate and low toxi-city, possibly leading to the prolongation of survival and improvement in the quality of life.
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  • 26
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    Journal of neural transmission 107 (2000), S. 1427-1436 
    ISSN: 1435-1463
    Keywords: Keywords: Brain ; MRI ; PSP ; MSA ; parkinsonism.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary. To establish diagnostic magnetic resonance imaging (MRI) criteria for differentiating progressive supranuclear palsy (PSP) from multiple system atrophy (MSA), magnetic resonance images from eight patients with probable PSP, 30 with probable MSA {nine striatonigral degeneration (MSA-P) and 21 olivopontocerebellar atrophy (MSA-C)}, and ten age-matched controls were retrospectively studied. Anteroposterior diameters in the midline sagittal T1-weighted image of the rostral (RMT) and caudal midbrain tegmentum (CMT), caudal pons and medulla were measured. Divergence of the red nuclei (RN) in the axial T2-weighted image was judged. All PSP images had a smaller RMT diameter than the lower limit of the normal range, showed RN divergence, and had a pontine diameter within the normal range. All MSA images had a CMT diameter within the normal range; no MSA images showed divergence of RN. Forty-four percent (4/9) of MSA-P and 76% (16/21) of MSA-C images had a pontine diameter smaller than the lower limit of the normal range. On basis of the results, we propose MRI diagnostic criteria for differentiating PSP from MSA.
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  • 27
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    Child's nervous system 16 (2000), S. 731-734 
    ISSN: 1433-0350
    Keywords: Keywords Children ; Brain ; Tumour ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The author reviews the progress made during the last 25 years in noninvasive diagnosis of brain tumours in children. MRI has replaced all other modalities available at that time. The diagnosis is still based on a precise anatomical analysis of the lesion rather than on other specific findings. New techniques, such as spectroscopy and diffusion, may help to characterise further brain tumours in children preoperatively.
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  • 28
    ISSN: 1433-0350
    Keywords: Keywords Syringomyelia ; Chiari I malformation ; Foramen magnum decompression ; Children ; Scoliosis ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The authors studied the role of the sole posterior fossa bony decompression in the management of symptomatic children affected by Chiari type I anomalies. The series in the pediatric literature on this subject were reviewed and compared with that presented in this article. From May 1994 to December 1998, 53 patients (3 months to 26 years) were observed. They were divided into: asymptomatic patients (27), who received no surgical treatment and were only subject to clinical observation; symptomatic patients (brain stem compression 16, syringomyelia 10, including 7 with holocord). All the symptomatic patients were treated with the same surgical approach: bony decompression of posterior fossa with removal of the posterior arch of C-1 and the outer layer of the dura without dural opening. In all 16 (100%) of the 16 patients with brain stem compression the symptoms resolved or improved; in patients with syringomyelia the symptoms were resolved or improved in 94.4% of cases. Two children required further surgery after 13 and 24 months, respectively.This series seems to demonstrate that even a simple extradural surgical approach, with a lower rate of postoperative complications and short stay in hospital, is sufficient to arrest the disease and to improve the symptomatology in a high percentage of cases (97.2%), which is comparable to that achieved with other, more aggressive, procedures.
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  • 29
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Multiple Sklerose ; Apoptose ; Immunpathogenese ; CD95 ; TNF ; Keywords Multiple sclerosis ; Apoptosis ; Immunopathogenesis ; CD95 ; TNF
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Apoptosis, or programmed cell death, is a physiological cell suicide program mainly leading to selective elimination of useless cells. This mechanism is important for the homeostasis of the immune system and presumably plays a two-sided role in the pathogenesis of multiple sclerosis (MS). On the one hand, evidence has been provided that impaired apoptosis might result in increased numbers or persistence of activated myelin-specific T cells, thus inducing the pathophysiologic processes in MS. On the other hand, local tissue damage might involve apoptosis of glial and neuronal cells and lead to the clinical symptoms. Here, an overview is presented on the current knowledge of the role of apoptosis in the pathogenesis of MS, and implications for related therapeutic strategies are discussed.
    Notes: Zusammenfassung Apoptose, auch programmierter Zelltod genannt, stellt einen physiologischen Prozess zur selektiven Eliminierung vor allem von unerwünschten körpereigenen Zellen dar. Dieser für die Homöostase des Immunsystems wichtige Mechanismus nimmt wahrscheinlich eine ambivalente Schlüsselrolle in der Ätiopathogenese der multiplen Sklerose (MS) ein. So existieren Hinweise dafür, dass bei der MS eine eingeschränkte Apoptose zur pathologischen Existenz und Persistenz aktivierter myelinspezifischer T-Zellen führt, die wiederum für die charakteristische intrazerebrale Entzündung verantwortlich gemacht werden. Gleichzeitig deuten aktuelle Arbeiten aber darauf hin, dass auf der Endstrecke der entzündlichen Reaktion der apoptotische Untergang von Glia- und evtl. auch Nervenzellen zur Gewebeschädigung und somit entscheidend zur klinischen Symptomatik beitragen. Ziel dieser Übersicht ist die Zusammenstellung der bislang gewonnenen Erkenntnisse zur Bedeutung von Apoptose für die Pathogenese der MS und eines Ausblicks auf mögliche apoptoseorientierte Therapiestrategien.
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  • 30
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    Der Nervenarzt 71 (2000), S. 91-95 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Creutzfeldt-Jakob-Krankheit ; Diagnostik ; Diffussionswichtung ; MRT ; Bildgebung ; Übertragbare spongiforme Enzephalopathien ; Key words Creutzfeldt-Jakob disease ; Diagnosis ; Diffusion-weighted image ; MRI ; Brain images ; Transmissible spongiform encephalopathies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Today the diagnosis of Creutzfeldt-Jakob disease (CJD) is proven only postmortem or by evidence of neuropathology. During the patient's lifetime EEG recordings or cerebrospinal fluid analysis may support the diagnosis. In most cases, T2-MRI scans show hyperintensities of the basal ganglia. A new imaging technique called diffusion-weighted MRI (DWI) has recently been established. The sensitivity of DWI was evaluated in five patients suspected of CJD. All five cases showed hyperintense signal changes in the basal ganglia on DWI sequences. These findings were more pronounced in DWI than in T2, FLAIR, or PD-weighted images. Thus, DWI seems to be the most sensitive sequence for detecting changes in patients with suspected CJD. Moreover, its short scanning time ensures that fewer artifacts occur, especially in the case of myoclonus.
    Notes: Zusammenfassung Die sichere Diagnose der Creutzfeldt-Jakob-Krankheit kann nur bioptisch oder autoptisch durch Untersuchung von Hirngewebe gestellt werden. Die klinische Verdachtsdiagnose erhärten können technische und laborchemische Untersuchungen; hierzu gehört neben dem EEG die Surrogatmarkerbestimmung im Liquor. Nachdem sich bei der Mehrzahl der Patienten Veränderungen der Basalganglien gezeigt haben, gehört das MRT zu den bildgebenden Verfahren, die bei Verdacht auf CJD eingesetzt werden können. Inzwischen ist die Diffusionswichtung (DWI) in die neuroradiologische Diagnostik eingeführt worden. DWI-gewichtete MRTs bei 5 CJD-Patienten wurden von uns untersucht. Alle 5 Fälle zeigten im DWI-MRT signalintense Veränderungen der Stammganglien. Diese Veränderungen waren jeweils deutlicher als in der T2, Flair- oder Protonenwichtung. Das DWI-MRT halten wir für sensitiver zum Nachweis kortikaler und basaler Veränderungen bei CJD-Patienten im Vergleich zu Standardsequenzen. Durch die kurze Untersuchungszeit können besonders bei den häufig vorhandenen Myoklonien andere Wichtungen aufgrund von Bewegungsartefakten oftmals nicht in der gewünschten Qualität durchgeführt werden.
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  • 31
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Manganintoxikation ; Parkinsonismus ; MRT ; Verlaufskontrolle ; L-Dopa-Therapie ; Key words Manganese intoxication ; Parkinsonism ; MRI ; Follow-up study ; L-dopa treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Manganese intoxication is an unusual, severe form of intoxication. This report deals with a patient now 80 years old who accidentally ingested a solution of potassium permanganate for a period of at least 4 weeks 14 years ago. Since then, the patient suffers from a mild parkinsonian syndrome and distally accentuated polyneuropathies. Psychiatric disorders, especially demential or depressive symptoms, were not observed. Manganese analysis of his hair still shows a clear increase in manganese concentration. The MRI of his brain showed no pathological changes, in particular none of those often described with symmetric signal elevation in T1 in the area of the basal ganglia. In this study, we present clinical, laboratory, and neuroradiological findings. Unusual in this case with a short exposition is the long duration and clinical improvement without L-dopa treatment.
    Notes: Zusammenfassung Eine Manganintoxikation ist eine ungewöhnliche, schwere Intoxikationsform. Wir berichten über einen jetzt 80-jährigen Patienten, der vor 14 Jahren über die Dauer von mindestens 4 Wochen versehentlich Kaliumpermanganat eingenommen hatte. Der Patient leidet weiterhin unter einem leichten Parkinsonsyndrom und einer distal betonten Polyneuropathie. Psychiatrische St¨rungen, insbesondere ein dementielles oder depressives Symptom, fanden sich nicht mehr. Die Mangananalysen der Haare zeigen auch jetzt noch deutlich erhöhte Konzentrationen. Das MRT des Gehirns erbrachte keinen pathologischen Befund, insbesondere keine häufig bei Manganintoxikationen beschriebenen Veränderungen mit symmetrischen Signalanhebungen in T1-Wichtung im Bereich der Basalganglien (Globus pallidus). In einer aktuellen Untersuchung werden klinische, laborchemische sowie neuroradiologische Ergebnisse vorgestellt. Die Besonderheit des Falles erklärt sich aus einer kurzen Expositionsdauer mit einer langen Verlaufszeit und klinischer Befundbesserung ohne L-Dopa-Behandlung.
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  • 32
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    Der Nervenarzt 71 (2000), S. 411-415 
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Kufs ; Neuronale Zeroidlipofuszinose ; Demenz ; PET ; MRT ; Key words Kufs disease ; Neuronal ceroid lipofuscinosis ; Dementia ; PET ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The case of a 35-year-old man with progressive dementia from the age of 17 is presented. Clinical examination showed mild extrapyramidal and cerebellar signs and rare myoclonus. Neuropsychological evaluation disclosed severe cognitive deficits. Magnetic resonance imaging (MRI) revealed moderate generalized atrophy with abnormal iron deposition in the basal ganglia. Positron emission tomography (PET) with 18-fluorodeoxyglucose (18-FDG) demonstrated clear temporoparietal hypermetabolism. The clinical symptoms and course are typical for the rare adult type of neuronal ceroid lipofusconoses (Kufs' disease). The diagnosis is supported by the electron microscope detection of an abnormal accumulation of lipid vacuoles and lipofuscin in the eccrine sweat glands and the rectal ganglia cells.
    Notes: Zusammenfassung Berichtet wird der Fall eines 35-jährigen Patienten mit langsam progredienter Demenz seit dem 18. Lebensjahr. Zum Zeitpunkt der Untersuchung fielen klinisch eine leichtgradige extrapyramidale und zerebelläre Symptomatik sowie seltene Myoklonien auf, während die neuropsychologische Testung ausgeprägte kognitive Defizite ergab. Die kraniale Magnetresonanztomographie zeigte eine mäßige globale Atrophie und eine abnorme Eisenablagerung in den Basalganglien. In der Positronenemissionstomographie mit 18-FDG war ein deutlicher temporoparietaler Hypometabolismus erkennbar. Klinik und Verlauf sind typisch für die seltene adulte Variante der neuronalen Zeroidlipofuszinosen (Kufs-Typ). Diese Diagnose wird gestützt durch den elektronenmiroskopischen Nachweis abnormer Akkumulationen von Fettvakuolen und Lipofuszinablagerungen in den ekkrinen Schweißdrüsen der Haut und in den rektalen Ganglienzellen.
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  • 33
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    Gastric cancer 3 (2000), S. 39-44 
    ISSN: 1436-3305
    Keywords: Key words Chemosensitivity ; Apoptosis ; TUNEL ; Gastric cancer ; Small specimen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Because chemosensitivity tests usually require a large amount of tissue, they are not used routinely in patients with unresectable gastric cancer. The aim of this study was to investigate whether apoptosis can be used as a sensitivity assay for chemosensitivity in small gastric cancer specimens. Methods. Apoptosis, detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick labeling (TUNEL), was investigated in small specimens of the MKN-1, MKN-45, and TMK-1 human gastric cancer cell lines as a marker of chemosensitivity following exposure to antineoplastic agents. Results. Doxorubicin (DXR), SN-38 (active metabolite of irinotecan), and paclitaxel (Taxol) induced DNA fragmentation in MKN-45 and TMK-1 cells, but not in MKN-1. In contrast, neither 5-fluorouracil (5-FU) nor cisplatin (CDDP) induced DNA fragmentation in any of the three cell lines. Small pieces cut from tumors implanted in nude mice were exposed to the antineoplastic agents in culture medium for 24 h, and the percentage of TUNEL-positive cancer cells (TUNEL positivity) was examined. TUNEL positivity in all three cancers increased after exposure to DXR, SN-38, and Taxol, but not after exposure to CDDP or 5-FU. MKN-45 showed the highest TUNEL positivity with SN-38 and Taxol, and TMK-1 TUNEL positivity was highest with DXR. MKN-45 and TMK-1 were the most sensitive to these three antineoplastic agents in vitro, while MKN-1, with the lowest TUNEL positivity, was the least sensitive to these three antineoplastic agents. TUNEL positivity after exposure to Taxol correlated with the antitumor effects of this compound in an animal model. Conclusion. These results suggest that, in small gastric cancer specimens where apoptosis is implicated, TUNEL positivity may be applicable to a chemosensitivity test.
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  • 34
    ISSN: 1436-2023
    Keywords: Key words Osteonecrosis ; Femoral head ; Bone marrow edema ; MRI ; Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sequential magnetic resonance imaging (MRI) was performed on a 38-year-old woman with systemic lupus erythematosus who had received corticosteroid and had developed non-traumatic osteonecrosis of the femoral head. The initial MR finding was a band lesion on the T1-weighted image, which had been present before the onset of symptoms. At the onset of symptoms, a diffuse bone marrow edema pattern, with a low signal intensity on T1 and high signal intensity on T2-weighted images, was noted around the band lesion, extending to the femoral neck. Histopathologically, this region was found to consist of serous exudate, focal interstitial hemorrhage, and mild fibrosis, without any evidence of extension of osteonecrosis. It should be noted that extension of a low signal intensity area on MRI after the onset of hip pain may not be the result of the extension of osteonecrosis, but may represent concomitant edema due to collapse.
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  • 35
    ISSN: 1432-0843
    Keywords: Key words Taxanes ; Cervical cancer ; Apoptosis ; Tubulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Using a model of human cervical cancer (ME-180 cells), the anti-tumour activity of paclitaxel was compared to that of docetaxel and IDN5109, a newly developed taxane. The growth inhibition effect of taxanes was assessed after 3 days of exposure. DNA analysis, the taxane-dependent modulation of the expression of the α and β subunits of tubulin and DNA fragmentation were assessed by flow cytometry. The presence of apoptosis was confirmed by morphological analysis using a laser scan cytometer. For the evaluation of “in vivo” anti-tumour activity, taxanes were administered to nude mice intravenously once daily, according to a q3/4d × 4 schedule. Docetaxel, IDN5109 and paclitaxel obtained “in vitro” IC50 values of 0.86, 1.4 and 2.4 nM, respectively. DNA analysis demonstrated a transient block at the G2/M phase of the cell cycle only after 12 h of culture in the presence of taxanes and an increase of nuclear fragmentation suggestive for apoptosis after additional 12 and 60 h of exposure. Morphological analysis confirmed the presence of apoptosis. Taxanes induced a down-modulation of the α subunit of tubulin in the G0/1 phase of the cell cycle, and an overexpression of the β subunit in the G2/M phase. A strong anti-tumour activity was obtained “in vivo” for nude mice xenografted using ME-180 cells (T/C=0% for all drugs). These data indicate that the three taxanes are strongly active both “in vitro” and “in vivo” toward ME-180 cells. Clinical studies are now needed to ascertain if the higher anti-tumour activity observed “in vitro” using docetaxel and IDN5109 yields a better clinical response in advanced cervical carcinoma with respect to paclitaxel.
