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PubMed1992

Ontogenic expression of somatostatin-messenger RNA in the intestinal tract of neonatal rats.

Ontogenic expression of somatostatin (SRIF) -messenger RNA (mRNA) in the gastrointestinal tract was examined in neonatal rats aged from 1 day preterm to 60 days postpartum in comparison with that in the hypothalamus. SRIF-mRNA in the hypothalamus was already expressed in prenatal rats and its developmental change was relatively small. In contrast, a unique pattern of SRIF-mRNA expression was seen in the different intestinal regions, gastric antrum, duodenum, jejunum and colon. In the duodenum, SRIF-mRNA level was low at birth, markedly increased during the postnatal 3 days and declined to the previous level by day 21. Jejunal SRIF-mRNA was found in neonates but progressively decreased in a similar way to duodenum. On the contrary, gastric SRIF-mRNA level, which was low during early development, rose rapidly to a peak on day 21 and gradually declined to an adult level. In the colon age-related change was not conspicuous, remaining at a low level. These results indicate that (1) expression of SRIF gene in the intestinal tract is regulated by local factor(s) as well as developmental stage, and (2) shift of SRIF-mRNA pattern occurs during weaning from the duodenum-dominant infantile pattern to the gastric-dominant adult pattern.

Age Factors↗

PubMed1993

Heat shock applied early in sporulation affects heat resistance of Bacillus megaterium spores.

Cells of Bacillus megaterium 27 were challenged by a 30-min heat shock at 45 degrees C during various sporulation stages and then shifted back to a temperature permissive for sporulation (27 degrees C), at which they developed spores. Heat shock applied at 120 min after the end of the exponential phase induced synthesis of heat shock proteins (HSPs) in the sporangia and delayed the inactivation of spores at 85 degrees C. Several HSPs, mainly HSP 70, could be detected in the cytoplasm of these spores. An analogous HSP, the main HSP induced by increased temperature during growth, belongs to the GroEL group according to its N-terminal sequence. The identity of this protein was confirmed by Western blot (immunoblot) analysis with polyclonal antibodies against B. subtilis GroEL. Sporangia treated by heat shock immediately or 240 min after exponential phase also synthesized HSPs, but none of them could be detected in the spores in an appreciable amount. These spores showed only a slightly increased heat resistance.

Amino Acid Sequence↗

PubMed1998

A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, hemoccult.

OBJECTIVE: To review effectiveness of screening for colorectal cancer with faecal occult blood test, Hemoccult, and to consider benefits and harms of screening. DESIGN: Systematic review of trials of Hemoccult screening, with meta-analysis of results from the randomised controlled trials. SUBJECTS: Four randomised controlled trials and two non-randomised trials of about 330 000 and 113 000 people respectively aged >=40 years in five countries. MAIN OUTCOME MEASURES: Meta-analysis of effects of screening on mortality from colorectal cancer. RESULTS: Quality of trial design was generally high, and screening resulted in a favourable shift in the stage distribution of colorectal cancers in the screening groups. Meta-analysis of mortality results from the four randomised controlled trials showed that those allocated to screening had a reduction in mortality from colorectal cancer of 16% (relative risk 0.84 (95% confidence interval 0.77 to 0.93)). When adjusted for attendance for screening, this reduction was 23% (relative risk 0.77 (0.57 to 0.89)) for people actually screened. If a biennial Hemoccult screening programme were offered to 10 000 people and about two thirds attended for at least one Hemoccult test, 8.5 (3.6 to 13.5) deaths from colorectal cancer would be prevented over a period of 10 years. CONCLUSION: Although benefits of screening are likely to outweigh harms for populations at high risk of colorectal cancer, more information is needed about the harmful effects of screening, the community's responses to screening, and costs of screening for different healthcare systems before widespread screening can be recommended.

Adult↗

PubMed1991

Nutritional monitoring of a pediatric burn patient.

The pediatric burn patient presents a particular challenge nutritionally. Nutritional reserves are limited, and excesses are often poorly tolerated. Ongoing monitoring is essential for discovering at an early stage the dynamic shifts in energy, protein, and other nutrients that may be occurring. Adequate enteral intake may be difficult to achieve as a result of repeated holding of feedings on surgery days and gastrointestinal tolerance problems such as poor gastric emptying and abdominal distention. This case report illustrates techniques, such as the nutritional assessment record and parenteral nutrition evaluation form, which may assist the clinician in optimizing the nutritional management of the patient.

