Increased nuchal translucency and decreased fetomaternal transfusion after chorionic villus sampling

OBJECTIVE

To investigate the relationship between nuchal translucency (NT) and fetomaternal transfusion (FMT) after chorionic villus sampling (CVS).

METHODS

The level of FMT was determined in 272 viable, singleton pregnancies in which 10-14-week ultrasound scanning, NT measurement and CVS for fetal karyotyping had been performed. The pre-CVS NT was measured transvaginally, and the women were divided into two groups, i.e. those with NT < 2.5 mm (Group 1) or >or= 2.5 mm (Group 2). The level of FMT was determined via the maternal serum alpha-fetoprotein levels before and after CVS. FMT was analyzed in relation to the pre-CVS NT.

RESULTS

Of the 272 pregnancies, 213 were in Group 1 and 59 in Group 2. The mean levels of FMT after CVS were 23.3 +/- 12.2 and 5.4 +/- 2.9 micro L in Groups 1 and 2, respectively (P < 0.01). An FMT > 100 micro L was found in 19 cases in Group 1, whereas the maximum in Group 2 was 67.2 micro L. Aneuploidies were diagnosed in 17 cases, 15 (88.2%) of them in Group 2. When the pregnancies with adverse outcome were excluded from the two groups, a higher level of FMT was observed in Subgroup 1 than in Subgroup 2 (P < 0.01).

CONCLUSIONS

The mean level of FMT after CVS was significantly lower in pregnancies with an increased pre-CVS NT, a relationship observed in euploid pregnancies also. An increased pre-CVS NT seems to be inversely correlated with the FMT increase after CVS. Further studies are planned to investigate the background to this phenomenon.

Tissue reaction initiated by different sealers

AIMS

To analyse the type and degree of inflammatory reaction initiated by four sealers.

METHODOLOGY

Twenty-four root canals of Macaca mulatta monkeys were filled within the canal and eight were overfilled with AH26, Apexit, Endomethasone or Grossman's sealers. The result of the treatment was evaluated after 6 months by histological assessment of the periapical tissues.

RESULTS

In the group of root canals filled within the root, no inflammatory reaction was detected in specimens of Apexit and Grossman's sealers, but the other two sealers initiated different degrees of lymphocytic/plasmocytic tissue reactions. Endomethasone initiated a mild lymphocytic/plasmocytic reaction in three of the nine cases and AH26 caused mild lymphocytic/plasmocytic infiltration in two of the seven cases. In the group of overfilled root canals, all four sealers initiated inflammatory reactions. The periapical tissue reactions of overfilled root canals were similar to reactions detected in cases filled within the canal. However, additional histological features developed in specimens of Endomethasone and AH26: Endomethasone initiated a foreign body-type granulomatous reaction around the sealer particles and AH26 particles were engulfed by macrophages. The overfilled root canals of Apexit and Grossman's sealers initiated only lymphocytic/plasmocytic reactions.

CONCLUSIONS

This study suggests that sealers with different chemical compositions initiate different histological reactions. It also emphasizes the importance of confining root filling to the canal system because all sealers initiate inflammatory reactions when they are present in the apical tissues

Etched track detectors and the low dose problem

The risk to human health of exposure to low-level radiation is not precisely known yet. One way of studying this is to carry out in vitro biological experiments with cell cultures and to extend the conclusions to biological models. To relate the macroscopically deteminable 'low dose' to the damage of cells caused by a certain type of ionising particle is nearly impossible. therefore the number of hits and the imparted energy are the significant quantities. They can be estimated by particle transport calculations and by direct measurements. The effect of low dose was investigated in radio-adaptation experiments when mono-layers of different unsynchronised cell cultures were irradiated by neutrons produced in the filtered beam of the Budapest Research Reactor (BRR). The energy deposition was investigated by replacing the mono-layers with etched track detectors of the CR-39 type.

