Transport of the placental estriol precursor 16α-hydroxy-dehydroepiandrosterone sulfate (16α-OH-DHEAS) by stably transfected OAT4-, SOAT-, and NTCP-HEK293 cells.

16α-Hydroxy-dehydroepiandrosterone sulfate (16α-OH-DHEAS) mainly originates from the fetus and serves as precursor for placental estriol biosynthesis. For conversion of 16α-OH-DHEAS to estriol several intracellular enzymes are required. However, prior to enzymatic conversion, 16α-OH-DHEAS must enter the cells by carrier mediated transport. To identify these carriers, uptake of 16α-OH-DHEAS by the candidate carriers organic anion transporter OAT4, sodium-dependent organic anion transporter SOAT, Na(+)-taurocholate cotransporting polypeptide NTCP, and organic anion transporting polypeptide OATP2B1 was measured in stably transfected HEK293 cells by LC-MS-MS. Furthermore, the study aimed to localize SOAT in the human placenta. Stably transfected OAT4-HEK293 cells revealed a partly sodium-dependent transport for 16α-OH-DHEAS with an apparent Km of 23.1 ± 5.1 µM and Vmax of 485.0 ± 39.1 pmol/mg protein/min, while stably transfected SOAT- and NTCP-HEK293 cells showed uptake only under sodium conditions with Km of 319.0 ± 59.5 µM and Vmax of 1465.8 ± 118.8 pmol/mg protein/min for SOAT and Km of 51.4 ± 9.9 µM and Vmax of 1423.3 ± 109.6 pmol/mg protein/min for NTCP. In contrast, stably transfected OATP2B1-HEK293 cells did not transport 16α-OH-DHEAS at all. Immunohistochemical studies and in situ hybridization of formalin fixed and paraffin embedded sections of human late term placenta showed expression of SOAT in syncytiotrophoblasts, predominantly at the apical membrane as well as in the vessel endothelium. In conclusion, OAT4, SOAT, and NTCP were identified as carriers for the estriol precursor 16α-OH-DHEAS. At least SOAT and OAT4 seem to play a functional role for the placental estriol synthesis as both are expressed in the syncytiotrophoblast of human placenta.

Digit span and other WISC-R scores in the diagnosis of dyslexia in children.

The examination of subtest scores on the Wechsler Intelligence Scale is needed to provide confirmatory evidence for various subtest categorizations as there is no consensus about what patterns might be diagnostically useful. The present study supports the use of the ACID/AVID profiles (Arithmetic, Coding or Vocabulary, Information, and Digit Span) as elements in the diagnosis of dyslexia. WISC-R scores from 44 subjects were analyzed for specific subtest patterns of scores which might separate dyslexic individuals from the WISC-R standardization group. Perhaps some WISC-R ACID/AVID profile pattern analyses may be valid in the diagnosis of a stringently defined population of learning disabled individuals such as dyslexic children.

Contrast sensitivity differences between proficient and disabled readers using colored lenses.

Colored overlays or lenses (e.g., Irlen lenses) have been used in attempts to remediate reading difficulties. The present study included four middle-socioeconomic status (SES) adults and four middle-SES children with reading disabilities as well as an equal number of nondisabled readers of the same age groups and SES. Examined were (a) the relationship of wavelength (lens color) to visual grating performance, (b) the effect of reading disability on performance with each lens-color/luminosity-grating combination, (c) group performances on a visual detection task with the clear and chromatic lenses, and (d) peripheral retinal brightness thresholds. The spatial frequency of the gratings (and not the lens color) permitted subjects with reading disabilities to be differentiated from the proficient readers. Subjects with reading disabilities displayed significantly lower contrast sensitivity when tested with sine-wave gratings, as well as displaying higher brightness thresholds in the peripheral retina.

Percutaneous recanalization of iliac artery occlusions: results of a prospective study.

PURPOSE: To evaluate the long-term results of recanalization of occluded iliac arteries with local low-dose thrombolysis, angioplasty, and, if necessary, stent implantation. MATERIALS AND METHODS: Forty-seven patients with acute or chronic occlusions of the common or external iliac artery, or both, underwent local low-dose thrombolysis (n = 47), percutaneous transluminal angioplasty (PTA) (with balloon dilation [n = 43] and rotational angioplasty [n = 30] in the patients in whom a retrograde recanalization was performed), and, if needed, intravascular stent placement (n = 18). Follow-up lasted 3-53 (mean, 21) months. RESULTS: The primary recanalization rate was 98% (46 of 47). The mean ankle-brachial index increased from 0.33 to 0.81 within 14 days after treatment and was 0.76 at the most recent follow-up. Two early (< 14 days) and two late reocclusions (after 24 and 30 months) occurred; one restenosis detected with duplex sonography and angiography was observed after 19 months. CONCLUSION: This therapy represents a true alternative to vascular surgery and a first-line treatment for acute or chronically occluded iliac arteries.

The social misperception syndrome in children with learning disabilities: social causes versus neurological variables.