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  • 36
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    Cancer chemotherapy and pharmacology 45 (2000), S. 183-191 
    ISSN: 1432-0843
    Keywords: Key words Epoxide-containing piperazines ; Apoptosis ; Chemotherapeutics ; AbbreviationsNCO-700 Bis[ethyl(2R,3R)-3-[(S)-3-methyl-1-[4-(2,3,4-trimethoxyphenylmethyl)piperazin-1-ylcarbonyl]butylcarbamoyl]oxirane-2-carboxylate]- sulfate ; TOP-008 Bis[ethyl(2R,3R)-3-[(S)-3-methyl-1-[4(3-phenyl-2-propenyl)piperazin-1-ylcarbonyl]butyl- carbamoyl]oxirane-2-carboxylate]sulfate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: The overall purpose of this study was to determine the potential efficacy of epoxide-containing piperazines as a new class of anti-cancer agents. Two representative compounds, specifically NCO-700, a 4-trimethoxyphenyl-substituted epoxide-piperazine, and TOP-008, a 4-phenylpropenyl-substituted epoxide-piperazine were tested in cytotoxic assays with human breast and prostate cancer cell lines. A second objective was to determine if these two compounds had anti-cancer activity in vivo when tested against xenograft tumors in nude mice or human tumors grown under the kidney capsule in mice. A final objective of this study was to establish if NCO-700 and TOP-008 achieved cancer cell killing through an apoptotic mechanism. Methods: The anti-proliferative activity of NCO-700 and TOP-008 were tested in a 7 day cell-survival assay utilizing a number of well characterized breast (HS-578T, T47D, MCF-7) and prostate (DU-145, PC-3, LNCaP) cancer cell lines. In vivo studies with the two compounds were performed, in nude mice bearing DU-145 xenograft tumors, and in normal mice in which DU-145 prostate cancer cells and HS-578T breast cancer cells were grown as solid tumors in the subrenal capsules of the animals. Apoptotic cell death of cancer cells was determined by a number of established techniques that detect apoptosis, including the confocal laser microscopy of treated cells and mitochondrial leakage assays utilizing the cationic dye, JC-1. Finally, the activation of the caspase cascade, enzymes that carry out apoptosis in mammalian cells, was examined in treated cells by immunoblot assays. Results: NCO-700 and TOP-008 displayed cytotoxicity to HS-578T human breast cancer cells, with ED50 values in the 3–6 μM range. Cytotoxicity to androgen receptor-negative human prostate cancer cells (PC-3 and DU-145 cells) occurred with ED50 values in the 5–20 μM range. Cytotoxicity to hormone receptor-positive breast and prostate cancer cell lines occurred at 10 to 20-fold higher concentrations of the two compounds. When human prostate (DU-145) or breast cancer (HS-578T) cells were grown as solid tumors in the subrenal capsules of mice, significant anti-tumor activity of NCO-700 was observed at 20 mg/kg and 50 mg/kg body weight respectively, for prostate and breast tumors. In nude mice bearing DU-145 prostate tumor xenografts, 50 mg/kg doses of the two compounds either stopped (TOP-008) tumor growth or slowed (NCO-700) growth. The mechanism of cytotoxicity was shown to be through apoptosis, (a) by confocal microscopy studies revealing nuclear fragmentation, (b) by mitochondrial studies revealing disruption of the mitochondrial membrane and release of the cationic dye, JC-1, into the cytoplasm and (c) by protein immunoblot assays indicating that over a 6 h period, TOP-008 induced a significant accumulation of the pro-apoptotic protein, bak, in the mitochondrial fraction of HS-578T human breast cancer cells, accompanied by activation, at 2.5 h, of caspase-3. Conclusions: These studies indicated that the epoxide-containing piperazines, as exemplified by NCO-700 and TOP-008, were effective anti-cancer agents when tested in vitro and in vivo against human breast and prostate tumors. Our studies also indicated that TOP-008 induced the initiation of the caspase cascade leading to apoptosis. Previous toxicology studies in rodents and dogs, as well as a Phase I study in humans, showed NCO-700 to be a well-tolerated, non-toxic compound. Taken together with our current findings, these results suggest that this class of compounds has the potential to be relatively safe, new chemotherapeutic agents for refractory breast and prostate cancers.
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  • 37
    ISSN: 1432-0851
    Keywords: Key words Drug therapy ; T cells ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Noscapine, a phthalideisoquinoline alkaloid derived from opium, has been used as an oral anti-tussive agent and has shown very few toxic effects in animals or humans. Recently, we reported that noscapine binds stoichiometrically to tubulin and promotes microtubule polymerization. Noscapine causes growth arrest of tumor cells in mitosis and induces apoptosis of tumor cells in vitro. Previous experiments also showed that noscapine has potent antitumor activity in mice when administered parenterally or by gastric lavage. Here, we report that the anti-mitotic effect was specific to noscapine since closely related compounds did not inhibit the growth of a lymphoma cell line. In addition, noscapine was shown to be effective in reducing the growth of the lymphoma and increasing the survival of tumor-bearing mice when administered in the drinking water. It is noteworthy that, noscapine showed little or no toxicity to kidney, liver, heart, bone marrow, spleen or small intestine at tumor-suppressive doses. Furthermore, oral noscapine did not inhibit primary immune responses, which are critically dependent upon proliferation of lymphoid cells. Thus, our results indicate that noscapine has the potential to be an effective chemotherapeutic agent for the treatment of human cancer.
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  • 38
    ISSN: 1432-0843
    Keywords: Key words Gemcitabine ; Non-small-cell lung cancer ; NSCLC ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the antiproliferative and the proapoptotic ability of gemcitabine in three non-small-cell lung cancer (NSCLC) cell lines. NCI-H292 (mucoepidermoid carcinoma), NCI-CorL23 (large-cell carcinoma) and NCI-Colo699 (adenocarcinoma) cells were cultured with and without 0.5, 0.05 and 0.005 μM gemcitabine for 24, 48 and 72 h, respectively. Gemcitabine exerted a stronger and earlier antiproliferative and proapoptotic effect on H292 cells than on CorL23 or Colo699 cells. Fas receptor expression was increased in all three cell lines and was higher in Colo699 than in CorL23 cells. The incubation of NSCLC with anti-Fas agonistic monoclonal antibody (CH11) induced cell apoptosis in H292 cells, demonstrating that the Fas receptor was functionally active. Finally, gemcitabine and CH-11 exerted a synergistic effect on cell apoptosis in H292 cells. This study demonstrates that gemcitabine induces apoptosis in NSCLC and that this effect might be exerted by modulating functionally active Fas expression, and these effects of gemcitabine were stronger in H292 cells than in either CorL23 or Colo699 cells.
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  • 39
    ISSN: 1432-0843
    Keywords: Key words Caspase family protease ; Caspase-3 ; Cisplatin resistance ; Apoptosis ; A431
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: Cisplatin (cis-diamminedichloroplatinum(II), CDDP) has been reported to induce apoptosis in cancer cells, the mechanism of the apoptosis in cancer cells induced by CDDP is still unclear. Recent studies have revealed that caspase family of cystine proteases play an important role in the regulation of several apoptotic processes. In this study, whether apoptosis induced by CDDP could be mediated by the activation of caspase-3, a caspase family protease, was investigated. Methods: The CDDP-resistant subline A431/CDDP2 from the previously established human epidermoid carcinoma cell line A431 was used. The parent A431 cells (A431/P) and the A431/CDDP2 were exposed to CDDP with or without a caspase family protease inhibitor (Z-Asp-CH2-DCB), and cellular sensitivity to CDDP was determined. DNA fragmentation was then analyzed, and the caspase-3 protein levels determined by Western blotting following exposure of the cells to CDDP with or without Z-Asp-CH2-DCB. Results: In the A431/P cells, the cytotoxicity of CDDP was clearly reduced by Z-Asp-CH2-DCB compared with its cytotoxicity in A431/CDDP2 cells. Furthermore, quantitative analysis of DNA fragmentation revealed that Z-Asp-CH2-DCB inhibited DNA fragmentation induced by CDDP in A431/P cells, but not in A431/CDDP2 cells. Western blotting analysis demonstrated a marked reduction in procaspase-3 protein levels in A431/P cells treated with Z-Asp-CH2-DCB. In the A431/CDDP2 cells, procaspase-3 protein levels were no different with and without Z-Asp-CH2-DCB. Conclusions: These findings suggest that caspase-3 may mediate apoptosis induced by CDDP, and its induction could represent a novel approach to the effective treatment of malignant tumors.
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  • 40
    ISSN: 1432-0843
    Keywords: Key words Head and neck cancer ; Cisplatin ; Glutathione ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: To evaluate the correlation between cisplatin sensitivity, intracellular glutathione, and platinum/DNA adduct formation (measured by atomic absorption spectroscopy) in a series of seven head and neck cancer cell lines, and to evaluate the effect of biochemical modulation of glutathione on platinum/DNA adduct formation and repair. Methods: Cisplatin/DNA adducts were measured by atomic absorption spectroscopy. Glutathione content was measured by enzymatic assay and was modulated with buthionine sulfoximine. Apoptosis was measured by double-labeled flow cytometry. Results: Intracellular glutathione concentration was strongly correlated with cisplatin resistance (P = 0.002, R 2=0.7). There was also a statistically significant inverse correlation between cisplatin/DNA adduct formation and the IC50 for cisplatin in these cell lines. (P=0.0004, R 2=0.67). In addition, resistant cells were able to repair approximately 70% of cisplatin/DNA adducts at 24 h, while sensitive cells repaired less than 28% of adducts in the same period. However, despite the positive correlation between cellular glutathione and cisplatin resistance, there was no direct correlation between intracellular glutathione concentration and platinum/DNA adduct formation. Further, depletion of intracellular glutathione by buthionine sulfoximine did not dramatically alter formation of cisplatin/DNA adducts even though it resulted in marked increase in cisplatin cytotoxicity and was associated with increased apoptosis. Conclusions: These results suggest that glutathione has multiple effects not directly related to formation of cisplatin/DNA adducts, but may also be an important determinant of the cell's ability to repair cisplatin-induced DNA damage and resist apoptosis.
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  • 41
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    Cancer immunology immunotherapy 48 (2000), S. 673-683 
    ISSN: 1432-0851
    Keywords: Key words CD20 ; Apoptosis ; Mechanisms ; Lymphomas ; Immunotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Anti-CD20 monoclonal antibodies have been successfully employed in the clinical treatment of non-Hodgkin's lymphomas in both unmodified and radiolabeled forms. Previous publications have demonstrated that the antitumor effects of unmodified anti-CD20 mAb are mediated by several mechanisms including antibody-dependent cellular cytotoxicity, complement-mediated cell lysis, and induction of apoptosis by CD20 cross-linking. In this report, we demonstrate induction of apoptosis by three anti-CD20 monoclonal antibodies [1F5, anti-B1, and C2B8 (Rituximab)]. The magnitude of apoptosis induction was greater with the chimeric Rituximab antibody than with the murine 1F5 and anti-B1 antibodies. Apoptosis could be enhanced with any of the antibodies by cross-linking with secondary antibodies (or Fc-receptor-bearing accessory cells). The signaling events involved in anti-CD20-induced apoptosis were investigated, including activation of protein tyrosine kinases, increases in intracellular Ca2+ concentrations, caspase activation, and cleavage of caspase substrates. Our results indicate that anti-CD20-induced apoptosis can be attenuated by PP1, an inhibitor of protein tyrosine kinases Lck and Fyn, chelators of extracellular or intracellular Ca2+, and inhibitors of caspases, suggesting that anti-CD20-induced apoptosis may involve modulation of these signaling molecules. We also demonstrated that varying the expression of Bcl-2 did not affect the magnitude of anti-B1-induced apoptosis, possibly because of the sequestering effects of other Bcl-2 family members, such as Bad. These studies identify several of the signal-transduction events involved in the apoptosis of malignant B cells that transpire following ligation of CD20 by anti-CD20 antibodies in the presence of Fc-receptor-expressing cells or secondary goat anti-(mouse Ig) antibodies and which may contribute to the tumor regressions observed in mouse models and clinical trials.
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  • 42
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    Cancer immunology immunotherapy 49 (2000), S. 335-345 
    ISSN: 1432-0851
    Keywords: Key words Immunotherapy ; CD95 ; Lymphocyte activation ; Apoptosis ; Gene expression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A variety of malignancies express Fas ligand (FasL), which can induce apoptosis in effector lymphocytes and may limit the success of cellular immunotherapy. Our laboratory has been investigating a population of ex vivo activated T cells, termed cytokine-induced killer (CIK) cells. These cells share functional and phenotypic properties with natural killer cells and a subset of cytolytic cells have the phenotype CD3+CD56+. CIK cells expand in culture, have significant antitumor activity and are presently being tested in phase I/II clinical trials. In this study, we investigated the sensitivity of CIK cells to Fas-mediated apoptosis. Fas engagement leads to apoptosis in small numbers of CIK cells and does not significantly influence antitumor cytotoxicity. CIK cells will undergo apoptosis following Fas engagement when protein synthesis is inhibited, suggesting the expression of antiapoptotic genes. Evaluation of antiapoptotic gene transcripts shows an up-regulation in the expression of cFLIP, Bcl-2, Bcl-xL, DAD1 and survivin. Resistance to Fas-mediated apoptosis may come about through an in vitro selection for Fas resistance, since CIK cells synthesize FasL and supernatant from CIK cultures contains biologically active soluble FasL, which can be inhibited with Fas:Fc. These results indicate that CIK cells are a suitable form of immunotherapy against FasL-positive tumors.
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  • 43
    ISSN: 1432-1335
    Keywords: Key wordsN4-Alkyl-AraC derivatives ; NOAC-AraC dimer ; Cytotoxicity ; Apoptosis ; Drug resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The arabinofuranosylcytosine (AraC) derivative N 4-octadecyl-1-β-D-arabinofuranosylcytosine (NOAC) and its (5′ → 5′)-heterodinucleoside phosphate analog NOAC-AraC were compared with AraC for cytotoxicity, cell-cycle dependence, phosphorylation by deoxycytidine (dC) kinase and apoptosis induction in native, AraC- or NOAC-resistant HL-60 cells. NOAC was cytotoxic in all cells with three to seven-fold lower IC50 concentrations than those of NOAC-AraC or AraC. In contrast to NOAC-AraC, the lipophilic monomer NOAC overcame AraC resistance, inducing apoptosis in more than 80% of native and AraC-resistant HL-60 cells. This suggests that NOAC-AraC may be cleaved intracellularly only at very slow rates to AraC and NOAC or to the 5′-monophosphates, whereas NOAC exerts different mechanisms of action from AraC. In vitro the dimer was cleaved by phosphodiesterase or human serum to NOAC, AraC and AraC monophosphate. In contrast to AraC, N 4-alkylated AraC derivatives with alkyl chains ranging from 6–18 C atoms were not substrates for dC kinase. Furthermore, treatment of the multidrug-resistant cell lines KB-ChR-8-5 and KB-V1 with the N 4-hexadecyl-AraC derivative NHAC did not induce P-170 glycoprotein expression, suggesting that the N 4-alkyl-AraC derivatives are able to circumvent MDR1 multidrug resistance. The in vivo activity of liposomal NOAC in a human acute lymphatic leukemia xenograft model confirmed the antitumor activity of this representative of the N 4-alkyl-arabinofuranosylcytosines.