Disturbed regulation of cholesterol synthesis in monocytes of obese patients with hypercholesterolemia

The aim of the present study was to clarify the influence of obesity on the functions of low-density lipoprotein receptors (LDL-R) and 3-hydroxy-3-methylglutarate-coenyzme A (HMG-CoA) reductase both in healthy control subjects and in patients with hypercholesterolemia (HC). Experiments were performed on monocytes of 15 non-obese (C I) and 11 obese (C II) healthy control subjects and on 22 non-obese (HC I) and 26 obese (HC II) patients with HC. [(125)I]LDL was used to determine LDL-R activity by measuring binding and intracellular degradation. The rate of endogenous cholesterol synthesis was measured using [(14)C]acetate incorporation into the cholesterol fraction of monocytes. The binding ability of [(125)I]LDL was identical across all groups. The [(14)C]acetate incorporation in resting monocytes was increased only in obese HC group. The 50-microg/mL LDL protein-induced inhibition of [(14)C]acetate incorporation was significantly diminished (P <.001) in the same group. A strong positive correlation was detected between the [(14)C]acetate incorporation by resting cells and LDL-induced inhibition in all groups except the obese HC group, in which their correlation was negative (P <.001). Furthermore, in the obese HC group, a significant positive correlation was detected between body mass index (BMI) and the basal level of [(14)C]acetate incorporation, whereas a negative correlation was found between BMI and LDL-induced inhibition of [(14)C]acetate incorporation. The present data suggest that in patients with HC the concomitant obesity results in dysregulation of cholesterol homeostasis, which may contribute to the accelerated atherosclerosis.

Vertical transmission of human immunodeficiency virus

Sensitive detection methods, such as DNA PCR and RNA PCR suggest that vertical transmission of human immunodeficiency virus (HIV) occurs at three major time periods; in utero, around the time of birth, and postpartum as a result of breastfeeding (Fig. 1). Detection of proviral DNA in infant's blood at birth suggests that transmission occurred prior to delivery. A working definition for time of infection is that HIV detection by DNA PCR in the first 48 h of life indicates in utero transmission, while peripartum transmission is considered if DNA PCR is negative the first 48 h, but then it is positive 7 or more days later [1]. Generally, in the breastfeeding population, breast milk transmission is thought to occur if virus is not detected by PCR at 3-5 months of life but is detected thereafter within the breastfeeding period [2]. Using these definitions and guidelines, studies has suggested that in developed countries the majority, or two thirds of vertical transmission occur peripartum, and one-third in utero [3-6]. The low rate of breastfeeding transmission is due to the practice of advising known HIV-positive mothers not to feed breast milk. However, since the implementation of antiretroviral treatment in prophylaxis of HIV-positive mothers, some studies have suggested that in utero infection accounts for a larger percentage of vertical transmissions [7]. In developing countries, although the majority of infections occurs also peripartum, a significant percentage, 10-17%, is thought to be due to breastfeeding [2, 8, 9].

A comparison of the shaping characteristics of two nickel-titanium endodontic hand instruments

AIM

The purpose of this study was to compare the shaping characteristics of Ni-Ti K-files and Ni-Ti S-files manipulated by hand.

METHODOLOGY

A total of 60 extracted human roots were embedded in resin blocks. The embedded roots were divided into three groups: (i) roots with straight; (ii) apically curved; and (iii) continuously curved canals. Each of the three groups was randomly divided into two subgroups; one subgroup in each group was prepared with Ni-Ti K-files and the other with Ni-Ti S-files. The files were used with a step-back technique and enlarged so that the master apical file was size 30, and the canals were stepped back to size 40. The performance of the files was assessed by the superimposition of projected radiographs taken in bucco-lingual and mesio-distal directions before and after the preparation. The results were analysed statistically using analysis of covariance and Duncan's multiple range test.