Family shortcomings or other intrinsic psychological deficits are frequently viewed as contributing factors to the social misperceptiveness frequently seen in children with learning disabilities. This article attempts to synthesize research defining the social problems of some children with learning disabilities. Particularly emphasized is the role of communication skills deficits. Breakthroughs in neurophysiology negate, to a large extent, traditional emphases on family dysfunction, school failure, or personality distrubances as primary causes of the social problems of some children with LD. Advances in vision and language research allow departure from the social paradigm of the "misperceptive syndrome" to consider constitutionally based hypotheses of neural dysfunction. Neural aberrations are viewed as triggering deficient language processing, which in turn may lead to unsatisfactory social interactions. Several correlates and characteristics of family, school, and environmental systems are discussed in the context of their impact on personality development and on changes in the life adjustments of both children and adults with learning disabilities.

Reply to Stuart and Lovegrove's question, "visual processing deficits in dyslexia: receptors or neural mechanisms?".

Recently Stuart and Lovegrove questioned the receptor hypothesis of Grosser and Spafford which these authors used to account for the findings that dyslexic individuals have superior peripheral color discrimination to normal readers but also have poorer peripheral brightness discrimination than normal readers. Stuart and Lovegrove hypothesized that dyslexics instead have an impaired transient visual system. The receptor hypothesis is an attempt by Grosser and Spafford to link the functioning of the rods and cones to transient and sustained visual system functioning in a more specific manner than has been tried heretofore by suggesting that, while the parvocellular system is almost entirely fed by cones, both kinds of receptors drive magnocellular cells (but with the rapid onset of early transient system responding being due to the highly light sensitive rods). The rods are proposed to be the receptors initiating the rapid onset of responding in the magnocellular, transient pathway. In dyslexic individuals, they maintain, there are relatively fewer rods to provide for the rapid onset of transient system responses, resulting in a diminished capacity of the transient system to inhibit sustained system activity (as occurs with normal readers). Their receptor hypothesis supplements the concept of transient-vs-sustained system differences.

Retinal differences in light sensitivity between dyslexic and proficient reading children: new prospects for optometric input in diagnosing dyslexia.

The role of visual processes in dyslexia has been overlooked in the recent past as linguistic explanations for this problem dominated educational thought. It is the intent of this paper to relate new information about visual functions with dyslexia. Static perimetry was used to assess brightness thresholds of dyslexic and proficient-reading children. The dyslexic subjects obtained significantly lower sensitivity scores (higher thresholds) than proficient readers for the upper hemifields. Visual field screening tests may be useful in the differential diagnosis of dyslexia.

[Captopril-renal function scintigraphy in the clarification of arterial hypertension]. / Captopril-Nierenfunktionsszintigraphie (C-NFSZ) bei der Abklärung der arteriellen Hypertonie.

Renal artery stenosis (RAS) is a rare cause of hypertension. Radiological tests can disclose the morphological changes, but not their functional effect on renal function and perfusion. Normalization of the blood pressure can be achieved by intervention (operation, percutaneous transluminal renal angiography; PTRA), in cases of prolonged RAS-induced hypertension long-term preservation of the organ function is most important. The purpose of this study was the validation of captopril renography as a screening test for hypertension secondary to RAS prior to PTRA. Captopril renography with 99mTc-MAG 3 has a high sensitivity (94%) and acceptable specificity (88%) for the screening of hypertensive patients. The positive predictive value is 74% and the negative predictive value 98%, compared with the "gold standard" of angiography.

Light sensitivity in peripheral retinal fields of dyslexic and proficient readers.

This present study furthers research on perceptual differences between dyslexics and normal readers which is contrary to the current linguistic approaches to this problem. Specifically, thresholds of light intensity for small retinal areas were examined. As hypothesized, the peripheral retinas of proficient readers evidenced lower thresholds than the peripheral retinas of dyslexic readers. These results are consistent with Grosser and Spafford's previous research which showed that dyslexics were better able to detect colors with their peripheral retinas than proficient readers. This research lends support to the premise that dyslexics' retinas have unusually high cone density in the periphery. Additional research is warranted to improve both diagnosis and treatment of dyslexia.

Diagnostic imaging in metastatic lung disease.

Chest radiographs, full lung tomography and computed tomography of the chest provide increasing sensitivity for evaluation of pulmonary metastases. Pulmonary nodules of 5-10 mm diameter are detectable with increasing frequency by use of high kilovoltage chest radiographs. Full lung linear tomography provides an overall accuracy of 72-97% in diagnosis of pulmonary nodules. Chest CT delineates pulmonary nodules as small as 3 mm within 10 mm slice sections. However, as sensitivity increases, specificity diminishes in identifying metastatic nodules. Sensitivity in CT is also reduced by false negative findings due to unequal respiratory cycles. Comparative radiologic-pathologic evaluation of nodule detection proved CT to be the most sensitive screening method for pulmonary metastases. Timing of follow-up studies for pulmonary nodule detection in cancer patients can be determined by tumor growth kinetics; 3-6 month intervals proved to be useful.

[Renal artery aneurysm in Wegener's granulomatosis]. / Nierenarterienaneurysmen bei Wegenerscher Granulomatose.