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  • 44
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    Journal of cancer research and clinical oncology 126 (2000), S. 305-310 
    ISSN: 1432-1335
    Keywords: Key words Ethanol ; Spheroids ; Cell viability ; Apoptosis ; Necrosis ; Hepatocellular carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: We have shown previously that 1 mM ethanol reduces cell proliferation and increases apoptosis in monolayers of human hepatocellular carcinoma (HepG2) cells. However, in vivo liver tumors are usually three-dimensional and multicellular. The purpose of this study was therefore to determine the effect of ethanol in multicellular tumor spheroids (MCTS) as a model system in vitro. Methods: After the application of 1 mM ethanol for 24 h and 48 h, viable, apoptotic and necrotic cells within MCTS were stained with specific fluorescent dyes, and their amount and distribution within the MCTS were assessed by confocal laser scanning microscopy. To evaluate the effect on HepG2 cell migration and cell proliferation, the outgrowth potential after 1 week in culture was evaluated. Results: As assessed by YO-PRO-1 staining, ethanol increased the number of apoptotic cells from 21.5 units (U) in control spheroids to 364 U and 482.2 U after 24 h and 48 h in ethanol-treated spheroids, respectively (P 〈 0.001). Merocyanine staining fluorescence increased from 10.7 U in the control to 122 U after 24 h and 293.2 U after 48 h (P 〈 0.001). Cell viability, as determined by staining with the acetoxymethyl ester of calcein, decreased from 578.5 U in the control to 236 U and 73.4 U after 24 h and 48 h of ethanol exposure respectively (P 〈 0.001). Necrosis showed an increase from 2 U in control to 24.9 after 24 h and 54 U after 48 h. MCTS treated with ethanol showed almost complete inhibition of outgrowth potential after 1 week in culture, compared to controls (P 〈 0.005). Conclusions: Small concentrations of ethanol (1 mM) induced apoptosis in HepG2 MCTS with a concomitant inhibition on outgrowth potential, accompanied with a low degree of necrosis. These findings suggest that low concentrations of ethanol may already be sufficient for the treatment of hepatocellular carcinoma.
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  • 45
    ISSN: 1432-0932
    Keywords: Key words Chronic low back pain ; Erector spinae muscle ; MRI ; Muscle biopsy ; Fibre type ; distribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Many studies have documented an association between chronic low back pain (LBP) and deficits in back muscle strength and endurance. The sub-optimal performance is believed to be the result of alterations in the size and structure of the muscle, although the long-standing issue of whether the observed changes precede or are a consequence of the pain remains unresolved. If consequent to the problem, and predominantly related to disuse of the muscles, then it may be expected that a relationship between muscle structure and symptom duration would exist. Lumbar paraspinal muscle samples were obtained from 59 chronic LBP patients using the percutaneous biopsy technique. The samples were subject to routine histochemical analysis for the examination of muscle fibre type characteristics and cytochemical architectural changes. In 55 of the patients, the gross cross-sectional areas of magnetic resonance images of the trunk muscles were also measured. Multivariate analysis showed that symptom duration was the strongest predictor of the individual proportions of the fast-fatigable type IIX fibres; with age and gender included in the model, nearly 30% of the variance in fibre type distribution could be accounted for. Duration of pain had no influence on fibre size. Gross muscle cross-sectional area correlated directly with lean body mass and inversely with age, but showed no relationship with symptom duration. Pathological changes in the internal fibre structure were more frequently encountered in older patients, and were independent of symptom duration. The results suggest that, over the long term, fibre type transformations rather than alterations in fibre size are the predominant changes to be found in the muscles of chronic LBP patients. The direction of change supports the results of many previous studies that have demonstrated corresponding differences in the fatigability of the muscles. There is a strong case for the early implementation of active measures to attempt to offset the development of these changes in back pain patients.
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  • 46
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    European radiology 10 (2000), S. 1691-1696 
    ISSN: 1432-1084
    Keywords: Key words: Herniography ; MRI ; Hernia ; Groin pain
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aims of the present study were to assess if MRI gives the same diagnostic information as herniography concerning the presence of hernias and reveals other causes of groin pain. The prospective study enrolled 20 patients referred for herniography, 6 women and 14 men, mean age 48 years. After herniography the patients underwent MRI using T1-weighted, fat-suppressed inversion recovery (STIR), and magnetic resonance cholangiopancreaticography (MRCP) pulse sequences. No contrast medium was administered at MRI. Herniography revealed 11 hernias and MRI depicted 8 of these. Magnetic resonance imaging depicted well the anatomy in the groins. In 3 patients where hernias were not revealed, MRI revealed inflammatory changes in the symphysis region as a possible cause of groin pain. The primary diagnostic tool for diagnosing hernias is herniography. If the herniogram is normal, MRI may reveal other causes of groin pain and may also better visualize related structures in the groin.
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  • 47
    ISSN: 1432-1084
    Keywords: Key words: Eye injuries ; CT ; MRI ; Eye foreign body
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Detection and characterization of intraorbital foreign bodies (IFB) is fundamental in acute trauma setting, preventing inflammatory sequelae or complications related to IFB movements when a MRI study is planned. Papers concerning plain film and CT sensibility in IFB detection show controversial results. For this reason we investigated plain film, CT and MRI sensibility in the evaluation of IFB. For an in vitro model, specimens of dry and fresh wood, glass, iron, plastic and graphite were immersed in animal lard and in a 0.9 % sodium chloride plus 3.5 g/dl human serum albumin solution. Specimens of different size and nature where also implanted into enucleated pig eyes. Air bubbles were introduced also. Plain film, CT and MRI investigation were performed. Plain films underestimated intraocular IFB as plastic, fresh or dry wooden IFB were not demonstrated. The CT study was always able to depict and differentiate IFB according to the attenuation values. Severe artefacts prevented demonstration of iron, glass and graphite IFB on MRI, whereas plastic or wooden IFB were always detected. Despite radiographs have been suggested as a prerequisite for MR imaging, because our results showed plain film to underestimate radiolucent IFB, we suggest CT as the modality of choice when IFB has to be ruled out.
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  • 48
    ISSN: 1432-1262
    Keywords: Keywords Fecal incontinence ; Constipation ; MRI ; Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This study assessed the value of common surface coil mag-netic resonance imaging (MRI) in patients with evacuatory disorders including fecal incontinence and constipation. These findings were then compared with those from other standard physiological examinations and/or surgical findings. From July 1996 to June 1997, 14 consecutive patients underwent surface coil MRI for evaluation of either fecal incontinence (n=5) or constipation (n=9). In patients with incontinence we compared the findings from endoanal ultrasound (EAUS), anal MRI, and surgery regarding morphopathological findings of the internal and external anal sphincter components. In constipated patients the findings of videoprography and dynamic pelvic MRI were compared regarding the presence of rectocele, rectoanal intussusception, and sigmoidocele as well as the measurements of anorectal angle and perineal descent. The five incontinent patients were all women, with a median age of 67 years (range 43–77). EAUS revealed an anterior sphincter defect in two patients, a posterior defect in one, and normal anal sphincter images in two. Surgical findings confirmed an anterior external anal sphincter scar in two patients, an internal anal sphincter defect in one, and an anatomically normal anal sphincter in two. In one patient, although anal MRI showed posterior external anal sphincter defect, EAUS and surgery revealed normal external anal sphincter appearance. The accuracy rate between EAUS and anal MRI was only 20%, that between surgery and anal MRI 40%, and that between surgery and EAUS 80%. Thus EAUS was more accurate than anal MRI in incontinent patients. The nine constipated patients were all women, with a mean age of 59 years (range 40–78). Videoproctography revealed an anterior rectocele in six patients, rectoanal intussusception in three, and sigmoidocele in five; no abnormalities were identified in two patients. On dynamic pelvic MRI anterior rectocele was seen in three patients and sigmoidocele in two, and five studies were interpreted as normal. One of the patients underwent sigmoidectomy for sigmoidocele, and five patients were treated by biofeedback. Thus the accuracy rate of dynamic pelvic MRI against videoproctography was 60% for anterior rectocele, 40% for sigmoidocele, and zero for rectoanal intussusception. In conclusion, neither MRI for the evaluation of patients with fecal incontinence nor for the evaluation of patients with constipation added any significant information that would warrant its continued use in these patient groups. Perhaps the more widespread availability of an endoanal coil will alter this conclusion; however, at the present time we cannot routinely endorse the expense, time, or inconvenience of these MRI investigations in patients with these diagnoses. Larger prospective comparative studies are required prior to endorsing the technique.
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  • 49
    ISSN: 1432-1262
    Keywords: Keywords Nonsteroidal anti-inflammatory drugs ; Colon cancer ; Apoptosis ; Caspase ; Poly(ADP-ribose) polymerase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Epidemiological studies have demonstrated that nonsteroidal anti-inflammatory drugs (NSAIDs) decrease the incidence of and mortality from colon cancer. In addition, NSAIDs reduce the number and the size of polyps in patients with familial adenomatous polyposis. The mechanisms responsible for the antineoplastic effect of NSAIDs are not yet completely understood, but one of the possible mechanisms is an induction of apoptosis. We explored the role of caspase-3, a major apoptosis-executing enzyme, in NSAID-induced apoptosis of colon cancer cell line HT-29. Treatment of HT-29 cells with indomethacin induced a dramatic increase in caspase-3-like protease activity measured by a cleavage of the fluorogenic substrate Ac-DEVD-AMC. Western blot analysis showed that indomethacin treatment led both to decrease in pro-caspase-3 and to cleavage of its substrate poly(ADP-ribose) polymerase (PARP). Furthermore, the caspase- 3-like protease inhibitor Ac-DEVD-CHO attenuated indomethacin- induced DNA fragmentation dose dependently. However, mRNA expression of CASP genes was not affected by the addition of indomethacin, highlighting the importance of posttranslational modification of this enzyme for the activation. These results suggest that NSAIDs, including indomethacin, induce apoptosis in colon cancer cells through a caspase-3 dependent mechanism which may contribute to the chemopreventive functions of these agents.
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  • 50
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    Journal of mammary gland biology and neoplasia 5 (2000), S. 65-73 
    ISSN: 1573-7039
    Keywords: Apoptosis ; casein ; plasminogen ; embryo
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The insulin-like growth factor binding proteins (IGFBPs)3 are a family of proteins which bindto the IGFs with high affinity. Their expression within the mammary gland is species specific;it has thus been difficult to determine the biological roles of these binding proteins duringlactation. In this article we propose a role for IGFBP-5 in the mammary gland involving theinitiation of apoptosis induced by sequestration of IGF-1, an important survival factor for themammary gland. We have shown that this binding protein retains its high affinity for IGF-1and that it is present in extremely high concentrations compared with the growth factor. Theseobservations make it likely that IGFBP-5 is capable of preventing interaction of IGF-1 withits receptor on the epithelial cells synthesizing milk. We have also demonstrated thatIGFBP-5 interacts with αs2-casein and that this interaction implicates it in the regulation of plasminogenactivation in the mammary gland. The generation of plasmin is a key initiating event in theremodeling of the extracellular matrix during mammary involution. As such, IGFBP-5 mayplay a key role in coordinating cell death and tissue remodeling processes. Many of themolecules involved in embryological development are also expressed in the developing andinvoluting mammary gland. We believe that our studies may offer mechanistic explanationsfor apoptotic events in a wide variety of tissues. We have recently shown that IGFBP-5 isapoptotic in the chick embryonic limb bud, adding further support to our belief thatIGFBP-5 serves this function in the mammary gland. We hope to be able to explore the role of thisbinding protein in the mammary gland with a transgenic mouse model expressing IGFBP-5on the β-lactoglobulin promoter.
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  • 51
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    Neurochemical research 25 (2000), S. 1373-1383 
    ISSN: 1573-6903
    Keywords: Apoptosis ; Bcl-x ; NF-κB ; oxidative stress ; transcription factor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Both acute and chronic insults to the nervous system can result in changes in homeostasis that result in cell death or recovery processes that alter function. The signaling mechanisms for this broad spectrum of events that impair neurological function span the gamut from abrupt injury to the slow onset of neurodegenerative diseases in extreme aging. A common element in all of these events is the triggering of signal cascades that determine cellular commitment to apoptosis as a ameliorative alternative to inflammatory necrosis. Key in these cascades is the activation of the caspase and Bcl-family of proteins by the NF-κB transcription factor. Here we consider aspects of specificity of activation as a result of the differential expression of NF-κB proteins and their regulation of selective genes as a result of binding to select DNA consensus sequences out of the 64 different combinations that constitute the NF-κB DNA binding consensus sequence.
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  • 52
    ISSN: 1573-675X
    Keywords: Apoptosis ; cytokines ; cytotoxic T cells ; Ebola virus ; macrophages.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract In fatal Ebola virus hemorrhagic fever massive intravascular apoptosis develops rapidly following infection and progressing relentlessly until death. While data suggest that T lymphocytes are mainly deleted by apoptosis in PBMC of human fatal cases, experimental Ebola infection in animal models have shown some evidence of destruction of lymphocytes in spleen and lymph nodes probably involving both T and B cells. Nevertheless, we are able to conclude from the accumulated evidence that early interactions between Ebola virus and the immune system, probably via macrophages, main targets for viral replication, lead to massive destruction of immune cells in fatal cases.
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  • 53
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    Apoptosis 5 (2000), S. 107-114 
    ISSN: 1573-675X
    Keywords: Apoptosis ; caspases ; NF-kB ; PKR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Interferons are a family of cytokines that exerts antiviral, antitumor and immunomodulatory actions by inducing a complex set of proteins. One of the best known IFN-induced protein is the dsRNA-dependent protein kinase (PKR), that mediates both antiviral and anticellular activities. PKR inhibits translation initiation through the phosphorylation of the alpha subunit of the initiation factor eIF-2 (eIF-2α) and also controls the activation of several transcription factors such as NF-κB, p53, or STATs. In addition, PKR mediates apoptosis induced by many different stimuli, such as treatment with LPS, TNF-α, viral infection, or serum starvation. The mechanism of apoptosis induction by PKR involves phosphorylation of eIF-2α and activation of NF-κB. In this way, expression of different genes is regulated by PKR. Among the genes upregulated in response to PKR are Fas, Bax and p53. The pathway of PKR-induced apoptosis involves FADD activation of caspase 8 by a mechanism independent of Fas and TNFR. Since IFNs are used as drugs for different disorders such as viral infection and cancer, understanding the pathway of apoptosis induction triggered by PKR should be useful in the rational design of IFN therapies.
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    Apoptosis 5 (2000), S. 115-116 
    ISSN: 1573-675X
    Keywords: Apoptosis ; Bcl-2 ; Bfl-1 ; 6-hydroxydopamine ; PC12 cells ; stable transformants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Gene transfection and ectopic expression is a widely used method in experimental biology. In the present report, we would like to point out that this approach may, in certain circumstances, lead to a modification of the transfected cell phenotype. Indeed, we observed that after transfection of bcl-2 gene in the neuronal PC12 cell line some of the selected clones have lost their neuronal and catecholaminergic characteristics, i.e. TH expression and ability to grow neurites in response to NGF. Thus, the resistance of some PC12-Bcl-2 clones against neurotoxic insults may not necessarily reflect the potential benefit afforded by Bcl-2 expression. We therefore encouraged authors to verify cell phenotype after stable transfection to avoid misinterpretation of their results.
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  • 55
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    Neurological sciences 21 (2000), S. 151-155 
    ISSN: 1590-3478
    Keywords: Key words Epilepsy ; Venous angioma ; MRI ; Vascular malformations ; Focal cortical dysplasia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to evaluate the frequency and characteristics of epilepsy associated with cerebral venous angiomas (VA). We examined epileptic patients in which magnetic resonance imaging (MRI) showed VA. The characteristics of epilepsy and its relationships to VA were studied. Out of 1020 epileptic patients submitted to MRI in a 10-year period, 4 presented with VA. All had partial seizures, most frequently complex partial, with secondary generalizations in 3. Drug resistance was observed in 2. One patient had a small area of cortical dysplasia near the VA; another had a cutaneous angioma. In 2 patients, there was no topographic concordance between the VA and the focus on electroencephalography. Our study reveals that VA are rarely found in epileptic patients, differently from other vascular malformations, in particular cavernomas. Topographic and/or etiological relationships between VA and epilepsy are still undefined.