RESULTS

Although canal preparation using Ni-Ti K-files was quicker, there were no statistically significant differences between file types. The Ni-Ti S-file removed significantly more material at the most coronal level (P < 0.05). There were minor differences between instruments at the apical level. Only in the proximal view of apically curved canals prepared with Ni-Ti S-files was significantly more dentine removed from the outer aspect of the curvature (P < 0.05). At the middle level (wide danger zone) the Ni-Ti S-files removed more dentine from the inner aspect of the curvature in those roots with apically curved canals.

CONCLUSIONS

Under the conditions of this study, preparation with Ni-Ti K-files produced more appropriate shapes in roots with apically curved canals than Ni-Ti S-files.

Elaboration of a complex GIS application in a catchment area

Rearrangement of land resources after political changes has not yet been finished in Hungary. It is almost impossible to collect information necessary for planning activities on outer areas of settlements. The data are distributed among various organizations and can be found in diverse forms or there are no available data at all. However water quality protection has become legally ordered concerning municipal activities around Lake Balaton which is considered as the most important recreation area and tourist target in Hungary and is also affected by a number of factors providing sources of environmental conflicts. Settlements in a catchment area (Tetves Creek) on the southern shoreline of Lake Balaton in Central Hungary tendered a complex project for collecting sources of authentic data of the Hungarian rural areas along with systematizing and saving these data in a uniform GIS. An application using Autodesk MapGuide Program for Internet realization was developed. The implemented web-based system can be used in Internet and Intranet environments.

[Mathematical description of human root canal curvatures]

There is a necessity of a mathematical formula for the description of root canal curvatures. The aim of this study was to give a mathematical description of root canal forms. The measurements of 60 roots were conducted on isometric radiographs taken from the clinical view. Seven points of the imaginary axis were approximated using fourth-degree polynomial functions. Fourth-degree approximation for the description of the shape of root canal curvatures proved to be exact and reliably repeatable. This method may serve the classification of root canal forms as well as the description of the spatial curve of root canals.

Four years experience of first-trimester nuchal translucency screening for fetal aneuploidies with increasing regional availability

BACKGROUND

A prospective screening study was carried out at the regional genetic and perinatal center in South Hungary in order to determine the efficiency of first-trimester nuchal translucency screening for fetal aneuploidies, following augmentation of the availability of nuchal translucency screening in the region by the inclusion of newly-trained hospital sonographers.

METHODS

Nuchal translucency thickness was measured by transvaginal sonography in 7,044 women with singleton or multiple pregnancies at weeks 10-12. Fetal karyotyping was performed when the nuchal translucency was . or = 2.5 mm, and in women with fetuses at high cytogenetic risk.

RESULTS

Follow-up was performed in 6,841 of the 7,044 screened women. An abnormal karyotype was found in 33 cases (0.48%). The level of increased nuchal translucency was 4.5% at a cutoff of > or = 2.5 mm, and 2.8% at a cutoff of > or = 3 mm. Seventeen cases of trisomy 21, eight of trisomy 18, four of trisomy 13, one of 45,X, one of triploidy and two cases with other chromosomal abnormalities were detected. In the 33 fetuses with a chromosomal abnormality, the nuchal translucency thickness was <2.5 mm in a case of trisomy 18, > or = 2.5 mm in 32 cases and > or = 3 mm in 28 cases. With cutoffs of 2.5 mm and 3 mm, the sensitivity was 96.97% and 84.85%, respectively.

CONCLUSIONS

Application of a nuchal translucency thickness cutoff of 2.5 mm is highly efficient for the screening of fetal aneuploidies at 10-12 weeks. This efficiency can be maintained by increasing the regional availability of nuchal translucency screening through the inclusion of newly-trained hospital sonographers.

Repeated biopsies in evaluation of therapeutic effects in prostate carcinoma

BACKGROUND

Apoptosis is one of the major events following total androgen blockade (TAB). The aim of this study was to determine the predictive value of some histological parameters including apoptosis and gene products which influence apoptosis, based on repeated biopsies taken from the same patients.