Burns↗

PubMed1983

Sleep and the enuresis alarm device.

The effect on sleep of the wire-mesh element within the `buzzer and pad' enuresis alarm device was studied using healthy adult volunteers in a single or double crossover design. Polygraphic recording revealed a reduction in the number of shifts between sleep stages, and in the time spent in wakefulness, movement and stage 1, on the nights when the mesh was in the bed. This effect may be responsible for preventing some of the enuretic episodes which would otherwise have occurred at such times.

Adolescent↗

PubMed1994

Isolation and developmental expression of the amphibian homolog of the fibroblast growth factor receptor 3.

Recent observations suggest that fibroblast growth factors (FGFs) and their receptors are involved in the control of embryogenesis. Several FGF receptor genes have been identified so far and their expression is differentially regulated. As part of a continuing effort to analyse the differential expression of FGF receptors and their potential role during amphibian development, we have isolated a Pleurodeles homolog of FGF receptor 3 (FGFR-3), which we designated PFR-3 because of its highest homology to human FGFR-3 (75% overall identity). PFR-3 is a maternally derived mRNA. While a low level of expression persists during the cleavage and gastrula stages, a significant increase in the mRNA was observed at the end of the gastrula stage. RNase protection analysis on dissected tissues showed that PFR-3 mRNA was mainly localized to the ectoderm at the early gastrula stage and then shifted to the embryonic neural tissues, whereas adult brain had decreased levels of PFR-3 mRNA expression. Consistent with the loss of FGF receptors during skeletal muscle terminal differentiation, PFR-3 as well as other FGF receptor mRNAs were undetectable in the adult skeletal muscle. However, highest levels of PFR-3 mRNA expression were found in the testis. In situ hybridization revealed strong expression in the germinal epithelium of the embryonic brain (especially the diencephalon and rhombencephalon) and neural tube, in the lens and the cranial ganglia. The epithelium of the developing gut, like the pharynx and esophagus, also prominently expressed PFR-3 mRNA. Other sites of expression were found in the liver and in the mesenchymal condensation sites of branchial arches.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗

PubMed1991

Hybrid dysgenesis in Drosophila melanogaster: a new type of gonadal dysgenic sterility expressed at the pre-pupal stage.

Two sublines, B-202 and B-207, which were derived from crosses between Or-R (M) females and Cy/Pm (P) males were found to cause a new type of gonadal dysgenic sterility, designated as the GD-3. GD-3 sterility showed a typical reciprocal cross effect under the P-M system. It was caused at the frequency close to 100% in dysgenic offsprings reared above 25 degrees C, of which gonads were morphologically clearly different from those of usual GD sterility, whereas there was no indication of GD-3 sterility at temperatures below 24 degrees C. Temperature sensitive period of GD-3 sterility was estimated to the prepupal stage by shift-down experiment. In the B-202 subline, the 2nd chromosomes marked with Pm alone carried GD-3 elements. Those of the B-207 subline, however, were estimated to locate both on the 2nd and 3rd chromosomes, acting synergistically with each other.

Animals↗

PubMed2006

Percutaneous radiofrequency ablation: minimally invasive therapy for renal tumors.

Currently, up to 60% of renal tumors are detected incidentally by abdominal imaging. Most of these tumors are small and localized to the kidney. Owing to the shift to lower stage at diagnosis, radical nephrectomy has fallen out of favor and has been replaced by nephron-sparing surgery. Currently, partial nephrectomy is the treatment of choice for patients with small renal tumors. As the trend towards less invasive therapy continues, laparoscopic and percutaneous ablation techniques have gained popularity for the treatment of renal tumors in patients who are high-risk surgical candidates, or have a solitary kidney, limited renal function or multifocal disease. Percutaneous radiofrequency ablation is a safe, minimally invasive treatment option for those patients.

Adult↗

PubMedDate not supplied

The diagnosis and management of ductal carcinoma in-situ of the breast.

