Is HIV infection a risk factor for advanced cervical cancer?

TNF-alpha plays a critical role in the cascade of neuroendocrine events during inflammation and septic shock. It also affects the release of pituitary hormones and acts as a growth factor in immune and nonimmune cells. The aim of the present study was to investigate the release of TNF-alpha from rat anterior pituitary cells and the effect of the steroid medium on its release. Cultured anterior pituitary cells from lactating rats spontaneously released TNF-alpha. The presence of lipopolysaccharide (LPS, 0.1 microg/mL) in the culture medium significantly increased TNF-alpha release and inhibited prolactin release. Chronic estrogenization of ovariectomized rats or the presence of 17 beta-estradiol in the culture medium also increased TNF-alpha release. LPS significantly stimulated TNF-alpha release in all groups and abrogated the estrogen-induced prolactin release. We also investigated the effect of TNF-alpha on prolactin release. The presence of TNF-alpha (50 ng/mL) in the culture medium inhibited prolactin release from anterior pituitary cells. These data show that anterior pituitary cells in culture release TNF-alpha and that this release is stimulated by estrogens. Our results also indicate that LPS inhibits prolactin release in an estrogenic environment, suggesting that TNF-alpha could affect pituitary hormone release during endotoxemia.     

An in vitro evaluation of distractors used for osteogenesis

OBJECTIVE: The objective of this investigation was to evaluate and compare the mechanical behaviors of distractors used for osteogenesis under various conditions by means of common engineering standards. STUDY DESIGN: Five groups of 5 synthetic mandibles were used in this study (N = 25). The first portion of the investigation compared mandibles without intervention (group A [controls]; n = 5), mandibles that had uniform osteotomies stabilized with an external distractor (group B; n = 5), and mandibles that had simulated sagittal osteotomies rigidly fixated with 3 positional screws (group C; n = 5). The second portion of the investigation compared uniform osteotomies (group B; n = 5) and uniform corticotomies (group D; n = 5) that were stabilized with the same external distractor. The last portion of the investigation compared osteotomies stabilized with an external distractor (group B; n = 5) and osteotomies stabilized with an internal distractor (group E; n = 5). Each construct was subjected to vertical loads on a mechanical testing unit. Common engineering standards, including yield load, yield displacement, maximum load, displacement at maximum load, and stiffness, were measured, recorded, and compared by means of a 1-way analysis of variance and a Scheffé multiple comparison test or independent-samples t test. The means between groups were considered significant for P < .05. A polynomial best-fit curve was calculated for the load/displacement data for each group. RESULTS: During the first portion of the investigation, no significant differences were noted between the control, rigidly fixated sagittal osteotomy, and external distractor with osteotomy groups for displacement at maximum load (P = .19). Significant differences were noted between groups for yield displacement (P = .009), yield load (P < .001), maximum load (P < .001), and stiffness (P < .007). Failures occurred in the control and rigidly fixated groups with fractures of the synthetic mandibles. Failures occurred in the external distractor group with permanent deformation or torsion of the pins. During the second portion of the experiment, no statistically significant differences were noted between the corticotomy and osteotomy groups in stiffness (P = .363), maximum load (P = .207), or yield displacement (P = .940). Statistically significant differences were noted between groups for yield load (P = .036) and displacement at maximum load (P = .010). Failures occurred in both groups with permanent deformation or torsion of the pins. During the last portion of the investigation, statistically significant differences were noted between the external distractor and internal distractor groups in yield load (P < .001), yield displacement (P < .001), maximum load (P = .001), and displacement at maximum load (P = .01); no significant differences were noted in stiffness (P = .71). Failures occurred in the external distractor group with permanent deformation or torsion of the pins. Failures occurred in the internal distractor group with fracture of the model or displacement beyond 30.0 mm. CONCLUSIONS: Different patterns of mechanical behavior were found between the control and rigidly fixated sagittal osteotomy groups and the external distractor group, between the corticotomy and osteotomy groups, and between the internal and external distractor groups.     