METHODS

At the time of diagnosis by needle biopsy TNM stage, serum PSA, Gleason's grade, apoptotic and mitotic index, Ki67, p53, and bcl(2) expression were investigated in 60 prostate carcinoma patients. Antiandrogen therapy supplemented with surgical or chemical castration was administered. Serum PSA-test and needle biopsy were repeated 13-14 weeks after starting the therapy, simultaneously with determination of the apoptotic and mitotic index, Ki67, p53, and bcl(2) expression.

RESULTS

Forty-seven patients were alive at the end of the study, 13 patients died. Decrease in mitotic, increase in apoptotic index predicted favourable long-term response to antiandrogen therapy. Lower Ki67 and (mutant) p53 expression in the first and also in the second biopsy pointed to favourable effect of antiandrogen treatment. Since the ratio between Ki67 and apoptotic index strongly decreased in the survivors upon therapy, changes in Ki67/apoptosis ratio is recommended as a histologically detectable predictive factor. bcl(2) expression did not show significant correlation with the outcome of the disease.

CONCLUSIONS

Histological evaluation of mitotic and apoptotic index, Ki67, and p53 expression in repeated biopsies contributes to predicting the value of the actual treatment and may be useful to institute alterations in therapy.

Pseudotypes of vesicular stomatitis virus-bearing envelope antigens of certain HIV-1 strains permissively infect human syncytiotrophoblasts cultured in vitro: implications for in vivo infection of syncytiotrophoblasts by cell-free HIV-1

Intrauterine infection of the fetus is clearly an important mode of vertical transmission of human immunodeficiency virus type 1 (HIV-1). The syncytiotrophoblast layer of the human placenta must be traversed by HIV-1 in order to reach underlying cells and fetal capillaries. Although HIV-1 has been detected in the syncytiotrophoblast layer in situ, there is conflicting evidence regarding infection of syncytiotrophoblast cells with cell-free virus. The phenotypic mixing between HIV-1 and vesicular stomatitis virus (VSV) has been exploited to assay the susceptibility of human term syncytiotrophoblast cells to penetration by various strains of HIV-1. VSV(HIV-1(IIIB)) and VSV(HIV-1(Ba-L)) pseudotypes were found to enter syncytiotrophoblast cells. In contrast, VSV pseudotyped with envelope glycoproteins of RF, MN, or Ada-M strains of HIV-1 did not infect syncytiotrophoblasts. Plating efficiency of VSV(HIV-1(IIIB)) and VSV(HIV-1(Ba-L)) was 10-fold lower on syncytiotrophoblasts than on T-cells and macrophages, respectively. Incubation of VSV(HIV-1(IIIB)) and VSV(HIV-1(Ba-L)) viruses with appropriate HIV-1 neutralizing sera before infection strongly inhibited entry of pseudotyped VSV into syncytiotrophoblast cells. These findings demonstrated that infection of syncytiotrophoblasts with VSV(HIV-1) pseudotypes was mediated by Env from IIIB and Ba-L strains of HIV-1. Monoclonal antibodies (MAb) to CD4, CXCR4, CCR5, and CCR3 were tested for their ability to block VSV(HIV-1) infection of syncytiotrophoblast cells. Neither the anti-CD4 nor the anti-CXCR4, anti-CCR5, and anti-CCR3 MAb had any inhibitory effect on infection of syncytiotrophoblast cells with VSV(HIV-1) pseudotypes. Results from this study suggest that cell-free HIV-1 can enter syncytiotrophoblasts and the susceptibility of these cells to penetration by the virus is strain dependent. Pseudotype infection merely demonstrates that the first steps in HIV-1 replication are possible in syncytiotrophoblast cells.

Radiodiagnostic examination of the swimbladder of some fish species

Radiodiagnostic methods have not been used previously for studying the anatomy and diseases of the swimbladder of freshwater fish species. In this study, the radiographic anatomy of the swimbladder and species-related differences in swimbladder structure were studied on plain radiographs taken of 12 Hungarian fish species of major economic importance. Changes observed by radiography were also studied by conventional parasitological methods. The radiodiagnostic method reported here appears to be a useful complement to diagnostic examinations that have been based merely on dissection so far. It enables evaluation of the pathological lesions in live condition, without causing damage to the fish.