The widespread utilization of screening mammography has produced a shift in the stage of breast cancer at diagnosis in the US: Currently, 12% to 15% of newly diagnosed breast cancer cases annually are ductal carcinoma in-situ (DCIS). The diagnosis is made, in at least 90% of patients, with mammography. Only about 10% of patients will have a palpable mass. The accurate characterization and visualization of calcifications typically requires magnification of mammographic imaging. The morphology of the calcifications is generally considered to be the most important factor in differentiating benign from malignant formations. Round and uniform shapes are more likely to be benign, while linear and heterogeneous morphologies are associated with DCIS. Following a complete mammographic work-up, most suspicious lesions are potential candidates for a stereotactic core needle biopsy. Ten percent to 50% of patients initially diagnosed with atypical ductal hyperplasia by needle biopsy have subsequently been surgically diagnosed with cancer near the biopsy site. Due to this relatively high incidence of co-existent carcinoma, a needle biopsy diagnosis of atypical ductal hyperplasia necessitates subsequent surgical excision. The most important change in our thinking about DCIS was from a monolithic view, conceiving of DCIS as a single disease highly likely to invade if left untreated, to the realization that DCIS represents a non-obligate precursor with a variable risk of progression, depending on a combination of factors, such as histology, lesion, size, and margin status. In discussing treatment options, patients should understand that local recurrence following total mastectomy is rare and that this is the procedure of choice for disease that cannot be adequately encompassed with a breast-conserving approach. If the patient and her surgeon are in agreement about proceeding with a breast-conserving approach, there needs to be a clear understanding of the incidence and implications of local recurrence. In all such discussions with newly diagnosed patients, however, it is essential to emphasize the excellent prognosis with this disease, irrespective of the surgical approach.

Biopsy, Needle↗

PubMed2001

Decline in bilateral orchiectomy for prostate cancer in Olmsted county, Minnesota, 1956-2000.

OBJECTIVE: To assess long-term secular trends in the utilization of bilateral compared with unilateral orchiectomy in the community. PATIENTS AND METHODS: This population-based descriptive study reviewed medical records of all Olmsted County, Minnesota, men undergoing orchiectomy between 1956 and 2000. RESULTS: Over the 45-year study period, 381 Olmsted County men had a first unilateral orchiectomy, while 431 underwent bilateral orchiectomy (including 8 with a second unilateral orchiectomy). There was no change over time in the age-adjusted utilization of unilateral orchiectomy, which was performed for a wide range of indications, mostly cryptorchidism and testicular malignancy. Most bilateral procedures, on the other hand, were in elderly men for castration, and trends over time generally paralleled those reported for prostate cancer in this community. CONCLUSION: The declining incidence of prostate cancer in recent years, combined with a shift to earlier stages and younger ages at diagnosis, and the development of pharmacological approaches to hormonal manipulation have led to a dramatic decline in the utilization of bilateral orchiectomy, while unilateral orchiectomy rates have remained unchanged.

Age Distribution↗

PubMed1999

Up-regulation of cyclin D1 occurs in apoptosis of immature but not mature cerebellar granule neurons in culture.

Cerebellar granule neurons isolated from 7-day-old rats and cultured in normal medium undergo apoptosis, but remain healthy under depolarizing conditions with elevated K(+) (>==25 mM) or in the presence of brain-derived neurotrophic factor. Northern blot analysis showed that cyclin D1 mRNA was up-regulated in this apoptotic process. Both granule neurons and microglia were immunostained with anti-cyclin D1 antibodies, which is consistent with our previous finding that microglia become activated in response to neuronal cell death under these conditions. Only granule neurons, however, showed an enhanced expression of both mRNA and protein levels of cyclin D1 in the presence of aphidicolin that completely eliminated non-neuronal cells. The entire cell body of granule neurons became immunostained prior to cell shrinkage or nuclear condensation. Moreover, cell cycle blockers and an inhibitor of cyclin-dependent kinases suppressed both increased immunoreactivity and cell death, further substantiating the involvement of an abortive cell cycle in this process. In contrast, both levels of cyclin D1 remained unaltered in mature granule neurons undergoing apoptosis following combined serum withdrawal and low K(+) shift, suggesting developmental stage dependence of granule neuron apoptosis in vitro. This culture system is suitable for further analysis of the role of cyclin D1 in cell death.

Animals↗

PubMedDate not supplied

[New criteria for differential diagnosis of polycythemia vera and erythrocytosis].