Donor leukocyte infusions for recurrent hematologic malignancies after allogeneic bone marrow transplantation: impact of infused and residual donor T cells

OBJECTIVE: To prospectively evaluate whether subcutaneous buffered lidocaine (SQBL) significantly reduces the pain or adversely affects the success rate of i.v. cannulation (IVC) in adult ED patients. METHODS: A convenience sample of patients > or=18 years old requiring IVC in a regional military ED were prospectively randomized to receive SQBL, SQ normal saline with 0.9% benzyl alcohol (SQNS), or no pretreatment (NPTx), prior to IVC with an 18-gauge angiocatheter. SQ infiltration was accomplished using a 27-gauge insulin syringe. Investigators and patients were blinded to SQBL and SQNS in the pretreatment groups. The number of attempts at IVC was recorded for each patient. A 100-mm visual analog pain scale (VAPS) was used to record pain scores for both SQ infiltration and IVC. Comparisons of the mean numbers of attempts to achieve IVC and of the VAPS scores were accomplished by analysis of variance followed by Duncan's multiple range test if significance was found. RESULTS: A total of 103 patients (SQBL-34, SQNS-30, and NPTx-39) were enrolled between November 15, 1996, and June 13, 1997. There were no significant differences among the groups in either the mean number of attempts (SQBL=1.35, 95% CI+/-0.260; SQNS=1.13, 95% CI +/-0.124; and NPTx=1.28, 95% CI+/-0.203) (p= 0.367) or the success rate on the first attempt (SQBL =79.4%, SQNS=86.7%, NPTx=79.5%) (p=0.533). The median VAPS score of IVC without pretreatment (21 mm, 95% CI+/-7.97) was greater than that for SQBL infiltration alone (10 mm, 95% CI+/-9.11), SQNS infiltration alone (9 mm, 95% CI+/-7.37), and IVC after SQBL (6 mm, 95% CI+/-9.18) (p < 0.009 for each group). SQNS infiltration had no significant effect on the VAPS score of subsequent IVC (20 mm, 95% CI+/-10.5) compared with IVC without pretreatment (21 mm). CONCLUSIONS: SQBL significantly reduced the pain, while not adversely affecting the success rate, of IVC in adult patients in the ED.     

Determination of DMPC hydration in the L(alpha) and L(beta'') phases by 2H solid state NMR of D2O

OBJECTIVE: To compare the effect of vaginal misoprostol with that of placebo when used prior to dilation and aspiration in women with a missed abortion. METHOD: Eighty-four pregnant women with a missed abortion were randomized to receive either vaginal misoprostol (200 micrograms) or placebo the day before the planned dilatation and aspiration under inhalation anesthesia. RESULT: Thirty-five women (83.33%) in the misoprostol group and 6 women (17.14%) in the placebo group aborted spontaneously prior to the scheduled dilatation and aspiration, P < 0.0001. The mean insertion to spontaneous expulsion time was 11.63 +/- 6.14 h in the misoprostol group compared to 11.95 +/- 5.43 h in placebo. In the misoprostol group two women required intramuscular pethidine for analgesia. In the placebo group there were two cases of blood loss in excess of 500 ml and one woman with a uterine perforation. CONCLUSION: Vaginal administration of misoprostol to women with a missed abortion produced spontaneous expulsion of the pregnancy and reduced the need for surgical treatment.     

Regulation, replication, and integration functions of the Vibrio cholerae CTXphi are encoded by region RS2

CTXphi is a filamentous phage that encodes cholera toxin, one of the principal virulence factors of Vibrio cholerae. CTXphi is unusual among filamentous phages because it can either replicate as a plasmid or integrate into the V. cholerae chromosome at a specific site. The CTXphi genome has two regions, the 'core' and RS2. Integrated CTXphi is frequently flanked by an element known as RS1 which is related to RS2. The nucleotide sequences of RS2 and RS1 were determined. These related elements contain three nearly identical open reading frames (ORFs), which in RS2 were designated rstR, rstA2 and rstB2. RS1 contains an additional ORF designated rstC. Functional analyses indicate that rstA2 is required for CTXphi replication and rstB2 is required for CTXphi integration. The amino terminus of RstR is similar to the amino termini of other phage-encoded repressors, and RstR represses the expression of rstA2. Although genes with related functions are clustered in the genome of CTXphi in a way similar to those for other filamentous phages, the CTXphi RS2-encoded gene products mediating replication, integration and repression appear to be novel.     