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  • 56
    ISSN: 1615-6102
    Keywords: Apoptosis ; Atherosclerosis ; Endothelium ; Lipoproteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Summary Endothelial lesion by oxidized low-density liproproteins (LDL) is one of the first stages in the development of atherosclerosis. The effect of these lipoproteins can range from a functional lesion of the endothelium to death of the endothelial cells by apoptosis. High-density lipoproteins (HDL) are one of the factors which can have a protective effect against the development of atheromatous plaques. The aim of this study is to establish whether the death of endothelial cells by apoptosis induced by oxidized LDLs is prevented by HDLs. ECV304 endothelial cells and bovine aorta endothelial cells were incubated with native LDLs, oxidized LDLs, and a combination of both oxidized LDLs and HDLs. Oxidized LDLs caused a significant increase of mortality mainly by apoptosis. However, when HDLs were added together with oxidized LDLs the percentage of total mortality, the degree of lipoprotein oxidation in the medium, and the percentage of cells in apoptosis were all significantly decreased. HDLs protect against the cytotoxicity of oxidized LDLs possibly by preventing the propagation of the oxidative chain in these lipoproteins.
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    Neurological sciences 21 (2000), S. 53-55 
    ISSN: 1590-3478
    Keywords: Key words Genetic Creutzfeldt-Jakob disease ; Deafness ; MRI ; 14-3-3 protein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe a case of genetic Creutzfeldt-Jakob disease (CJD) with deafness at the onset. We report clinical features, 14-3-3 protein positivity, electroencephalography and brain stem auditory evoked potential abnormalities, and high signal on magnetic resonance imaging in basal ganglia and temporal cortex. Similarities with CJD Heidenhain variant are discussed.
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  • 58
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    Journal of biomedical science 7 (2000), S. 2-15 
    ISSN: 1423-0127
    Keywords: Apoptosis ; Mitochondria ; Necrosis ; Oxidative stress ; Reactive oxygen species
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Mitochondria are the major ATP producer of the mammalian cell. Moreover, mitochondria are also the main intracellular source and target of reactive oxygen species (ROS) that are continually generated as by-products of aerobic metabolism in human cells. A low level of ROS generated from the respiratory chain was recently proposed to take part in the signaling from mitochondria to the nucleus. Several structural characteristics of mitochondria and the mitochondrial genome enable them to sense and respond to extracellular and intracellular signals or stresses in order to sustain the life of the cell. It has been established that mitochondrial respiratory function declines with age, and that defects in the respiratory chain increase the production of ROS and free radicals in mitochondria. Within a certain concentration range, ROS may induce stress responses of the cell by altering the expression of a number of genes in order to uphold energy metabolism to rescue the cell. However, beyond this threshold, ROS may elicit apoptosis by induction of mitochondrial membrane permeability transition and release of cytochrome c. Intensive research in the past few years has established that mitochondria play a pivotal role in the early phase of apoptosis in mammalian cells. In this article, the role of mitochondria in the determination of life and death of the cell is reviewed on the basis of recent findings gathered from this and other laboratories.
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  • 59
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    Journal of biomedical science 7 (2000), S. 64-70 
    ISSN: 1423-0127
    Keywords: p53 ; Chemosensitivity ; Cell cycle ; Apoptosis ; Non-small cell lung cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract This study examined the effects of p53 gene status on DNA damage-induced cell death and chemosensitivity to various chemotherapeutic agents in non-small cell lung cancer (NSCLC) cells. A mutant p53 gene was introduced into cells carrying the wild-type p53 gene and also vice versa to introduce the wild-type p53 gene into cells carrying the mutant p53 gene. Chemosensitivity and DNA damage-induced apoptosis in these cells were then examined. This study included five cell lines, NCI-H1437, NCI-H727, NCI-H441 and NCI-H1299 which carry a mutant p53 gene and NCI-H460 which carries a wild-type p53 gene. Mutant p53-carrying cells were transfected with the wild-type p53 gene, while mutant p53 genes were introduced into NCI-H460 cells. These p53 genes were individually mutated at amino acid residues 143, 175, 248 and 273. The representative cell line NCI-H1437 cells transfected with wild-type p53 gene (H1437/wtp53) showed a dramatic increase in susceptibility to three anticancer agents (7-fold to cisplatin, 21-fold to etoposide, and 20-fold to camptothecin) compared to untransfected or neotransfected H1437 cells. An increase in chemosensitivity was also observed in wild-type p53 transfectants of H727, H441, H1299 cells. The results of chemosensitivity were consistent with the observations on apoptotic cell death. H1437/wtp53 cells, but not H1437 parental cells, exhibited a characteristic feature of apoptotic cell death that generated oligonucleosomal-sized DNA fragments. In contrast, loss of chemosensitivity and lack of p53-mediated DNA degradation in response to anticancer agents were observed in H460 cells transfected with mutant p53. These observations suggest that the increase in chemosensitivity was attributable to wild-type p53 mediation of the process of apoptosis. In addition, our results also suggest that p53 gene status modulates the extent of chemosensitivity and the induction of apoptosis by different anticancer agents in NSCLC cells.
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  • 60
    ISSN: 1423-0127
    Keywords: Apoptosis ; Differential display ; Glioma ; Okadaic acid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract To identify novel genes associated with apoptosis in glioma cells, we treated T98G glioma cells with okadaic acid (OA). Differential display using 15 random primers was performed on RNA extracted from these cells. Upregulated bands were excised from polyacrylamide gels and cloned. Northern blots were used to confirm RNA expression in T98G cells. 18 RNA fragments corresponding to the untranslated region of genes were identified and sequenced. Three unknown gene fragments were used to screen a fetal brain cDNA library resulting in three complete cDNA sequences. The three sequences corresponded to a human gene homologous to the yeast translation initiation factor Sui-1, a cAMP-regulated phosphoprotein, ARPP-16/19, and a novel gene designated O48. Transcription of Sui-1 increased in response to all stress factors tested, whereas ARPP only responded to OA. 2-kb and 4-kb O48 RNA species were identified. OA and stress factors increased 2-kb expression while K252a (protein kinase inhibitor) increased 4-kb expression. Differential display is effective for identifying genes associated with apoptosis. Novel genes may be identified by further analysis of the gene fragments identified in this study. The function of O48 is unknown.
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  • 61
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    Journal of biomedical science 7 (2000), S. 195-199 
    ISSN: 1423-0127
    Keywords: Opioid ; Enkephalin ; DADLE ; Transplantation ; Hibernation ; Apoptosis ; Methamphetamine ; Dopamine ; Ischemia ; Reperfusion ; PC12 cells ; Neuroprotection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract By studying the hibernation in ground squirrels, a protein factor termed hibernation induction trigger (HIT) was found to induce hibernation in summer-active ground squirrels. Further purification of HIT yielded an 88-kD peptide that is enriched in winter hibernator. Partial sequence of the 88-kD protein indicates that it may be related to the inhibitor of metalloproteinase. Delta opioid [D-Ala2,D-Leu5]enkephalin (DADLE) also induced hibernation. HIT and DADLE were found to prolong survival of peripheral organs preserved en bloc or as a single preparation. These organs include the lung, the heart, liver and kidney. DADLE also promotes survival of neurons in the central nervous system. Methamphetamine (METH) is known to cause destruction of dopaminergic (DA) terminals in the brain. DADLE blocked and reversed the DA terminal damage induced by METH. DADLE acted against this effect of METH at least in part by attenuating the mRNA expressions of a tumor necrosis factor p53 and an immediate early gene c-fos. DADLE also blocked the neuronal damage induced by ischemia-reperfusion following a transient middle cerebral artery occlusion. In PC12 cells, DADLE blocked the cell death caused by serum deprivation in a naltrexone-sensitive manner. Thus, DADLE, and by extension the endogenous delta opioid peptides and delta opioid receptors, may play an important role in organ and neuronal survival. Here, critical developments concerning these fascinating cell protective properties of DADLE are reviewed.
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  • 62
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    Journal of biomedical science 7 (2000), S. 322-333 
    ISSN: 1423-0127
    Keywords: Apoptosis ; HIV ; SIV ; Vpr ; Vpx ; Bcl-2 ; Bax
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract The growth inhibitory effects of Vpr and Vpx are species-and cell type-dependent. HIV-1, HIV-2 and SIV Vpr are primarily cytostatic in mammalian cells and HIV-1 Vpr has been reported to induce apoptosis in human cells. Our previous studies have shown that HIV-1, HIV-2 and SIV Vpr and Vpx have differential cytostatic and cytotoxic effects in the yeast cells [Zhang et al.: Virology, 230:103–112; 1997]. Here, we further examined the apoptosis function of HIV-1 Vpr in different species of mammalian cells and investigated if other primate lentiviral Vpr and Vpx exert similar functions. Our results show that none of the primate lentiviral Vpr or Vpx we tested induces apoptosis in nonhuman species of mammalian cells. However, HIV-1 Vpr, but not HIV-2 or SIV Vpr and/or Vpx, induced apoptosis in different types of human cell lines. Further, the apoptotic effect of HIV-1 Vpr can be distinguished from that of the human interferon-γ, a known proapoptotic protein, that HIV-1 Vpr shows little to no paracrine and/or bystander effect. When coexpressed with Bcl-2 or Bcl-XL, the apoptotic effect of HIV-1 Vpr became markedly attenuated. These results indicate that the apoptotic effect of HIV-1 Vpr is species-dependent and is intracellularly modulated by the Bcl-2 family of proteins. Our study also suggests that the proapoptotic function of HIV-1 Vpr is developmentally associated with human but not nonhuman primate species.
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  • 63
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    Journal of biomedical science 7 (2000), S. 459-465 
    ISSN: 1423-0127
    Keywords: Apoptosis ; Thermal brain injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Apoptosis has been implicated recently as a prominent response of the brain to a variety of insults, such as ischemia and trauma. In this study, we demonstrate that apoptosis is a prominent part of the brain's response to a thermal insult. To examine the brain's response to a thermal insult, a new model of thermal brain injury in the laboratory rat was developed. Water heated to 60°C was passed over an area of thinned calvarium for 1 min. This resulted in an actual brain temperature of 47–48°C. A uniform area of 2,3,5-triphenyl-tetrazolium chloride pallor was demonstrated and pyknotic neurons were seen in the area of injury by hematoxylin-eosin staining. Apoptosis was demonstrated by the characteristic DNA fragmentation seen by agarose gel electrophoresis, ApopTag in situ staining and electron microscopy. The findings of apoptosis were localized to the area of thermal injury and were time dependent, starting 6 h after the insult and peaking approximately 18 h after the insult. This represents one of the first demonstrations that apoptosis occurs in the brain in response to a thermal injury.
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  • 64
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    Archives of gynecology and obstetrics 264 (2000), S. 42-44 
    ISSN: 1432-0711
    Keywords: Key words Thecoma ; Ascites ; CA125 ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a 34-year-old woman with an ovarian thecoma and ascites who exhibited high serum levels of CA125. Measuring serum tumor markers and imaging are two important diagnostic tools for malignant ovarian tumors. In the present case, a preoperative diagnosis of benign ovarian tumor could not be made due to the elevation of CA125 (895 U/ml) and nonspecific MRI findings.
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  • 65
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    European spine journal 9 (2000), S. 426-429 
    ISSN: 1432-0932
    Keywords: Key words Osteoid osteoma ; MRI ; Inflammatory reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of 14-year-old male patient with osteoid osteoma of the cervical spine. Magnetic resonance imaging (MRI) revealed a large dumbbell-shaped paravertebral tumor in the region of the exiting left C6 nerve. A computed tomographic (CT) scan after myelography showed a much smaller bony defect in the medial aspect of the left C6 pedicle with central calcification and extensive bone sclerosis around the defect, typical of osteoid osteoma. The diagnosis was confirmed postoperatively. The resected specimen exhibited extensive vascularization of the osteoid tissue. The case is presented because MRI did not allow a specific diagnosis of osteoid osteoma, and suggested the tumor was larger than in reality it was, by also depicting the reactive inflammation around the tumor as if it were part of the tumor.
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  • 66
    ISSN: 1432-1335
    Keywords: Key words Genistein ; Eicosapentaenoic acid ; Apoptosis ; Bax ; Bcl-xL ; Caspase-3
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Genistein, a prominent isoflavone in soy products, produced dose- and time-dependent in vitro growth inhibition at high concentrations (at least 185 μM) with an IC50 of 7.0–274.2 μM after 72 h incubation in four breast cancer cell lines (DD-762, Sm-MT, MCF-7 and MDA-MB-231) and one breast epithelial cell line (HBL-100) of human and animal origin; it stimulated estrogen-receptor-positive MCF-7 cells at low concentrations (3.7 nM–37 μM). Genistein-exposed cells underwent apoptosis, confirmed by G2/M arrest followed by the appearance of a sub-G1 fraction in cell-cycle progression, and by a characteristic cell ultrastructure. The apoptosis cascade was due to up-regulation of Bax protein, down-regulation of Bcl-XL protein, and activation of caspase-3. Genistein acted in synergism with eicosapentaenoic acid (EPA), a fish oil component, on human breast cancer MCF-7 cells (genistein 〉 93.2 μM and EPA 〉 210.9 μM) and on MDA-MB-231 cells (genistein 〉 176.1 μM and EPA 〉 609.3 μM). Dietary intake of genistein in combination with EPA may be beneficial for breast cancer control.
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  • 67
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    Journal of cancer research and clinical oncology 126 (2000), S. 503-510 
    ISSN: 1432-1335
    Keywords: Key words Ethanol ; Hepatocellular carcinoma ; Cell proliferation ; Apoptosis ; Necrosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Purpose: The antiproliferative effect of high concentrations of ethanol (80–100 mmol) on liver carcinoma is well known. However, the high concentrations of ethanol affect both tumor cells and normal hepatocytes. The present study was designed to determine the effect of low ethanol concentrations (0–10 mmol) on cell proliferation and cell death (apoptosis and necrosis) in a human tumor cell line HepG2 and in normal rat hepatocytes. Methods: Primary cultures of normal rat hepatocytes and HepG2 cells cultures were used. Cells were incubated with increasing ethanol concentrations or without ethanol (control group) for 24 h and analyzed immediately (group I) or after an additional incubation time of 48 h without additional ethanol application (group II). Cell proliferation was determined by assessing 5-bromo-2′-deoxyuridine (BrdU) incorporation. Apoptosis was assessed by means of DNA fragmentation and cysteine aspartate-specific protease (caspase-3) activity. Necrosis was analyzed by quantification of lactate dehydrogenase (LDH) release into culture medium. Results: Twenty-four h exposure to 1 mmol ethanol inhibited cell proliferation in HepG2 cells by 75% (P 〈 0.05), while it remained unaltered in rat hepatocytes. The effect of ethanol persisted for another 48 h where cell proliferation was 5% of control in HepG2 cells and 70% of control in rat hepatocytes (P 〈 0.005). After 24 h incubation with 1 mmol ethanol 28% of HepG2 cells and 12% of rat hepatocytes showed DNA fragmentation as sign of apoptosis (P 〈 0.001). In group II 39% of HepG2 cells and 26% of rat hepatocytes were apoptotic (P 〈 0.001). Caspase-3 activation progressively increased after ethanol treatment in HepG2 cells and rat hepatocytes. The first significant difference was observed after 4 h (activity in HepG2 was 68% higher than in rat hepatocytes) and was maximum after 10 to 12 h where the activity in HepG2 was 180% of the activity in rat hepatocytes. Lactate dehydrogenase release into culture medium as an indicator of necrosis in HepG2 cells, increased from 0.5% in group I to 12% in group II, and from 0.1% to 8% in rat hepatocytes (P 〈 0.005). Increasing ethanol concentration to 10 mmol increased necrosis to 75% in HepG2 cells, and to 45% in rat hepatocytes (P 〈 0.05) whereas the effects on cell proliferation and apoptosis were not significantly different. Conclusions: Small ethanol concentrations (equivalent to 1 mmol) inhibit cell proliferation and increase apoptosis more strongly in HepG2 cells than in normal rat hepatocytes. These findings suggest the use of 1 mmol ethanol as a treatment for hepatocellular carcinoma because this mainly affects tumor cells but not surrounding normal tissue.