"Laborskel-analyzer" (PSL-1) was used to estimate red blood cell volume for the differential diagnosis in 36 polycythemia vera, 20 erythrocytosis patients and 30 normal subjects. Erythrocyte count of polycythemia vera patients (I, IIA and IIB stages) showed a shift to the left (an increase of microcytic fractions), while erythrocyte count++ of 20 erythrocytosis patients (16 of them with a relative erythrocytosis and 4 with an absolute erythrocytosis) were close to erythrocyte count++ of normal subjects. The counting of the percent content of erythrocytic fractions of varying volumes has proved fraction 5 with the erythrocytic volume from 56 microns 3 to 62 microns 3 to have the highest information content. The percent content of this fraction in polycythemia vera fluctuated from 3.9 to 19.5%, and in erythrocytosis it was from 0.9 to 3.0%, that could serve as a criterion for the differential diagnosis of polycythemia vera and erythrocytosis.

Adult↗

PubMed1991

Dose-dependent glucocorticoid effects on noradrenergic synaptogenesis in rat brain: ontogeny of [3H]desmethylimipramine binding sites after fetal exposure to dexamethasone.

Glucocorticoid administration slows the development of many types of cells, but may selectively accelerate differentiation of catecholaminergic cells. In the current study, pregnant rats were given dexamethasone on gestational days 17, 18 and 19 and noradrenergic synaptogenesis assessed in the offspring by measurements of binding capabilities for [3H]desmethylimipramine (DMI), a radioligand probe for noradrenergic presynaptic terminals. After treatment with 0.05 mg/kg of dexamethasone, a dose that did not suppress body or brain region growth, [3H]DMI was initially enhanced in midbrain + brainstem and in cerebellum; the former region also displayed a secondary phase of augmented [3H]DMI binding during the ontogenetic peak occurring in the second to third postnatal week. At a higher dose (0.2 mg/kg) that elicited moderate growth impairment, fetal dexamethasone exposure produced biphasic effects on [3H]DMI binding: initial enhancement was still apparent in cerebral cortex and cerebellum, but there were subsequent deficits in binding and the peak in midbrain + brainstem was shifted to later stages. At the highest dose (0.8 mg/kg), profound growth impairment was evident and only the cerebellum showed unequivocal evidence of enhanced [3H]DMI binding. All changes were associated with alterations in the maximum [3H]DMI binding capacity (Bmax) not in the binding affinity (Kd). These results suggest that low doses of dexamethasone that do not suppress general growth, enhance noradrenergic synaptogenesis in a regionally-selective and age-selective manner; at higher, growth-suppressing doses, this effect is intermixed with general delays in maturation, likely contributing to the variable effects of glucocorticoids on neurobehavioral development.

Animals↗

PubMed1991

Occurrence of breathing disorders during CPAP administration in obstructive sleep apnoea syndrome.

The spectrum of breathing events during sleep in patients with obstructive sleep apnoea syndrome (OSAS) after the abolition of obstructive apnoeas has been extensively studied in tracheostomized patients, but has received much less attention in patients submitted to continuous positive airway pressure (CPAP). We analysed the breathing pattern during sleep in forty patients while CPAP was administered. A regular breathing pattern throughout the sleep study was observed in 15 patients. In the remaining 25 subjects, one or more of the following events was observed: central apnoeas, hypopnoeas, periodic breathing, prolonged oxyhaemoglobin desaturations. Central apnoeas during non-rapid eye movement (NREM) sleep appeared almost exclusively after arousals or wakefulness periods; their prevalence did not significantly differ between subjects who showed and who did not show similar events before CPAP. Central apnoeas in rapid eye movement (REM) sleep had a random occurrence. Hypopnoeas were found only in REM sleep, and, like central apnoeas, occurred randomly; in one patient they had a prolonged duration (up to 110 s). Periodic breathing was observed in only two subjects, one of whom had congestive heart failure: it was limited to NREM sleep and was not associated with arousals or shifts in sleep stage. Prolonged oxyhaemoglobin desaturations were found mainly in REM sleep; most subjects with such abnormalities had daytime blood gas alterations. In conclusion, abnormalities of the breathing pattern of patients with OSAS can be observed during CPAP and after tracheostomy, but periodic breathing is less common than is reported after tracheostomy, and is probably caused by different mechanisms.

Female↗

PubMed1989

Allotransplantation in mechanical eyelid injuries.