Soluble gC1q-R/p33, a cell protein that binds to the globular "heads" of C1q, effectively inhibits the growth of HIV-1 strains in cell cultures

C1q and the outer envelope protein of HIV, gp120, have several structural and functional similarities. Therefore, it is plausible to assume that proteins that are able to interact with C1q may also interact with isolated gp120 as well as the whole HIV-1 virus. Based on this hypothesis, we studied the potential ability of the recombinant form of the 33-kDa protein, which binds to the globular "heads" of C1q (gC1q-R/p33), to inhibit the growth of different HIV-1 strains in cell cultures. gC1q-R/p33 was found to effectively and dose-dependently inhibit the production of one T-lymphotropic (X4) and one macrophage-tropic (R5) strain in human T cell lines (MT-4 and H9) and human monocyte-derived macrophage cultures, respectively. At a concentration range of 5-25 microg/ml, gC1q-R caused a marked and prolonged suppression of virus production. The extent of inhibition was enhanced when gC1q-R was first incubated with and then removed from the target cell cultures before virus infection, compared to that when the cells were infected with gC1q-R-HIV mixtures. The extent of inhibition was comparable to that of the Leu3a anti-CD4 antibody. Addition of gC1q-R to the cell cultures on day 1 or 2 after infection induced markedly less inhibition of HIV-1 growth than pretreatment of the cells just before or together with the infective HIV strains. In ELISA experiments, gC1q-R did not bind to a solid-phase recombinant gp120 while strong and dose-dependent binding of gC1q-R to solid-phase CD4 was observed. Our present findings indicate that gC1q-R is an effective inhibitor of HIV-1 infection, which prevents viral entry by blocking the interaction between CD4 and gp120. Since gC1q-R is a human protein, it is most probably not antigenic in humans. It would seem logical, therefore, to consider gC1q-R or its fragments involved in the CD4 binding as potential therapeutic agents.

Fetomaternal transfusion and pregnancy outcome after cordocentesis

OBJECTIVE

To study the extent of fetomaternal transfusion and the outcome of pregnancy after cordocentesis.

MATERIAL AND METHODS

268 women underwent percutaneous fetal umbilical cord blood sampling for fetal karyotyping between 15 and 26 gestations of weeks. Complete follow-up was available in 221 (82.5%) of the cases. Cordocentesis was performed under continuous real-time ultrasound guidance. The duration of the procedure and the post-procedural bleeding time was counted in seconds. Fetomaternal transfusion was calculated by using the measurements of the maternal serum levels of alpha-fetoprotein before and after the procedure. The data were analyzed by Student's t and multiple regression tests.

RESULTS

The maximum and mean amounts of fetomaternal transfusion were 1.067 and 0.061 ml, respectively. Twenty percent or more alpha-fetoprotein elevation was in 35.4% of the cases. Positive correlation was found between bleeding time after cordocentesis and fetomaternal transfusion (r = 0.174, p < 0.0129) as well as between the duration of the procedure (r = 0.165, p < 0.0171) and the amount of fetomaternal transfusion. Comparing the cordocentesis at the placental insertion site and at the free cord loop, a smaller amount of fetomaternal transfusion was observed (p < 0.0123) in the latter. Transplacental passage was associated with a higher amount of fetomaternal transfusion (p < 0.0067). No association was found between the extent of fetomaternal transfusion and the outcome of pregnancy. The fetal loss related to the cordocentesis was 0.50%.

CONCLUSIONS

The extent of fetomaternal transfusion was influenced by the subsequent four parameters: procedural time, bleeding time, puncture site and transplacental penetration. The lack of the association between the degree of fetomaternal transfusion and the outcome of pregnancy, along with the low (0.50%) post-procedural fetal loss rate, suggest that cordocentesis is clinically a safe procedure.