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  • 68
    ISSN: 1432-1335
    Keywords: Key words Cycloprodigiosin hydrochloride ; Breast cancer ; Apoptosis ; Intracellular acidification ; Bcl-2
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of cycloprodigiosin hydrochloride (cPrG · HCl), a H+/Cl− symporter, on five human breast cancer cell lines (KPL-1, T-47D, MCF-7, MKL-F, and MDA-MB-231), a human breast epithelial cell line (HBL-100), and a human fibroblast cell line (WI-38–40) was examined. cPrG · HCl inhibited the growth of all five breast cancer cell lines (IC50: 0.46–0.62 μM) and slightly inhibited HBL-100 and WI-38–40 cell growth (IC50: 1.75 μM and 2.26 μM respectively). cPrG · HCl treatment in KPL-1 cells increased the pH of acidic organelles, decreased intracellular pH, and caused apoptosis, which was confirmed by the appearance of a sub-G1 population by flow cytometry and DNA fragmentation. In addition, cPrG · HCl-induced apoptosis was strongly suppressed by imidazole, a cell-permeable base, suggesting that intracellular acidification was essential for the apoptosis. Further, cPrG · HCl treatment up-regulated Bax and Bak expression, down-regulated Bcl-2 expression, and activated caspase-3. Therefore, the intracellular acidification by cPrG · HCl treatment suppressed the growth of human breast cancer cell lines by inducing apoptosis.
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  • 69
    ISSN: 1432-1335
    Keywords: Key words 5-Fluorodeoxyuridine ; Heterodinucleoside dimers ; Prodrugs ; Prostate cancer ; Cytotoxicity ; Cell cycle ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Purpose: Current therapies have limited impact on the progression of metastatic hormone-refractory prostate cancer. Therefore, we investigated the utility of new heterodinucleoside phosphate dimers of 5-fluorodeoxyuridine (5-FdUrd) in p53-mutated and androgen-independent DU-145 human prostate tumour cells. Methods: The effects of the dimers were assessed in vitro by a cell proliferation assay for cytotoxicity, flow cytometry for cell cycle distribution, confocal laser scanning microscopy for the detection of apoptotic bodies, poly(ADP-ribose) polymerase cleavage for caspase 3 activity and by a thymidylate synthetase assay. Results: The new dimers N 4-palmitoyl-2′-deoxycytidylyl-(3′→5′)-5-fluoro-2′-deoxyuridine (dCydPam-P-FdUrd) and 2′-deoxy-5-fluorouridylyl-(3′→5′)-2′-deoxy-5-fluoro-N 4-octadecylcytidine (5-FdUrd-P-FdCydOct) caused marked cytotoxicity with IC50 values of 3–4 μM. 5-FdUrd-P-FdCydOct at 200 μM was capable of eradicating 100% of tumour cells whereas 10% of the cells were resistant to 5-FdUrd. Cytotoxicity was caused by a dramatic S-phase arrest, resulting in an increase of this cell population from 34% to 85% with 5-FdUrd-P-FdCydOct and to 81% with dCydPam-P-FdUrd. S-phase arrest was followed by apoptosis, as shown by 85% of the cells staining positive for Apo 2.7 antibody, a six- to eight-fold increased caspase 3 activity and DNA fragmentation. Thymidylate synthase activity was inhibited by 50% at 0.6–0.7 μM dimer concentration. The dimers were hydrolysed in vitro by phosphodiesterase I and human serum to the corresponding nucleosides and nucleoside monophosphates. Conclusions: The new dimers dCydPam-P-FdUrd and 5-FdUrd-P-FdCydOct are effective prodrugs of 5-FdUrd and have potential value for the treatment of p53-mutated and hormone-independent human prostate carcinomas.
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  • 70
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    Journal of neurology 247 (2000), S. I37 
    ISSN: 1432-1459
    Keywords: Key words Motoneuron ; Motoneuron disease ; RNA ¶metabolism ; Apoptosis ; Knockout mouse ; Animal model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Childhood spinal muscular atrophy (SMA) is a common autosomal recessive disorder which is characterized by muscle weakness due to degeneration of motoneurons in the spinal cord and brainstem nuclei. Positional cloning strategies have revealed several gene candidates including the genes for the survival motoneuron (SMN) and the neuronal apoptosis inhibitory protein (NAIP). Both genes are duplicated on chromosome 5. Homozygous deletions/mutations of the telomeric SMN gene, which is expressed from both copies on human chromosome 5, are associated with the disease. Recent reports suggest involvement of the SMN protein in the formation of spliceosomal particles in the cytoplasm and in the regeneration of spliceosomes in the nucleus. These data put spinal muscular atrophy into a growing group of disorders of RNA metabolism which also include fragile-X syndrome and myotonic dystrophy. Relevance of these previous data for the pathogenesis of the disease are discussed in this review.
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  • 71
    ISSN: 1432-1459
    Keywords: Key words Amyotrophic lateral sclerosis ; Genetics ; Presenilin-1 intron 8 polymorphism ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The mechanisms underlying motor neuron degeneration in amyotrophic lateral sclerosis are not fully understood. Recent studies suggest that apoptosis is involved in the abnormal neural death that occurs in this devastating disease. Presenilin-1, a transmembrane protein, seems to be implicated in apoptosis. To determine whether presenilin-1 intron 8 polymorphism has an influence in the course of amyotrophic lateral sclerosis, we examined this polymorphism genotypes in a large group of patients (n=72) with amyotrophic lateral sclerosis and in a random sample of 213 healthy individuals. The results showed a significant difference in genotype (P 〈 0.04) and allele (P 〈 0.03) distribution between patients and controls. These results suggest a possible intervention of presenilin-1 in the pathogenesis of amyotrophic lateral sclerosis.
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  • 72
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    Journal of neurology 247 (2000), S. II11 
    ISSN: 1432-1459
    Keywords: Key Words Diagnosis ; MRI ; MRS ; Parkinson’s disease ; SPECT ; PET
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper reviews the relative abilities of magnetic resonance imaging (MRI), positron emission tomography (PET), single photon emission tomography (SPECT), and proton magnetic resonance spectroscopy (MRS) to detect Parkinson’s disease and monitor its progression. Currently, the main role of MRI lies in its ability to discriminate atypical syndromes from Parkinson’s disease; however, new volumetric approaches may soon allow progression of nigral degeneration to be followed. Proton MRS can also detect reduced levels of putamen N-acetyl aspartate (NAA) in many patients with atypical parkinsonian syndromes. PET and SPECT are both sensitive means of detecting the presence of impaired dopamine terminal function in the striatum and following its progression. PET currently has the greater spatial resolution and provides the added advantages that it also allows extra-striatal dopaminergic function to be monitored.
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  • 73
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    Journal of cancer research and clinical oncology 126 (2000), S. 145-152 
    ISSN: 1432-1335
    Keywords: Key words Angiogenesis ; Apoptosis ; Glioma ; Thymidine phosphorylase ; Vascular endothelial growth factor ; AbbreviationsTP thymidine phosphorylase ; GBM glioblastoma ; AA anaplastic astrocytoma ; LGA low-grade astrocytoma ; VEGF vascular endothelial growth factor ; RT-PCR reverse transcriptase/polymerase chain reaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thymidine phosphorylase (TP) has been implicated as a potent angiogenic factor and a prognostic factor in various human solid tumors. We investigated the expression of TP in a series of human astrocytic tumors using immunohistochemistry, enzyme-linked immunosorbent assay, and reverse transcriptase/polymerase chain reaction (RT-PCR) analysis. A total of 63 astrocytic tumors [27 glioblastomas (GBM), 19 anaplastic astrocytomas (AA), 17 low-grade astrocytomas (LGA)] and 5 normal brain tissues were immunohistochemically stained with antibodies to TP, vascular endothelial growth factor (VEGF), p53, MIB-1, and factor-VIII-related antigen. They were also evaluated for the degree of apoptosis by a ApopTag kit. Ten tumors (5 GBM, 2 AA, 3 LGA) and 3 normal brain tissues were evaluated for their expression of VEGF and TP by RT-PCR analysis. TP was constantly localized in the cytoplasm of astrocytic tumor cells, less intensely in the cytoplasm of vascular endothelial cells, but not in the normal brain. Some of the TP-positive cells were of macrophage origin, but most positive cells were the tumor cells themselves. Vascular density, MIB-1 positivity, p53 positivity, VEGF expression, and the apoptotic index were significantly higher in the TP-positive tumors than in TP-negative tumors. There was a significant correlation between TP and VEGF mRNA expression. In a limited number of glioblastoma cases, the apoptotic index was significantly higher in TP-positive glioblastomas than in TP-negative glioblastomas. In human astrocytic tumors, TP was expressed in the tumor, macrophage, and endothelial cells. TP was a potent angiogenic factor closely associated with cell proliferation and tumor apoptosis.
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  • 74
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    Acta neuropathologica 99 (2000), S. 317-320 
    ISSN: 1432-0533
    Keywords: Key words Perineuritis ; Neuropathy ; Nerve biopsy ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 71-year-old man presented a 6-month history of progressive paresthesia of all four limbs. Sural nerve biopsy specimens showed dense mononuclear infiltrates in the perineurium and subperineurium, indicating sensory perineuritis. One section revealed disruption of the perineurial barrier. Perforin and granzyme B were present in the infiltrates, and apoptosis of perineurial cells was indicated by a terminal deoxynucleotidyl-transferase-mediated dUTP-digoxigenin nick end-labeling (TUNEL) method. These findings suggest T cell-mediated apoptosis of the perineurium and nerve injury caused by perineurial damage.
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  • 75
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    Acta neuropathologica 99 (2000), S. 402-408 
    ISSN: 1432-0533
    Keywords: Key words Ageing ; Dog brain ; Apoptosis ; DNA ¶fragmentation ; TUNEL method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Neuronal DNA fragmentation, as revealed with the method of in situ end-labeling of nuclear DNA fragmentation (TUNEL), has been reported in both the canine and human brains in normal ageing, and in some human age-related neurodegenerative diseases. These results have suggested that apoptosis plays an important role in age-related neuronal loss. It is not clear, however, whether the TUNEL method is highly specific for apoptosis, as DNA fragmentation also occurs in the late stages o necrosis. In this study we have examined 27 dogs aged from ¶8 to 18 years, to investigate the occurrence of nuclear DNA fragmentation. An autolysis index based on current histological criteria was assigned to each animal to evaluate the effects of autolysis on nuclear DNA integrity. Our results have shown that neuronal nuclear DNA fragmentation is frequent in aged dogs, although it is not accompanied by apoptotic morphology. Yet, a positive relation between TUNEL labelling and the degree of tissue autolysis was observed. In contrast, no TUNEL labelling was detected in young control dogs despite autolysis indices being similar to those in aged dogs. Taken together, these results suggest that neuronal nuclear DNA fragmentation is an age-related phenomenon, not due to apoptosis, whenever other factors render neuronal DNA more susceptible to autolytic fragmentation. We confirm the effect of autolysis in a subpopulation of neurons in the aged canine brain, inducing nuclear DNA fragmentation.
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  • 76
    ISSN: 1432-1084
    Keywords: Key words: Brain ; MRI ; Neoplasms ; Diffusion image ; Echo-planar MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We assess diffusion-weighted MR images in the differential diagnosis of intracranial brain tumors and tumor-like conditions. Heavily diffusion-weighted (b = 1100 or 1200 s/mm2) axial images were obtained with single-shot echo-planar technique in 93 patients with pathologically confirmed various intracranial tumors and tumor-like conditions with diffusion gradient perpendicular to the images. We compared signal intensity of the lesions with those of gray and white matter, and cerebrospinal fluid (CSF). In 29 cases (31.1 %) the lesions were isointense to gray and/or white matter. However, 5 cases (5.4 %) showed extremely increased signal intensity: two epidermoid cysts; two chordomas; and one brain abscess. The entire portion of a tumor was markedly hyperintense in 10 cases (10.8 %): four malignant lymphomas; four medulloblastomas; one germinoma; and one pineoblastoma. A CSF-like hypointense signal was seen in many cystic tumors, and cystic or necrotic portions of tumors. A neurosarcoid granulation was the only solid lesion showing characteristically a hypointense signal like CSF. The combination of markedly hyperintense and hypointense signals was seen generally in hemorrhagic tumors. Diffusion-weighted echo-planar MR imaging is useful in the differential diagnosis of brain tumors and tumor-like conditions, and suggests specific histological diagnosis in some cases.
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  • 77
    ISSN: 1432-1084
    Keywords: Key words: Lumbar spine ; Ganglion cyst ; Posterior longitudinal ligament ; Radiculopathy ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A 35-year-old man with a long history of left L5 radicular pain was found to have an intraspinal cystic lesion causing radicular compression. Magnetic resonance imaging demonstrated a round lesion situated in the anterior epidural space, with uniform high signal intensity on T2-weighted sequences characteristic of a cystic lesion. During surgery a liquid-containing cyst originating from the posterior longitudinal ligament was punctured and resected. The histologic aspect was that of a ganglion cyst without synovial layers. The radiologic differential diagnoses are discussed.
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  • 78
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    European radiology 10 (2000), S. 1832-1835 
    ISSN: 1432-1084
    Keywords: Key words: Platyspondyly ; MRI ; Progressive pseudorheumatoid dysplasia ; Bone ; Osteochondrodysplasia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A rare case of progressive pseudorheumatoid dysplasia (PPD) in a 9-year-old girl is presented. Clinically, chronic painless swollen joints, accompanied by progressive motion restriction and progressive walking difficulties, were found. Radiologically, there was enlargement of the epimetaphyseal portions of the large joints, metacarpal heads, and phalanges, and generalized platyspondyly with irregular delineation of the endplates of the vertebral bodies. The radioclinical features at the peripheral joints were originally misdiagnosed as juvenile rheumatoid arthritis (JRA), and the structural spinal abnormalities were neglected and interpreted as Scheuermann's disease. However, the absence of active inflammatory parameters argues against JRA, whereas the low age of onset of the irregularities at the vertebral endplates is an argument against the diagnosis of Scheuermann's disease. The combination of the dysplastic abnormalities of the spine, with platyspondyly and Scheuermann-like lesions at an unusually low age of onset, and radiological features mimicking JRA of the peripheral joints, is the clue to the diagnosis of this rare autosomal-recessive disease. This case is the first to document the MRI features of PPD of the spine.
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  • 79
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    Neuroradiology 42 (2000), S. 290-295 
    ISSN: 1432-1920
    Keywords: Key words Blake's pouch cyst ; Dandy-Walker complex ; Dandy-Walker malformation ; Posterior fossa malformation ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abnormal cerebrospinal fluid (CSF) collections within the posterior fossa are defined by the Dandy-Walker complex (DWC) and by arachnoid cysts (AC). The DWC includes the Dandy-Walker malformation (DWM), the Dandy-Walker variant (DWV) and the mega-cisterna magna (MCM). In addition, Tortori-Donati et al. added persistent Blake's pouch cyst (BPC) as an independent entity within the DWC. BPC represents a posterior ballooning of the superior medullary velum into the cisterna magna. All of these malformations are overlapping developmental anomalies characterized by varying degrees of malformation of the medullary vela, the cerebellar vermis and hemispheres, the fourth ventricle choroid plexus, the posterior fossa subarachnoid cisterns and the enveloping meningeal structures. We present two cases of persistent BPC detected in two adult women without history of gestational or subsequent growth problems. They underwent neuroradiological investigation because of headache and because of recurrent episodes of loss of consciousness, respectively. The MRI findings included tetraventricular hydrocephalus, wide communication of the fourth ventricle and the cystic posterior fossa (i. e. BPC), inferior posterior fossa mass effect with or without hypoplasia of both the cerebellar vermis and the medial aspects of the cerebellar hemispheres, and absence of communication between fourth ventricle and the basal subarachnoid space in the midline posteriorly. Persistent BPC is defined by a failure of embryonic assimilation of the area membranacea anterior within the tela choroidea associated with imperforation of the foramen of Magendie. Typically this condition becomes symptomatic early in life. In the current cases the normal function of the laterally positioned foramina of Luschka probably helped to maintain some CSF flow between intraventricular and subarachnoid spaces, with the establishment of a precarious equilibrium characterized by a compensatory enlargement of the cerebral ventricular system (i. e. hydrocephalus).