For the purpose of stabilizing the supportive connective tissue of the eyelid in mechanical non-gunshot injuries, the authors developed a technique of primary combination plastic surgery performed simultaneously with primary surgical treatment. The technique consists in the transfer of allogenic tissues (dura mater, amnion and others) performed already during the primary surgical treatment with the aid of one of the techniques used in one-stage autotransplantation (local shifting, free transfer, one-pedicle flap). Primary combination blepharoplasty (mostly performed by local shifting) was carried out in 120 patients with mechanical eyelid injury. Healing by first intention was seen in 97% of patients, and in 84% of persons of the control group. Good aesthetic and functional results were noted in the basic group of the patients in 96% when discharged, later on, in 97%; good results were also achieved in the control group--76.4% of discharged patients, and after a time interval in 23.7%. Primary combination plastic surgery of the eyelid has a wide range of indications in cases of non-gunshot injuries, in adults and children alike.

Adult↗

PubMed1989

Adenotomy under general anesthesia.

Experience obtained from adenotomy (AT) under general anesthesia using Ketamin hydrochloride (Ketalar, Narkamon) in children are presented in this paper. The authors had used intramuscular premedication with Prothazin, Dolsin and Atropin at the first stage, then they shifted to oral administration of a combination of Diazepam, Theadryl and Atropin. Ketamin may be applied intravenously in the dosage of 1.0 to 1.5 mg/kg of body weight in most children. Where it is not possible, a triple dose into the muscle is used. A total of 2,266 AT were performed. About 70% of patients were calm during the operation, once a suspected aspiration was considered but it was not confirmed. The main contribution of the method is 100% amnesia of the surgery made. The procedure is a compromise between a requirement for minimal traumatization of the child's psyche by the intervention and the resources available, particularly the need of personnel at the majority of otorhinolaryngo-logical departments nowadays.

Adenoidectomy↗

PubMed1988

The Akiyama procedure in the surgical management of oesophageal cardiacarcinoma.

Currently subtotal oesophagogastrectomy with reconstruction of the digestive tract by use of a gastric tube appears to be the treatment of choice in patients with a carcinoma of the thoracic oesophagus and gastroesophageal junction. The results of 96 patients with a clinically operable oesophageal-cardiacarcinoma operated upon between 1977 and 1983 are reviewed. Resection intended for cure could be performed in 57 patients (59.4%). Twenty-five patients underwent a 'standard' Ivor Lewis procedure with an intrathoracic anastomosis, whereas in twenty-one patients the Akiyama technique with a retrosternal gastric tube and cervical oesphagogastrostomy was accomplished. There was a great shift in stage-grouping from cTNM to pTNM. The major causes of mortality after oesophageal resection were respiratory and cardiac insufficiency (87% respectively 40% of the deaths) and sepsis from a mediastinitis caused by an intrathoracic anastomotic leak (20%). The postoperative mortality rate was similar in both procedures and amounted to 22.8%, but has decreased to 5% during the period 1983 to 1986. The 5-year survival rate for patients undergoing resections intended for cure was 20% as calculated by the actuarial method. There was no significant difference in long-term survival rates between the two resection groups. The late functional results were better in the cases with the Akiyama method, particularly where gastroesophageal reflux is concerned (P less than 0.05).

Adult↗

PubMed1987

[Organization of sleep in recent temporal lobe epilepsy before and after treatment with carbamazepine].

Sleep in epileptic patients with complex partial seizures has been considered as being less well organized than in normal subjects. This study attempted to precise whether this disorganization could be related to the length of the disease and could be improved by carbamazepine treatment. The study was performed in 15 patients with recently diagnosed (less than 3 months) and untreated temporal lobe epilepsy. Neurologic examination and CT scan were normal. Patients did not present a generalized seizure in the preceding 48 hours and during the study. Nocturnal sleep polygraphic recordings were performed: 2 recordings before treatment and 2 others after one month of carbamazepine administration (800 mg/day). Before treatment sleep was characterized by a marked instability (increase in awakenings, shifts in sleep stages, waking after sleep onset, stage 1 duration) when compared to normal subjects. Carbamazepine treatment improved sleep stability. Our data support the hypothesis of another possible mechanism than the occurrence of seizures to explain the disorganization of sleep in temporal lobe epilepsy. On the other hand sleep instability could not be related to the length of the disease since it existed soon after its onset. Carbamazepine treatment improved sleep stability and this improvement could play a role in the therapeutic effect of the drug.

Adolescent↗