Microaneurysms of renal and visceral arteries are characteristic signs of periarteritis nodosa. Normally they are not found in Wegener's disease, where glomerulonephritis is commonly observed. We report on a patient with vasculitis of the upper and lower respiratory tract, focal glomerulonephritis, prostatic and pulmonary granulomas and anti-cytoplasm antibodies corresponding to Wegener's disease. The most striking findings in angiography were multiple small aneurysms of the peripheral branches of the renal artery. At necroscopy these angiographic findings were histologically proven as necrosis of the arterial wall with destruction of the elastic lamina, causing local vascular ectasia. These renal vascular changes are a characteristic sign of periarteritis nodosa. The combination of clinical, laboratory, radiologic and histologic findings in our patient can be explained as an overlap-syndrome of Wegener's disease and periarteritis nodosa. We assume that the combination of pathologic findings in our patient correspond to a rare atypical renal manifestation of Wegener's disease.

[Embolization by the wall components after the PTA of pelvic arterial stenoses]. / Embolisation von Wandbestandteilen nach PTA von Beckenarterienstenosen.

Quality and frequency of embolisation caused by angioplasty of stenoses of iliac arteries were investigated in 50 patients. In 18% emboli were found. They mostly consisted of atheromatous material and were visible by macroscopic view in 10% of the patients. Complications caused by embolisation during angioplasty of iliac artery stenosis however are very rare.

[Primary manifestation of Wegener's granulomatosis of the prostate]. / Primärmanifestation einer Wegener'schen Granulomatose in der Prostata.

In approximately 2-7% of patients with Wegener's granulomatosis involvement of the prostate has been demonstrated histologically. This usually comes about quite late in the course of disease, after generalization of the granulomatous vasculitis from respiratory tract to kidneys and other organs. The patient we present had a highly atypical first manifestation of Wegener's granulomatosis in the prostate, generalized vasculitis not developing until later. When a biopsy shows unclear granulomatous changes in the prostate, a test for anticytoplasmatic antibodies should be performed in addition to the conventional serologic and cultural examinations. Anticytoplasmatic antibodies are highly specific for the diagnosis of active Wegener's granulomatosis. Early diagnosis and immediate initiation of immunosuppressive therapy with cyclophosphamide and corticosteroids can prevent or limit organ damage and improve the prognosis in Wegener's granulomatosis.

Perceptual evidence for an anomalous distribution of rods and cones in the retinas of dyslexics: a new hypothesis.

The present study tested the hypothesis that from the ability of dyslexics to read peripheral letters one may infer the presence of cones, those visual receptors specialized for acuity, in the peripheral retina. The cones are also the receptors for color discriminations. The method of retinal perimetry was used to map color-sensitive zones of the retina for 14 dyslexic and 14 control subjects. A statistically significant difference showed that the 14 dyslexics reported colors at more peripheral positions than did the 14 normal readers. These data are consistent with the premise that dyslexics have an anomalous distribution of retinal receptors. These findings perhaps may help to explain the erratic eye movements of some dyslexics. It is suggested that retinal perimetry might be one component of a diagnostic battery for the differential diagnosis of dyslexics.

[Significance of a transthoracic imaging technic in shoulder arthrography]. / Die Bedeutung der transthorakalen Aufnahmetechnik bei der Schulterarthrographie.

Even in this era of sonography, arthrography of the shoulder is an important diagnostic investigation, making it possible to exclude unrecognized connective tissue lesions in patients with chronic shoulder pain resistant to therapy. Sometimes standard X-ray techniques do not yield all the information the surgeon needs about ventral or dorsal localization of a rotator-cuff rupture. An additional approach to the joint is needed: a transthoracic lateral-view X-ray provides the surgeon with adequate information to help in selection of the most appropriate operative approach to the shoulder.

[The thymus gland in computerized tomography. Normal findings and pathology]. / Der Thymus im Computertomogramm. Normalbefunde und Pathologie.

The diagnostic value of CT in follicular thymic hyperplasia and in thymomas in 8 patients with myasthenia gravis and in 12 patients without myasthenia gravis suffering from thymic tumors was evaluated by correlating CT-findings to surgical results and pathological-histological findings. Thymic size of the six patients with histologically proven follicular hyperplasia were scattered within the normal range, but half of them were at the upper limit. Thymic tumors were differentiated between invasive and non invasive tumors by CT staging. Solid tumors with different histology could not be further classified; the attenuation values ranging from 15-55 HU were the same in tumors, follicular hyperplasia and normal thymus.

[Sonographic imaging and assessment of stomach wall changes]. / Sonographische Darstellung und Beurteilung von Magenwandveränderungen.

By the use of a special method of investigation, the true value of percutaneous echography was investigated using 28 patients with primary gastric neoplasms and 3 patients with secondary infiltration of the gastric wall, for the proof and the judgement of the tumors, their extension and their metastases. Tumorous gastric wall thickening could be demonstrated in 87% (27/31), tumor invasion in neighbouring structures in 85% (12/14) and lymph nodes metastases in 66% (10/15). In all patients, who had liver metastases (4) or ascites (5) they were demonstrable. The sonographic appearance of the different gastric wall changes are described and discussed.