Cytochemical studies on the fibroblast-preadipocyte relationships in cultured fibroblast cell lines

The theoretical basis of adipogenesis has always been a matter of debate. One concept suggests that all types of adipocytes are derived from undifferentiated connective tissue cells, whereas another concept suggests that adipocytes develop from specialized cells only that are able to accumulate fat. Many conflicting data have been published with respect to the transition of fibroblasts into preadipocytes. For example, this transition has been declared as impossible for dermal and perimysial fibroblasts. The present study analysed spontaneous accumulation of fat in various types of fibroblasts from different origin (retroocular, skin, NIH/3T3, and L929). It was found that intense Oil Red O-positive triglyceride-containing droplets accumulated in practically all types of fibroblasts provided that the cells were cultured on glass surface. When the cells were cultured on plastic surfaces, lipid staining was inhibited in a variable manner: inhibition was virtually complete in skin fibroblasts, whereas in other types of fibroblasts, inhibition was only partial. It is concluded that all types of fibroblasts can accumulate fat spontaneously, and thus can be considered as preadipocytes. Therefore, interpretations of data obtained with cultures of fibroblasts with respect to adipogenesis have to be reconsidered.

A computerized method for mathematical description of three-dimensional root canal axis

Knowledge of the three-dimensional (3D) morphology of root canals is important for successful endodontic treatment. The objective of the present study was to determine the 3D root canal axis mathematically. Two views (mesiodistal and buccolingual) of digitized images were taken from extracted natural human teeth. Geometric reconstruction to standardize projection geometry was conducted on images. Because 90-degree turn-around image pairs are Monge images of a given root canal, these Monge images were positioned using photogrammetric methods. Each well-ordered axis pair of a given root canal was put into a common coordinate system resulting in 3D polynomial function of the actual root canal. On the basis of the results gained using 10 samples evaluated with the Friedman statistical test, this description seems to be reproducible. The 3D representation of the root canal may help the clinicians in choosing the optimal instruments and shaping techniques. The root canal axis that is described by the 3D function forms a basis for determination of curvature values and torsion values in each of the axis points. Evaluating these values may also yield a new type of classification.

[Ethical aspects of prenatal screening for Down's syndrome]

Trisomy 21, the chromosomal base of Down's syndrome, results in severe mental and physical handicap. Owing to the development of medical genetics reliable screening and diagnostic procedures for the detection of the disorder are available in Hungary. To achieve the goals of prenatal screening it is important to address the main ethical issues arising through the application of technical-professional skills. The core objective of prenatal screening for Down's syndrome is to give information about the genetic condition of the fetus in order to enhance the autonomy of the parents in family planning. Screening programs should respect the ethical requirements of the principles of "do no harm", beneficence and autonomy of the patients, which are the most important ethical norms of doctor-patient relationship. Regarding the social aspects of screening it is essential to claim that voluntary participation and nondirective genetic counselling can exclude eugenic purposes. Though introduction of prenatal tests does not imply the discrimination of the disabled, anxiety of handicapped people deserves more attention. Abortion of affected fetuses isn't among the objectives of prenatal genetic screening but patient's autonomy is supported in decisions concerning the future of the pregnancy. Social justice can be taken into consideration by providing the test to all women without respect to their social position, educational level or their age. An open debate about the issues of prenatal screening for Down's syndrome could promote the formation of a consensus between professionals and the public.

Improving diagnostic accuracy of prostate carcinoma by systematic random map-biopsy

Systematic random rectal ultrasound directed map-biopsy of the prostate was performed in 77 RDE (rectal digital examination) positive and 25 RDE negative cases, if applicable. Hypoechoic areas were found in 30% of RDE positive and in 16% of RDE negative cases. The score for carcinoma in the hypoechoic areas was 6.5% in RDE positive and 0% in RDE negative cases, whereas systematic map biopsy detected 62% carcinomas in RDE positive, and 16% carcinomas in RDE negative patients. The probability of positive diagnosis of prostate carcinoma increased in parallel with the number of biopsy samples/case. The importance of systematic map biopsy is emphasized.