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  • 80
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    Arthroskopie 13 (2000), S. 132-137 
    ISSN: 1434-3924
    Keywords: Schlüsselwörter Qualitätssicherung ; Knorpeldefekte ; MRT ; Scores ; Keywords Quality control ; Cartilage repair ; MRI ; Clinical scores
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Most procedures currently in use for the treatment of full thickness cartilage defects lack solid data as a proof of quality. Various techniques for quality control are advisable. Meticulous documentation of adverse events and treatment failures is crucial. Patient self-assessment and clinical scores are often biased but focussed on the basis of medical efforts: the well-being of the patient. Second-look arthroscopies produce fewer facts for quality control than expected but enable therapeutical intervention. Magnetic resonance imaging will be essential for cartilage assessment in the future. To date, the evaluation of tissue quality is experimental. Histology and immunohistochemistry are widely accepted as precise tools to characterize cartilaginous tissue. Ethical reasons prohibit daily use. Quality control following the repair of cartilage defects is complicated, expensive, and of variable outcome, but dangerous if neglected. Multiple insignificant results can lead to a sharp image of the postoperative condition and may enable quality control of treatment and surgery.
    Notes: Die meisten Verfahren zur Behandlung von Gelenkknorpeldefekten werden angewendet, ohne dass ihre Qualität zweifelsfrei nachgewiesen ist. Verschiedene Möglichkeiten der Qualitätssicherung können derzeit mit vertretbarem Aufwand routinemäßig eingesetzt werden. Die Beurteilung der Sicherheit einer Behandlung hinsichtlich Komplikationen und Therapieversagern ist von eminenter Bedeutung. Patientenfragebögen und klinische Scores sind subjektiv, orientieren sich aber am eigentlichen Ziel einer Therapie: der Wiederherstellung des Wohlbefindens des Patienten. Noch in den Anfängen, aber mit hervorragenden Perspektiven für die Zukunft steht die Magnetresonanztomographie. Knorpelqualität und -aktivität können heute noch nicht beurteilt werden. Die Kontrollarthroskopie nach der Behandlung von Gelenkknorpeldefekten liefert weniger harte Daten für die Qualitätssicherung als erwünscht, ermöglicht aber therapeutische Maßnahmen. Histologische Untersuchungen stehen im Ruf der unbestechlichen Präzision. Dem breiten Einsatz stehen jedoch fehlende Standards und berechtigte ethische Bedenken entgegen. Qualitätssicherung nach der operativen Behandlung von Gelenkknorpeldefekten ist schwierig, teuer und häufig ungenau – keine Qualitätssicherung ist oft gefährlich. Aus vielen, isoliert gesehen ungenauen Befunden werden die Bewertung eines Zustands immer sicherer und die Beurteilung der Qualität einer Behandlung möglich.
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  • 81
    ISSN: 1434-3940
    Keywords: Schlüsselwörter Kiefergelenk-MRT ; Diskusdislokation ; Kiefergelenkhistologie ; Keywords Temporomandibular joint (TMJ) ; MRI ; Anterior disk dislocation ; TMJ histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Problem. Anterior dislocation of the articular disk of the temporomandibular joint (TMJ) found by MRI tomography often presents a problem. It may persist in MRI despite improvement of articular symptoms and even be found in healthy persons free of any symptoms. Can this be explained by the similarity in structure of the anterior connective tissue of the disk and capsule and their pathological changes? Is a second coronal plane required for MRI investigation? Material and methods. The preauricular regions of 72 patients of the TMJ clinic were examined by oblique-sagittal and oblique-coronal MRI. A Siemens-Vision MRI was used. It was also possible to prepare 10 articular disks of the TMJ with anterior capsular tissue as well as 20 complete TMJs of adults from autopsy material. Sagittal, transversal, and horizontal serial sections were examined histologically. Results. In 49 of the 72 cases examined, an anterior dislocation without reduction found in the sagittal MRI was not confirmed in the oblique-coronal MRI. In the sagittal MRI it was possible to differentiate three, in the coronal MRI six typical forms of magnetic resonance signals, which are represented in figures. They are compared with anatomical and histological connective tissue findings adjacent to the TMJ. The structural similarity of the disk and anterior capsular tissue of the TMJ is demonstrated. The close connection of the disk and connective tissue surrounding the TMJ makes differentiation of MRI findings difficult especially following regressive and adaptive reactions. Conclusions. In MRI, anterior capsular tissue is able to simulate dislocation of the disk. Pathological tissue reactions may alter the MRI signal and lead to the wrong diagnosis of dislocation of the disk. Diagnosis of an anterior disk dislocation cannot be established solely on the basis of oblique-sagittal MRI findings.
    Notes: Zusammenfassung Fragestellung. Der Befund anteriore Diskusdislokation im sagittalen MRT beinhaltet 2 ungeklärte Probleme. Trotz Rückbildung einer Gelenksymptomatik können anteriore Diskusdislokationen im MRT unverändert bestehen, sie wurden sogar bei gesunden Probanden beschrieben. Ist die Ursache in der feingeweblichen Ähnlichkeit der anterioren Diskus- und Kapselbindegewebe und in deren pathologischen Strukturänderungen zu suchen? Kann auf die Befundung in der 2. koronalen Ebene verzichtet werden? Material und Methode. Die präartikulären Regionen im schräg-sagittalen und im schräg-koronalen MRT von 72 Patienten aus der Kiefergelenkspezialsprechstunde wurden befundet. Die Untersuchungen erfolgten mit dem Siemens-Vision-MRT. Bei unselektierten Sektionen konnten 10 Disci articulares mit dem anterioren Kapselgewebe sowie 20 Kiefergelenkpräparate Erwachsener präpariert werden. Sagittale, transversale und horizontale Serienschnitte wurden histologisch untersucht. Ergebnisse. Bei 49 von 72 ausgewählten Fällen gab es für eine anteriore Diskusdislokation ohne Reduktion im sagittalen MRT keine Bestätigung im schräg-koronalen MRT. Es konnten in den sagittalen MRT 3, in den koronalen MRT 6 sich wiederholende Signalformen differenziert werden. Sie sind skizziert. Ihre Zuordnung zu gelenkumgebenden Bindegeweben erfolgte mittels Vergleich dieser Signalformen mit den anatomischen und histologischen Kiefergelenkpräparaten. Die feingewebliche Ähnlichkeit des Discus articularis mit dem anterioren Kapselbindegewebe wird aufgezeigt. Seine enge Verbindung mit den gelenkumgebenden Bindegeweben erschwert die Differenzierung im MRT insbesondere beim Vorliegen regressiver und adaptiver Reaktionen. Schlussfolgerung. Das anteriore Kapselgewebe kann eine Diskusdislokation im MRT vortäuschen. Pathologische Gewebereaktionen ändern das MRT-Signal und tragen dazu bei, falsch-positive Befunde zur Diskusdislokation entstehen zu lassen. Schräg-sagittale MRT sind für die Diagnosefindung „anteriore Diskusdislokation mit und ohne Reposition“ nicht ausreichend.
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  • 82
    ISSN: 1434-3916
    Keywords: Key words Shoulder ; Calcifying tendinitis ; Shock wave ; MRI ; Prediction parameters ; Clinical outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This prospective study examined 62 patients (65 shoulders) with chronic courses of calcifying tendinitis of the shoulder before and after low-energy extracorporeal shockwave application (ESWA) in order to identify variables associated with the outcome of this treatment. Before ESWA, radiographs and contrast-enhanced magnetic resonance imaging (MRI) of the affected shoulders were obtained in order to document the size and morphology of the calcifications and the contrast media reactions in areas of interest (deposit, synovia, bursae), respectively. In addition, a clinical evaluation was performed. After ESWA (mean follow-up 18.2 months), clinical evaluations of all 65 shoulders revealed an increase in the Constant score from 44% to 78% (p 〈 0.0001). While size (p = 0.61) and morphology (p = 0.7) of the deposits before ESWA were not associated with the clinical outcome, negative contrast reactions around the deposits (p = 0.0001), synovia (p = 0.0049) and bursae (p 〈 0.01) were associated with improved clinical outcomes. After the total study group was divided into two groups, one with Constant scores ≥ 75% (n = 43) and the other with scores 〈 75% (n = 22), the positive predictive value (ppv), specificity (sp) and sensitivity (se) were determined for the negative reaction around the deposit (ppv: 0.94; sp: 0.95; se: 0.38), synovia (ppv: 0.84; sp: 0.82; se: 0.49) and bursae (ppv: 0.86; sp: 0.86; se: 0.44). In 5 cases (7.7%), surgery of the affected shoulder during the follow-up period was performed. No major side-effects were seen in the study group. In conclusion, our results suggest that in patients with chronic calcifying tendinitis, the absence of contrast enhancement, especially around the deposit, is a strong predictive parameter of a positive clinical outcome of ESWA.
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  • 83
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    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. 111-117 
    ISSN: 1434-3940
    Keywords: Schlüsselwörter Kiefergelenkfrakturen ; Kernspintomographie ; Achsiographie ; Diskusmobilität ; Diskusposition ; Key words TMJ fractures ; MRI ; Axiography ; Disc mobility ; Disc position
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Magnetic resonance imaging (MRI) assessment of traumatized temporomandibular joints (TMJ) usually focuses on disc position, defining regular joint function by normal, excentric or displaced disc position. So far, there are only few reports regarding disc position after open reduction of diacapitular or high condylar fractures of the TMJ with dislocation. The aim of the present study was to evaluate the role of the disc as regards postoperative functional outcome by electronic axiographic recordings of condylar movements and MRI, displacement of the disc and lesions of TMJ soft tissues being frequent in this type of mandibular fractures. A total of 30 subjects with 37 condylar fractures in whom osteosynthesis was performed using a preauricular approach were imaged postoperatively (mean 24 months) with a 1.5-Tesla MRI system to determine, (a) the position of the disc, (b) the range of mobility of the disc and (c) condylar mobility in closed and open mouth position, comparing fractured sides (FS) vs nonfractured sides (NFS). Linear movements between the two jaw positions in the sagittal plane were measured by superimposing transparencies. The results indicate: (1) more than 70% of the discs (FS) were found to be in normal position; there was no disc displacement without reduction. However, these data stood in contrast to severe limitations of the axiographic tracings as presented by almost 30% of the subjects. (2) Significant correlations were found between fixed (α = 0.05) or highly immobilized (α = 0.01) discs and axiographic limitations, suggesting disc mobility to be a valuable parameter for assessment of the postoperative functional outcome.
    Notes: Zusammenfassung Bei diakapitulären Frakturen bzw. hohen Kollumluxationsfrakturen mit Beziehung zum Lig. laterale sind Verlagerungen des Diskus häufig und werden nach konservativer Therapie mit einer Häufigkeit zwischen 50 und 100% angegeben. Informationen über die Diskusposition nach operativer Versorgung dieser Frakturgruppen liegen bisher nicht vor. Ziel der vorliegenden Studie war es, die Bedeutung von Position und Mobilität des Diskus für das postoperative funktionelle Ergebnis dieser Frakturgruppen zu klären. Die Objektivierung der operativen Ergebnisse bei 30 Patienten mit 37 über einen präaurikulären Zugang versorgten Gelenkfrakturen erfolgte mittels elektronischer Achsiographie und Kernspintomographie (1,5-T-System), im Mittel 24 Monate postoperativ. Erhoben wurden die Position und der Bewegungsumfang des Diskus bzw. des Kondylus im Seitenvergleich. Die linearen Bewegungen zwischen mundoffener und -geschlossener Position wurden durch Folienüberlagerung korrespondierender sagittaler MRT-Schichten ermittelt. Die Ergebnisse zeigten zum einen, dass 〉 70% der Disci auf der Frakturseite orthotop (Position A) lagen und keine fixierten anterioren Dislokationen (C) auftraten. Die achsiographischen Befunde zeigten in Diskrepanz dazu bei immerhin 30% der versorgten Gelenke höhergradige Limitationen der Exkursionsbahnen. Zum anderen bestehen signifikante Zusammenhänge zwischen fixierten (α = 0,05) bzw. hochgradig immobilisierten (α = 0,01) Disken und achsiographisch erfassten Limitationen der Translationsbewegung. Im Gegensatz zu bisherigen Studien sollten nach der operativen Versorgung von Gelenkfrakturen nicht nur die (statische) Diskusposition, sondern in erster Linie die Diskusmobilität als Parameter für das funktionelle Ergebnis berücksichtigt werden.
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  • 84
    ISSN: 1434-0879
    Keywords: Key words Kidney ; Ureter ; Urinary obstruction ; Hydronephrosis ; Hyperoxaluria ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hyperoxaluria is a well-known cause of renal stone disease and in vitro studies have shown that oxalate crystals have a stimulatory effect on apoptosis of renal tubular epithelial cells. Total and partial ureteral obstruction also have an accelerating effect on apoptosis of renal tubular epithelial cells. The aim of the present study was to investigate the apoptotic effect of unilateral ureteral obstruction in the presence of hyperoxaluria on the rat kidney. Twenty-eight male Wistar rats were divided into four groups, with seven rats in each. The groups were named G1 (control), G2 (hyperoxaluric), G3 (obstructive) and G4 (hyperoxaluric + obstructive). G2 and G4 rats were given 1% ethylene glycol (a precursor for oxalates) in their drinking water. G1 and G2 rats underwent sham operation, while left proximal ureteral ligation with a 5-zero silk suture was performed on G3 and G4 animals. The rats were sacrificed 2 weeks after the operation; left nephrectomy was then performed. We searched for the apoptotic cells by direct immuno-peroxidase detection of digoxigenin-labeled genomic DNA. The mean ± SD values of the apoptotic cell count was 0.86 ± 0.90 in G1 and 4.33 ± 3.81 in G2. The values for G3 and G4 were 30.17 ± 16.85 and 302.67 ± 184.45, respectively. We found a statistically significant difference between all groups (P 〈 0.001). When compared with the control group (G1), the mean apoptotic cell count was fivefold that of G2 and 35- and 351-fold those of G3 and G4, respectively. Our study demonstrated that hyperoxaluria with complete ureteral obstruction induces an excessive level of apoptosis, which is responsible for renal damage, and that ureteral obstruction is a more important factor for apoptosis than hyperoxaluria. Considering these data, we also believe that research studies for medical preventive measures must be considered for patients with ureteral obstruction and/or hyperoxaluria.
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    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S504 
    ISSN: 1434-3940
    Keywords: Schlüsselwörter CAD/CAM ; Knochenersatzmaterial ; MRT ; Qualitätskontrolle ; Titan ; Key words Bone substitute material ; CAD/¶CAM ; MRI ; Quality control ; Titanium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Computer-assisted prefabricated skull implants of pure titanium as a bone replacement material have been used in 22 departments since 1994. Our experience with 104 implants includes clinical aspects (indication; tissue quality; surgical technique; patient guidance), but also geometric and material-specific parameters (acquisition, transfer, and evaluation of CT data; construction; manufacturing; cleaning; postoperative use of radiologic techniques). While the clinical aspects are responsibly defined by the respective surgeon, the geometric and material-specific parameters of individual implants have to comply with the laws on medical products. Therefore, the prospective documentation for each implant includes: helical CT acquisition parameters; geometric data of the computer-based skull model and implant; the cleaning procedure; and the individual marking. Medically specified pure titanium is processed by milling only so that neither purity nor structure is impaired. A specially developed milling technique guarantees the fabrication of all constructed elements down to fine details of 50 μm. Considering the necessary radiologic follow-up of defects after tumor surgery, all patients in our hospital undergo postoperative MRI examination, partly with preoperative documentation as an intraindividual control. Such comprehensive documentation and quality assurance is essential for techniques of prefabricated bone substitution. Hand in hand with scientific research and clinical application, these formal criteria have to be elaborated and fulfilled for the respective techniques. The successful determination of specifically adapted MRI sequences goes even one step further: spin-echo sequences minimize inhomogeneities of the magnetic field induced by the titanium implants and enable accurate postoperative documentation and diagnostics especially in the follow-up after tumor surgery.