Metabolism of the extracellular matrix formed by intervertebral disc cells cultured in alginate

STUDY DESIGN: Cells from normal rabbit nucleus pulposus (NP) and anulus fibrosus (AF) were cultured in alginate beads for as long as 14 days to allow them to reform a matrix made up of two compartments: the cell-associated matrix (CM) and further removed matrix (FRM). At different time points, the CM and FRM made by each cell population were analyzed using histologic, biochemical, and immunologic assays. OBJECTIVES: To study the metabolism of normal rabbit NP and AF cells in alginate by characterizing the CM and FRM formed by each cell population, and to identify metabolic properties that may shed light on mechanisms at play in disc degeneration. SUMMARY OF BACKGROUND DATA: Little is known about the metabolism of intervertebral disc cells, in part because of the lack of microculture systems appropriate for the study of these cells in vitro. In recent studies from our laboratories, it was suggested that articular chondrocytes cultured in alginate beads remain phenotypically stable and reform a matrix similar to the one they populate in vivo. This culture system appears ideally suited for the study of intervertebral cells available only in limited numbers. METHODS: Rabbit NP and AF cells released from the matrix by sequential enzyme digestion were encapsulated in alginate beads (20,000 cells/bead) and cultured for as long as 14 days. At selected time points, beads were solubilized with calcium chelating agents, and the CM and FRM were isolated. The rate of 35S-sulfate incorporation into proteoglycans, and the contents of various extracellular matrix molecules (total sulfated proteoglycans, antigenic keratan sulfate, hyaluronan, collagen, and pyridinium crosslinks) were measured. RESULTS: Both NP and AF cells remained phenotypically stable in the alginate gel throughout the culture period and reestablished a matrix composed of CM and FRM compartments. The two cell populations exhibited numerous differences in their metabolic activities in vitro. Nucleus pulposus cells synthesized fewer proteoglycan and collagen molecules and were less effective in incorporating these into the CM than AF cells. CONCLUSIONS: Intervertebral disc cells, especially NP cells, are extremely sluggish in reforming a CM, a protective shell rich in proteoglycans and collagen molecules. This may help explain why damage to the NP often is accompanied by progressive degeneration of the disc in vivo.     

Laparoscopic surgery in Crohn's disease

In a prospective study the feasibility and safety of laparoscopic-assisted ileocaecal resection for Crohn's disease was studied and compared with 16 patients who had open ileocaecal resection, and the value of laparoscopic stoma surgery was assessed. From January to November 1995 laparoscopic-assisted ileocaecal resection for Crohn's disease was undertaken in 7 patients, laparoscopic-assisted stoma formation in 10 patients. In 1 patient laparoscopic ileocaecal resection was converted to open surgery due to an unrecognised ileocolic fistula. Operating time in laparoscopic-assisted ileocaecal resections was longer than in open ileocaecal resection (150 vs. 127 min, P = 0.7). Blood loss (386 vs. 445 ml, P = 0.7), first bowel movement (3.5 vs. 4.9 postoperative days, P = 0.07) and postoperative time to discharge (5.2 vs. 9.9 days, P < 0.01) in patients who had a laparoscopic-assisted ileocaecal resection were less than in patients who had open surgery. In all 10 patients laparoscopic formation of a stoma was possible. Operating time was 62 min. Oral solids were restored on the 1.5 postoperative day. Mean postoperative stay was 8.8 days, prolonged due to time needed for stoma-care training. These preliminary results indicate that laparoscopic-assisted ileocaecal resection and stoma surgery for Crohn's disease are feasible and safe. Both procedures are characterised by rapid recovery and superior cosmetic results.