Alterations of P53 and RB genes and the evolution of the accelerated phase of chronic myeloid leukemia

Using the single-strand conformation polymorphism and heteroduplex analyses, the P53 and RB genes were analyzed in cell samples from twenty-eight patients with chronic myeloid leukemia (CML) both at diagnosis and at the onset of accelerated phase (AP) of the disease. No alterations of the P53 or RB genes were found in any of the chronic phase (CP) samples. Structural abnormalities of the P53 gene were observed in ten of twenty-eight AP samples within exons 4, 5, 7 and 9. Of the ten cases of AP disease with altered P53 genes, five patients also suffered from the deletion of the other allele. Alterations of the RB gene could be detected in six AP samples, and aberrant band patterns were found in the analysis of exons 2, 3, 4, 6, 7, 13, 14, 17, 21 and 26. Among the six AP samples with structural abnormalities of the RB gene, two showed the loss of the other allele. It is of note that alterations of both P53 and RB genes were observed in two AP samples. Our data strongly suggest that abnormalities of the P53 and RB genes and acceleration of CML are linked events in some cases of AP.

[Genetic counseling and prenatal care after medications during the first trimester]

Analysis of the outcome of 127 pregnancies with first trimester medication (8.4% of the total number of the patients seeking genetic advice in 1997 at the Institute of Medical Genetics in Szeged) was carried out. The gestational age at the time of the medication and genetic counselling, the indications of the treatment, the drugs, the estimated fetal risk, and results of genetic ultrasound examinations and pregnancy outcome were evaluated. The majority of pregnant woman (78%) asked for genetic counselling before the 12. gestational week. The main indications the treatment were: infections, psychiatric-neurologic (depression, anxiety, epilepsy), endocrine (diabetes, hyperthyreoidism), and cardiovascular diseases and gastrointestinal problems. The main groups of the drugs were: antibiotics, antipyretic-, antidepressive-, antidiabetic- and antihypertensive drugs. When the multiple medication was conducted by simultaneous administration of two or more drugs, a complex risk calculation was performed. The fetal risk was higher than 10% in 31 cases (24%). The ultrasound examinations performed by qualified sonographer contributed to a correct evaluation and to reliable follow-up of pregnancies. No suspicious ultrasound finding was reported in the first trimester. However, a severe fatal brain malformation was found in a second trimester pregnancy, which was terminated by the couple's request in the 18th gestational week. A complete follow-up was obtained in 70.9% (90) of the cases. Out of 64 pregnancies intended to continue to term 4 fetal malformations were found. Of them three malformations (patent ductus arteriosus, Robin sequence and a ventricular septal defect) were explored at birth or in the newborn period. The actual 6.3% of fetal malformations was higher compared to the rate expected at birth, but almost equal to the rate of congenital malformation found up to the end of the first year of age in Hungary.

[Regional epidemiologic examination of dental health status]

This study examined the oral status of the adult population in South-West Hungary using panoramic radiographs. The results indicate that in this population group 5.2% of the teeth were carious and 38.6% were missing, 3.87% were endodontically treated. Around the apices of the endodontically treated teeth in this survey in 40%, radiographic signs of periapical pathology were observed. Only 18% of the missing teeth had fixed prosthodontic restoration. The results are indicating a substantial future need for dental treatment.