    Notes: Zusammenfassung Computergestützt vorgefertigte Schädelimplantate aus Reintitan als Knochenersatzmaterial werden seit 1994 in 22 Kliniken eingesetzt. Die Erfahrungen mit 104 Implantaten umfassen klinische (Indikationsstellung; Implantatlager; Operationstechnik; Patientenführung), aber auch geometrische und materialspezifische Aspekte (CT-Datenakquisition, -transfer und -auswertung; Konstruktion; Fertigung; Reinigung; postoperative Einsatzmöglichkeit bildgebender Verfahren). Während die klinischen Aspekte im Verantwortungsbereich ärztlichen Handelns definiert werden, gilt für die geometrischen und materialspezifischen Aspekte bei individuellen Implantaten das Medizinproduktegesetz. Prospektiv werden entsprechend für jedes Implantat die Spiral-CT-Akquisitionsparameter, die Geometriedaten des rechnerinternen Schädelmodells und des Implantats, das Reinigungsverfahren und die individuelle Kennzeichnung dokumentiert. Medizinisch spezifiziertes Reintitan wird ausschließlich durch Fräsung bearbeitet, sodass weder Reinheit noch Gefüge Änderungen erfahren. Eine eigens entwickelte Frästechnik garantiert die Umsetzung aller konstruierter Elemente bis zu einer Feinheit von 50 μm. Im Hinblick auf die bei tumorbedingten Defekten notwendige bildgebende Verlaufskontrolle werden sämtliche Patienten der eigenen Klinik postoperativ mit MRT untersucht, z. T. mit einer präoperativen Darstellung als intraindividuelle Kontrolle. Eine umfassende Dokumentation und Qualitätssicherung ist für Techniken des vorgefertigten Knochenersatzes unabdingbar. Parallel zur forscherischen Entwicklung und ärztlichen Anwendung müssen diese formalen Kriterien für das jeweilige Verfahren bearbeitet und erfüllt werden. Die erfolgreiche Erarbeitung von eigens adaptierten MRT-Sequenzen geht darüber noch hinaus: Spinechosequenzen minimieren die durch die Titanimplantate erzeugten Feldinhomogenitäten und erlauben eine aussagekräftige postoperative Dokumentation und Diagnostik insbesondere nach Tumoroperationen in der Verlaufsbeobachtung.
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  • 86
    ISSN: 1434-0879
    Keywords: Key words Cryptorchidism ; Contralateral descended testis ; Apoptosis ; Fertility ; Rat model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three rat strains have been studied, using a sensitive apoptotic detection method for germ-cell degeneration, to resolve the controversy regarding the effect of cryptorchidism on the contralateral descended testis (CDT). Sprague Dawley and Buffalo rats were made cryptorchid by operation at 20–22 days of age, while trans-scrotal (T-S) rats were a congenitally unilateral cryptorchid strain. Sham operated rats or normal T-S littermates were used as controls. Experiments were performed over a period ranging from 2 weeks to 18 months. Testis weight was assayed, as was the detection of apoptosis by agarose gel laddering and immunohistochemistry by using the TUNEL method. Labeled cells in 150 cross-sectioned testis tubules were counted on the TUNEL stained slides and the mean number of labeled cells per tubule was calculated. Paternity studies on Sprague Dawley and T-S rats were carried out at 12 and 24 weeks of age to assess fertility by the resultant number of pregnancies and litter sizes. Both Sprague Dawley and T-S rat models showed a biphasic distribution of apoptosis levels. This biphasic distribution was not observed in Buffalo rats as they were only studied at later time points (12–20 weeks). A significant effect on either testis weight or apoptosis in the CDT compared with the control descended testis (P ≥ 0.1) has not been found in these three cryptorchid models, and the present results are discussed with reference to observations of other researchers in rodents and humans. While the cryptorchid testis showed a high level of labeled apoptotic cells per tubule in all rat strains, fertility was not affected and remained the same as controls at 12 and 24 weeks. There was, however, a marked strain difference in fertility in T-S as compared with Sprague Dawley rats. After 24 weeks of cryptorchidism, both control and cryptorchid T-S rats had a 44% pregnancy incidence compared with a 90% pregnancy incidence in Sprague Dawley rats. In addition, litter size in T-S control and cryptorchid rats were small compared with those of Sprague Dawley rats at 12 and 24 weeks.
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  • 87
    ISSN: 1434-3924
    Keywords: Schlüsselwörter Arthroskopie ; Klinische Untersuchung ; Kniegelenk ; MRT ; Key words Arthroscopy ; Clinical examination ; Knee ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Magnetic resonance imaging (MRI) is used frequently in the diagnosis of knee injuries. The aim of this study was to compare the accruracy of MRI and clinical examination in diagnosing meniscal and cruciate ligament tears. Between January 1997 and June 1998, a total of 883 patients had undergone knee joint arthroscopy, operated on by one orthopedic surgeon. Of these, 144 patients had a preoperative MRI (group 1). This group was compared with 309 patients who had undergone arthroscopy without MRI between January 1997 and June 1997 (group 2). Sensitivity, specificity and accuracy for tears of the medial meniscus were 80.6%/58.8%/72.9% in group 1 and 83.3%/78.5%/80.3% in group 2, respectively, for tears of the lateral meniscus 44.4%/88.9%/83.3% in group 1 and 60.6%/98.8%/92.5% in group 2 and for tears of the anterior cruciate ligament 58.1%/92.0%/¶84.7% in group 1 and 80.1%/96.6%/¶89.6% in group 2. This study demonstrates that an experienced orthopedic surgeon can rely on the clinical diagnosis and decide whether arthroscopy is necessary in most cases without MRI. He will find intraarticular pathology in almost all cases if arthroscopy is performed. MRI should be reserved for special cases and should not be performed without first conducting a thorough clinical examination. The orthopedic surgeon should decide whether MRI is needed.
    Notes: Zusammenfassung Mit zunehmender Häufigkeit wird beim Verdacht auf einen Kniebinnenschaden die Magnetresonanztomographie (MRT) eingesetzt. Ziel der vorliegenden Arbeit war es, die Treffsicherheit von MRT und klinischer Untersuchung bei der Diagnose von Meniskusläsionen und Kreuzbandverletzungen zu vergleichen und daraus zu schlussfolgern, wann ein MRT am Kniegelenk indiziert ist. Vom 1.1.1997 bis zum 30.6.1998 wurden 883 Kniegelenkarthroskopien durchgeführt. Bei 144 Kniegelenken lag präoperativ ein MRT vor (Gruppe 1). Dieser Gruppe wurde eine Vergleichsgruppe, bestehend aus allen vom 1.1.1997 bis zum 30.6.1997 arthroskopierten Kniegelenken ohne präoperatives MRT (n = 309) gegenübergestellt (Gruppe 2). Sensitivität, Spezifität und Präzision betrugen für den medialen Meniskus 80,6%, 58,8% bzw. 72,9% in Gruppe 1 und 83,3%, 78,5% bzw. 80,3% in Gruppe 2, für den lateralen Meniskus 44,4%, 88,9% bzw. 83,3% in Gruppe 1 und 60,6%, 98,8% bzw. 92,5% in Gruppe 2 und für das vordere Kreuzband 58,1%, 92,0% bzw. 84,7% in Gruppe 1 und 80,1%, 96,6% bzw.89,6% in Gruppe 2. Mit einer sorgfältigen klinischen Untersuchung können in Verbindung mit Standardröntgenaufnahmen in den meisten Fällen die Diagnose und damit die Indikation zur Arthroskopie mit ausreichender Sicherheit gestellt werden. Die Magnetresonanztomographie sollte Spezialindikationen vorbehalten bleiben und durch den Operateur veranlasst werden.
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  • 88
    ISSN: 1434-3940
    Keywords: Schlüsselwörter CT ; MRT ; Mundhöhlen- und Oropharynxtumoren ; Diagnose ; Tumorstaging ; Keywords CT ; MRI ; Head and neck tumors ; Diagnosis ; Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Problem: There is a lack of clear criteria for the use of MR and CT in the diagnosis of head and neck cancer – some of it is even contradictory. The results of this study should lead to the establishment of more clear criteria. Patients: 165 patients suffering from head and neck tumors were subjected to a total of 463 CT and 197 MRI examinations. Results: The CT and MRI staging corresponded in 67% and 60% of the oropharynx tumors, respectively, with the clinical findings. In the case of oral cavity tumors, the clinical TNM stages were identical with CT and MRI results in 50% and 43% of cases, respectively. In the case of lymphatic node staging, the frequency of error was slightly higher using MRI, at 27%, compared with the CT rate of 22%. In the evaluation of cervical lymphatic nodes, CT proved to be more sensitive attaining 78% compared to the MRI rate of 69%. Conclusion: The results provide clear indications as to the MRI and CT examinations. Primary preoperative screening and post-therapeutic aftercare should be assessed using CT, as should lymphatic node diagnosis in the neck area. In the case of special problems such as, for example, the relevant bone and periostium infiltration, MR should be considered as a supplementary examination at a second stage.
    Notes: Fragestellung: Die Differenzialindikation von MRT und CT bei der Diagnostik von Malignomen im Kopf-Hals-Bereich wird in der Literatur kontrovers diskutiert. Mit der vorliegenden Studie soll versucht werden, eine eindeutige Auswahl des Verfahrens zu begründen. Patientengut: Bei 165 Patienten mit Tumoren des Oropharynx und der Mundhöhle wurden insgesamt 463 CT- und 197 MRT-Untersuchungen durchgeführt. Ergebnisse: Bei 67% bzw. 60% der Oropharynxtumoren stimmten das CT- bzw. MRT-TNM-Tumorstaging mit der Klinik überein. Bei den Mundhöhlentumoren waren die klinischen TNM-Stadien in 50% bzw. 43% mit den CT- bzw. MRT-Befunden identisch. Beim Lymphknotenstaging war die Fehlerhäufigkeit bei der MRT mit 27% etwas höher als bei der Computertomographie mit 22%. Bei der Beurteilung der zervikalen Lymphknoten war die CT der MRT bezüglich der Sensitivität mit 78% gegenüber 69% überlegen. Schlussfolgerung: Aufgrund der Ergebnisse ergeben sich eindeutige Indikationen zur MRT- und CT-Untersuchung. Das primäre präoperative Screening und die posttherapeutische Nachsorge sollten durch CT beurteilt werden ebenso wie die Lymphknotendiagnostik im Halsbereich. Bei speziellen Fragestellungen, wie z. B. bezüglich der Periost- und Knocheninfiltration, ist die MRT eine ergänzende Untersuchung des 2. Schritts.
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  • 89
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    Der Unfallchirurg 103 (2000), S. 1079-1085 
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Knie ; MRT ; Arthroskopie ; Meniskus ; Key words Knee ; MRI ; Arthroscopy ; Meniscus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In order to assure diagnostic accuracy, 172 knee joints were examined prospectively by MRI. After MRI, all knee joints were examined by arthroscopy. Tears of the medial meniscus were found in 102 patients, the lateral meniscus showed a tear in 29 cases. Assuming that arthroscopy represents the golden standard of diagnostic measure concerning the knee joint, it can be stated that false-positive MRI findings on the medial and lateral meniscus were diagnosed in three cases and false-negative MRI findings were diagnosed for two knee joints regarding the medial meniscus and four times regarding the lateral meniscus. For the medial meniscus a sensitivity of 98%, a specificity of 96%, an accuracy of 94%, and the positive and negative value of prediction were calculated at 97% each. Regarding the lateral meniscus, a sensitivity of 85%, a specificity of 98%, an accuracy of 92%, a positive predictive value of 88%, and a negative predictive value of 85% were found. Under the prerequisite that the MRI is carried out correctly and assessed by an experienced radiologist, the accuracy of the MRI for meniscus diagnosis is almost equivalent to the one by arthroscopy. Under these conditions, MRI can be recommended when no safe and sufficient clinical diagnosis can be made. The rate of unnecessary arthroscopies with a pure diagnostic purpose can be lowered significantly by means of MRI.
    Notes: Zusammenfassung Zur Überprüfung der diagnostischen Treffsicherheit wurden prospektiv 172 Kniegelenke mittels Magnetresonanztomographie (MRT) untersucht. Nach der MRT erfolgte bei allen Kniegelenken die arthroskopische Überprüfung der bildgebenden Diagnose. Rissbildungen des Innenmeniskus fanden sich bei 102 Patienten, am Außenmeniskus wurde 29-mal ein Riss befundet. Unter der Annahme, dass die Arthroskopie der “golden standard” diagnostischer Maßnahmen am Kniegelenk darstellt, ergab sich, dass falsch-positive MRT-Befunde am Innen- und Außenmeniskus in jeweils 3 Fällen und falsch-negative MRT-Befunde am Innenmenikus bei 2 Kniegelenken und am Außenmeniskus 4-mal erhoben wurden. Für den Innenmeniskus wurde eine Sensitivität von 98%, eine Spezifität von 96%, eine Genauigkeit von 94% und der positive bzw. negative Vorhersagewert mit jeweils 97% errechnet. Bezüglich des Außenmeniskus ließ sich eine Sensitivität von 85%, eine Spezifität von 98%, eine Genauigkeit von 92%, ein positiver Vorhersagewert von 88% und ein negativer Vorhersagewert von 85% ermitteln. Unter der Voraussetzung, dass die MRT korrekt durchgeführt und von einem erfahrenen Radiologen befundet wird, ergibt sich eine annähernd gleichwertige Treffsicherheit der MRT für die Meniskusdiagnostik wie mit der Arthroskopie. Die MRT kann daher unter diesen Voraussetzungen zur Anwendung empfohlen werden, wenn klinisch keine ausreichend sichere Diagnose zu stellen ist. Die Rate unnötiger rein diagnostischer Arthroskopien kann durch die MRT entscheidend gesenkt werden.
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  • 90
    ISSN: 1433-0350
    Keywords: Key words Hydrocephalus ; Endoscopic III ventriculostomy ; Outcome ; MRI ; Cine-MRI ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  In order to analyze the surgical outcome according to clinical characteristics and to evaluate the correlation between clinical improvement and neuroimaging changes, we retrospectively reviewed 32 children who had undergone endoscopic III ventriculostomy (ETV) from February 1994 to May 1998. There were 15 boys and 17 girls, with a mean age of 5.2 years (range: 1 month to 13 years). The etiology of the hydrocephalus was primary aqueductal stenosis in 18 patients, secondary aqueductal stenosis caused by tumors in 5, IV ventricle outlet obstruction in 5, and hydrocephalus associated with meningomyelocele in 4. The mean duration of follow-up was 19.4 months (range 1–50 months). Overall, surgical outcome was regarded as good in 21 of 29 patients. Surgical outcome was poor in patients younger than 1 year (P〈0.05). Neuroimaging 1 month after ETV showed a decrease in ventricular size in 11 of the 16 patients with good surgical outcomes. Five showed minimal changes only. In patients with good outcomes, ventricular size tended to decrease as time passed. Resolution of periventricular edema, flow void in the III ventricle on T2-weighted axial images, and cine-MR imaging were sensitive indicators of good outcome. We suggest that ETV be considered as a primary treatment option in patients older than 1 year of age with noncommunicating hydrocephalus. In addition, time factors should be taken into consideration when surgical outcome is judged. Changes in ventricular size could not predict surgical outcome completely in themselves. Therefore, a comprehensive postoperative assessment should be made with the help of T2-weighted MRI and cine-MRI.
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  • 91
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    Child's nervous system 16 (2000), S. 200-202 
    ISSN: 1433-0350
    Keywords: Key words Scoliosis ; Syringomyelia ; Chiari malformation ; MRI ; Gardner ; Obex
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The clinical notes of 35 children presenting with scoliosis were reviewed; all 35 had been investigated with MRI. Seven were found to have syringomyelia, and six of these had Chiari malformation. Correction of the syrinx resulted in improvement or stabilisation of the spinal curvature. We recommend that all cases presenting with primary scoliosis should have MRI and should be treated if a syrinx is found.
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  • 92
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Gliomatosis cerebri ; MRT-Diagnose ; Enzephalitis ; Key words Gliomatosis cerebri ; MRI ; Diagnosis ; Encephalitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The diagnosis of the rare disease Gliomatosis cerebri requires the correlation of clinical, radiological, and pathological findings. We report on two patients with intravitally diagnosed gliomatosis cerebri. Due to the unusually high malignancy of the tumor cells, diagnosis was complicated by atypical findings such as gadolinium enhancement in MRI and raised intracranial pressure. The clinical course, differential diagnosis, and literature are summarized briefly.
    Notes: Zusammenfassung Die Diagnose der seltenen Gliomatosis cerebri kann nur in Zusammenschau von klinischen, radiologischen und histopathologischen Befunden gestellt werden. Im vorliegenden Artikel berichten wir über 2 Patienten, bei denen intra vitam nach stereotaktischer Hirnbiopsie die Diagnose Gliomatosis cerebri gesichert wurde. Da in beiden Fällen für Gliomatosis cerebri ungewöhnlich hochgradig entdifferenzierte Tumorzellen vorlagen, wurde die Diagnosefindung durch atypische Befunde wie Kontrastmittelaufnahme im MRT und klinische Zeichen der intrakraniellen Drucksteigerung erschwert. Klinischer Verlauf, Differentialdiagnosen und Literatur werden kurz dargestellt.
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  • 93
    ISSN: 1433-0407
    Keywords: Schlüsselwörter Hallervorden-Spatz-Krankheit ; Parkinsonsyndrom ; MRT ; 123J-β-CIT ; 123J-IBZM ; Keywords Hallervorden-Spatz Disease ; Parkinson's syndrome ; MRI ; 123I-β-CIT ; 123I-IBZM
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Hallervorden-Spatz disease (HSD), a rare extrapyramidal motor illness, is usually only confirmed after death. In vivo diagnosis has relied hitherto on the combination of typical magnetic resonance imaging (MRI) findings (the “eye of the tiger” sign) and heterogeneous clinical symptoms of movement disorder which have been regarded as almost pathognomonic. We report on the diagnostic contribution of 123J-β-CIT single photon emission computed tomography (SPECT) and 123J-IBZM SPECT in akinetic-rigid Parkinson's syndrome occurring in a case of HSD. In contrast to Parkinson's disease and multisystem atrophies, the results of both tests were normal. This constellation of findings shows that the degeneration lies primarily outside the nigrostriatal system, supporting arguments for the nosologic distinction of HSD from other extrapyramidal illnesses.
    Notes: Zusammenfassung Die Diagnose der Hallervorden-Spatz-Krankheit (HSD), einer seltenen extrapyramidal-motorischen Erkrankung, konnte gewöhnlich erst postmortal gesichert werden. Bislang galt der typische MRT-Befund mit dem “Tigerauge-Zeichen” in Kombination mit der heterogen klinischen Symptomatik von Bewegungsstörungen als nahezu pathognomonisch und diente zur Diagnosestellung zu Lebzeiten. In der vorliegenden Kasuistik soll der diagnostische Beitrag von 123J-β-CIT und 123J-IBZM-SPECT bei einem akinetisch-rigiden Parkinsonsyndrom im Rahmen einer HSD dargestellt werden. Für beide Untersuchungen wurden im Gegensatz zum M. Parkinson und Multisystematrophien Normalbefunde gefunden. Diese Befundkonstellation zeigt einerseits, dass die Degeneration primär außerhalb des nigrostriatalen Systems liegt, und andererseits unterstützt sie die Diskussion der nosologischen Abgrenzung der HSD von anderen extrapyramidalen Erkrankungen.
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  • 94
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    Der Urologe 39 (2000), S. 214-221 
    ISSN: 1433-0563
    Keywords: Schlüsselwörter Krebs ; Karzinogenese ; Zellzyklus ; Protoonkogene ; Tumorsupressorgene ; DNA-Reparaturgene ; Apoptose ; Telomere ; Key words Multi-step carcinogenesis ; Cell cycle ; Proto-oncogene ; Tumor suppressor gene ; DNA repair gene ; Apoptosis ; Telomeres
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The development of cancer is one of the most intensively studied areas of medical research resulting in an immense quantity of data. Therefore, the purpose of this article is to give an overview of the basic principles of cancer development. Key words such as multi-step carcinogenesis, cell cycle, proto-oncogene, tumor suppressor gene, DNA repair gene, apoptosis and telomeres are explained and described in examples. This paper aims to connect recent information of molecular and cellular biology in an overview of cancer origin and development.
    Notes: Zusammenfassung Die Entstehung von Tumoren und die Entwicklung von entsprechenden Modellen gehört zu den sehr intensiv untersuchten Fragestellungen medizinischer Forschung mit einer schier unerschöpflichen Datenflut. Ziel dieses Artikels ist daher die möglichst anschauliche und daher sicher vereinfachende Darstellung grundlegender Prinzipien der Krebsentstehung. Es werden Begriffe wie Mehrschrittkarzinogenese, Zellzyklus, Protoonkogene, Tumorsupressorgene, DNA-Reparaturgene, Apoptose und Telomere in Zusammenhang gebracht und anhand von Beispielen erklärt. Dieser Artikel soll damit zum Verständnis der Zusammenhänge der Molekular- und Zellbiologie bei der Krebsentstehung beitragen.
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  • 95
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    Rechtsmedizin 10 (2000), S. 90-95 
    ISSN: 1434-5196
    Keywords: Schlüsselwörter Geschosse ; Verletzungen ; MRT ; Beurteilung ; Dokumentation ; Keywords Projectiles ; Injuries ; MRI ; Assessment ; Documentation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Description / Table of Contents: For the assessment of gunshot injuries, conventional X-ray examination, ultrasound and CT examinations are commonly used imaging techniques. With the exception of some authors, there is agreement that projectiles indicate a contraindication for MRI because of artificial imaging side-effects and the potential of secondary dislocation due to ferromagnetism. MRI testing was carried out on 56 projectiles for ferromagnetism and imaging quality in vitro and in pig carcasses with a 0.2 T and a 1.5T-MRI scanner. The image quality was compared to that of a CT scan. Projectiles with ferromagnetic properties can easily be distinguished from non-ferromagnetic ones by pretesting the motion of an projectile of the same type within the magnetic field of the MR scanner. When ferromagnetic projectiles were excluded, MRI yielded the more precise images compared to other imaging techniques. Projectile localization and associated soft tissue injuries were visualized without artifacts in all cases. When ferromagnetism is excluded MRI gives an excellent imaging procedure for the assessment and documentation of gunshot injuries. Therefore this imaging procedure may be also useful for medico-legal investigations.
    Notes: Zur Beurteilung des Ausmaßes von Schußverletzungen und zur Lokalisationsdiagnostik werden allgemein konventionelle Röntgenübersichtsaufnahmen sowie die Sonographie und die Computertomographie angewendet. Mit Ausnahme weniger Autoren wird generell davon ausgegangen, daß Projektile aufgrund der Generierung von Artefakten in der Bildgebung und der Gefahr einer sekundären Fremdkörperdislokation, bedingt durch den Ferromagnetismus, nicht mit der MRT beurteilt werden dürfen. 56 verschiedene Projektile wurden nach entsprechender Vortestung bezüglich ihrer Ferromagnetizität mit je einem 0,2-T- und 1,5-T-MRT-Gerät in vitro und anschließend in Schweinekadavern untersucht. Die Bildqualität wurde mit denen von CT-Bildern verglichen. Die ferromagnetischen Eigenschaften der Projektile können leicht beurteilt werden, indem man Vergleichsgeschosse desselben Typs in das Magnetfeld des MRT-Gerätes legt. Nach Ausschluß der Ferromagnetizität übertrifft die MRT alle anderen bildgebenden Verfahren. In allen Fällen gelang eine exakte Projektillokalisation sowie eine überlegene Darstellung der Weichteilverletzungen. Aufgrund der Ergebnisse ist die MRT, nach Ausschluß von ferromagnetischen Fremdkörpern, ein exzellentes Verfahren zur Beurteilung und Dokumentation von Schußverletzungen. Abhängig von den Fragestellungen kann dieses bildgebende Verfahren auch in der Rechtsmedizin eingesetzt werden.
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  • 96
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    Virchows Archiv 436 (2000), S. 102-108 
    ISSN: 1432-2307
    Keywords: Key words Oral ; Squamous cell carcinoma ; Proliferation ; Apoptosis ; Tumour suppressor gene ; Oncogene ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Tumour progression is characterised by an imbalance between cell proliferation and apoptosis. The aim of our study was to estimate the importance of proliferation and apoptosis associated parameters in primary squamous cell carcinomas (SCCs) of the oral cavity and oropharynx. For determination of apoptosis, the enzymatic labelling of DNA fragmentation with a terminal transferase reaction was used in 156 tissue samples of 107 patients, including corresponding lymph-node metastases in nine cases. P53, bcl-2, and Ki-67 were determined immunohistologically. P53 was detectable in 50.5% of the cases. Positive staining was associated significantly with decreased apoptosis (P〈0.003). Bcl-2 was upregulated in 31.8% of the cases depending on the tumour grading (P〈0.001) and correlated negatively with apoptosis (P〈0.001). Proliferation (P〈0.006) and apoptosis (P〈0.03) were enhanced in larger tumours, though a direct correlation between these two parameters was not proven. Nevertheless, in contrast to the conventional tumour staging and grading, neither the expression of p53 or bcl-2 nor the apoptosis or Ki-67 measurements were able to predict survival or recurrence-free survival of the patients suffering from a SCC in the oral cavity or oropharynx. Our observations suggest that the function of wild-type p53 to induce apoptosis is lost in at least half of the SCCs under study and that the physiological function of bcl-2 as potent inhibitor of apoptosis is widely preserved in oral SCC.
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  • 97
    ISSN: 1432-2307
    Keywords: Key words  Pseudomelanosis coli ; Large bowel ; Colonic adenoma ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Pseudomelanosis coli is characterized by pigment deposition in the lamina propria and caused by increased epithelial apoptosis. Pseudomelanosis coli is absent in colonic neoplasia. The aim of our studies was to investigate this phenomenon in more detail. Apoptotic fragments of epithelial cells and their distribution, cell proliferation (Ki-67, MIB 1 immunostaining), macrophages (CD68 immunostaining), Bcl-2 expression and apoptosis [terminal-deoxynucleotidyl-transferase mediated dUTP fluorescein nick end labeling (TUNEL) assay] were studied in adenomas arising in normal and melanotic colonic mucosa, in normal colonic mucosa and colonic mucosa with pseudomelanosis alone. In adenomas, we found 7.0 apoptotic bodies per 100 epithelial cells in the epithelial layer and only 0.2 apoptotic bodies per high power field (HPF) in the lamina propria. In contrast, in melanotic mucosa 1.7 apoptotic bodies per 100 epithelial cells in the epithelial layer and 2.5 per HPF in the lamina propria were found. Our results show that apoptotic fragments remain in the neoplastic (adenomatous) epithelium and do not reach (at least in higher amounts) the lamina propria. They can, therefore, not contribute to the development of pseudomelanosis in these lesions. However, macrophages are diminished in adenomas. Proliferation (Ki-67) and also Bcl-2 expression are highly increased in adenomas. The pathway of mucosal macrophages is also discussed.
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  • 98
    ISSN: 1432-2307
    Keywords: Key words Colon ; Nonpolypoid adenoma ; Apoptosis ; Proliferation ; Morphogenesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Nonpolypoid neoplasms, as well as ordinary polypoid tumours, are occasionally found in the colorectum. To clarify whether cell kinetic status affects the macroscopic morphology of colorectal neoplasms, we investigated proliferative indices (PI), apoptotic indices (AI), and the expression of apoptosis-related gene products. We examined 110 colorectal neoplasms comprised of 36 polypoid, 38 flat elevated and 36 depressed tumours. According to WHO’s criteria these tumours consisted of 61 adenomas with low grade dysplasia (LGD), 30 adenomas with high grade dysplasia (HGD) and 19 carcinomas with submucosal invasion. Apoptotic cells were detected by TUNEL staining. Proliferating cells and apoptosis-related gene products were assessed by immunohistochemistry for Ki-67, p53, Bcl-2, and Bax antigens. AI were closely associated with macroscopic morphology in adenomas but not in carcinomas. PI were relatively constant among the three macroscopic types in adenomas and carcinomas. Median AI values of polypoid, flat elevated and depressed tumours were 1.8%, 2.1% and 4.6% for adenomas with LGD, 0.8%, 2.4% and 6.2% for adenomas with HGD and 2.9%, 4.0% and 3.6% for carcinomas, respectively. Overall PI were significantly higher in carcinomas than in adenomas with LGD, whereas AI were not different. Although the incidence of expression was significantly higher in carcinomas for p53 and in adenomas for Bcl-2 than the others, the expression of apoptosis-related gene products (p53, Bcl-2 and Bax) was similar among polypoid, flat elevated and depressed tumours. Macroscopic morphology of colorectal adenomas is determined by the apoptosis not by proliferation, and high apoptosis found in depressed adenomas implies their low net growth.
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  • 99
    ISSN: 1432-2307
    Keywords: Keywords Medullary thyroid carcinoma ; MEN2 ; Proliferation ; Apoptosis ; bcl ; p53
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  C-cell hyperplasia (CCH) and medullary thyroid carcinoma (MTC) in patients affected by germline mutations of the RET oncogene represent an exceptional opportunity to study the regulation of proliferation and apoptosis during tumour initiation and progression. In 56 specimens [CCH, n=1; MTC with CCH, n=26; MTC, n=20; lymph-node metastasis (LNM), n=9] from 46 patients [multiple endocrine neoplasia type 2a (MEN2a), n=24; MEN2b, n=2; familiar MTC (FMTC), n=4; sporadic MTC, n=16] and 3 cases of non-neoplastic CCH, proliferation activity (MIB1), the rate of apoptosis [dUTP nick end labelling (TUNEL)] and expression of p53, bcl-2, bcl-x and bax were investigated and compared with clinical data. In MEN-associated CCH and small MTC, bcl-2 was strongly expressed, bcl-x was moderately expressed and bax was only weakly expressed. Advanced tumours and LNM did show a more heterogeneous bcl-2 staining accompanied by an increased bax expression and accelerated proliferation. The rate of apoptosis was extremely low in all investigated tumours. P53 was detectable in three patients with rapidly growing and extensively metastasising MTC. No somatic p53 mutations were found. Hereditary MTC with germline RET mutations at codon 918 (MEN2b) and codon 634 revealed a bias towards a higher proliferation activity at a younger age and are more frequently accompanied by LNM. CCH and MTC are characterised with a preponderance of bcl-2 as a factor blocking the programmed cell death. While MTC, in general, is a slowly growing tumour, a minority of tumours do progress rapidly with high proliferation. The factors leading to an accelerated tumour progression do not seem to take their effect via the regulation of apoptosis. Certain alterations of RET are supposed to have a direct or indirect implication on proliferation and, because of this, an effect on the clinical course.
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  • 100
    ISSN: 1432-2277
    Keywords: Key words FTY 720A ; Transplantation ; Immunosuppression ; Lymphopenia ; Apoptosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The novel immunosuppressive compound FTY 720A posseses a mode of action which is different from all other immunosuppressive drugs. The most prominent feature is a reversible decrease in peripheral lymphocyte counts observed in animal experiments. We investigated in the first human trial (phase 1) whether FTY 720A induces apoptosis of peripheral blood mononuclear cells (PBMC) in stable renal allograft recipients. Monitoring of lymphocyte counts revealed a significant and dose-dependent decrease within 6 h post-FTY 720A dose: placebo 5.1 %; 0.25 mg 36.4 %; 0.5 mg 40.8 %; 0.75 mg 39.4 %; 1 mg 45.8 %; 2 mg 67.2 %; 3.5 mg 64.9 %. PBMC apoptosis rates did not change, as determined before intake of FTY 720A and 2 h, 6 h, 24 h and 96 h post-FTY 720A dose. We detected no significant difference in apoptosis rates between patients who received placebo or FTY 720A. However, in vitro experiments showed that high concentrations of FTY 720 A induced apoptosis in human PBMC.
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