Differential patterns of interaction between HIV type 1 and HTLV type I in monocyte-derived macrophages cultured in vitro: implications for in vivo coinfection with HIV type 1 and HTLV type I

The interaction between human immunodeficiency virus type 1 (HIV-1) and human T cell leukemia-lymphoma virus type I (HTLV-I) has generated substantial interest. However, there is disagreement on the in vivo consequences of the double infection. We investigated the interactions between HIV-1 and HTLV-I in monocyte-derived macrophages cultured in vitro. For study, the T cell-tropic strain IIIB and the macrophagetropic strain Ada-M of HIV-1 were used. The HTLV-I was prepared from the supernatants of the virus-producing MT-2 cell line. We found that coinfection of macrophages with T cell-tropic HIV-1 and HTLV-I significantly enhanced HIV-1 replication, whereas double infection of the cells with macrophage-tropic HIV-1 and HTLV-I resulted in marked upregulation of HTLV-I production. Stimulatory interactions between HIV-1 and HTLV-I were mediated by their trans-acting proteins. Results of study on nuclear translocation of proviral DNA showed that the tax gene product of HTLV-I was able to facilitate the nuclear import of the reverse-transcribed HIV-1(IIIB) DNA. In contrast, the HIV-1 Tat protein did not increase the intranuclear trafficking of HTLV-I DNA, which suggests another mechanism for HTLV-I enhancement by the tat gene product. In conclusion, this study provides possible mechanisms whereby coinfection of an individual with HIV-1 and HTLV-I may influence the clinical outcome of double infection.

Disturbed LDL and scavenger receptor functions in monocytes from chronic haemodialysed patients

BACKGROUND

The most frequent complication in patients with end-stage renal failure on chronic haemodialysis (HD) treatment is atherosclerosis, i.e. the different forms of heart and vascular diseases. The complete disorder of serum lipid and lipoprotein patterns is well demonstrated, whereas our knowledge about the low-density lipoprotein (LDL) and scavenger receptor expression and function are poorly understood.

METHODS

In our current work, LDL and scavenger receptor expression and functions were simultaneously studied in monocytes obtained from 15 healthy male control subjects and from 11 chronic HD male patients applied with (125)I-labelled LDL, isolated from healthy volunteers. To study the scavenger LDL receptors, labelled acetylated LDL (acLDL) was used.

RESULTS

LDL binding to the monocytes of the HD-group was found to be decreased in comparison to that of the controls. As a result, the 50 microg LDL protein-induced inhibition of endogenous cholesterol synthesis was also diminished. In contrast, acLDL binding was greatly increased, though it could trigger only a low apoE synthesis. Consequently the number of cholesterol inclusions in monocytes was increased.

CONCLUSIONS

The disturbed expression and function of LDL and scavenger receptors both may play significant roles in pathogenesis of cardiovascular complications in chronic HD patients. Based on our present results, it can be assumed that dysfunction of scavenger receptors is at the centre of cardiovascular complications of HD patients with renal failure.

Placental macrophage contact potentiates the complete replicative cycle of human cytomegalovirus in syncytiotrophoblast cells: role of interleukin-8 and transforming growth factor-beta1

Although syncytiotrophoblast (ST) cells can be infected by human cytomegalovirus (HCMV), in vitro studies have indicated that ST cells do not support the complete viral reproductive cycle, or HCMV replication may occur in less than 3% of ST cells. The present study tested the possibility that placental macrophages might enhance activation of HCMV carried in ST cells and, further, that infected ST cells would be capable of transmitting virus to neighboring macrophages. For this purpose, we studied HCMV replication in ST cells grown alone or cocultured with uninfected placental macrophages. Our results demonstrated that HCMV gene expression in ST cells was markedly upregulated by coculture with macrophages, resulting in release of substantial amounts of infectious virus from HCMV-infected ST cells. After having become permissive for viral replication, ST cells delivered HCMV to the cocultured macrophages, as evidenced by detection of virus-specific antigens in these cells. The stimulatory effect of coculture on HCMV gene expression in ST cells was mediated by marked interleukin-8 (IL-8) and transforming growth factor-beta1 (TGF-beta1) release from macrophages, an effect caused by contact between the different placental cells. Our findings indicate an interactive role for the ST layer and placental macrophages in the dissemination of HCMV among placental tissue. Eventually, these interactions may contribute to the transmission of HCMV from mother to the fetus.