Prevalence of Chlamydia trachomatis and bacterial vaginosis in women presenting to the early pregnancy unit

A total of 674 women attending the early pregnancy unit during the study period were offered screening with high vaginal and endocervical swabs and 516 agreed to participate in the study. The overall prevalence of chlamydia was 1.96% (95% CI 0.9-3.6). Some 10.5% were under the age of 25 years and the prevalence in this group was 1.85% (95% CI 0.05-9.9). The overall prevalence of bacterial vaginosis was 3.5% (95% CI 2.2-5.5). The prevalence of common genital infections is low in a population of women presenting to the early pregnancy unit. This is of relevance to women having surgical evacuation for miscarriage and randomised trials should be undertaken to evaluate the role of prophylactic antibiotics for such cases.

Are women with chlamydia infection who self-refer to genitourinary medicine clinics different?

The objective of this study was to explore whether patients with Chlamydia trachomatis infection who self-refer to genitourinary medicine clinics have different demographic characteristics to those who initially attend other agencies. This study took place in three genitourinary medicine clinics from Birmingham, Nottingham and Sheffield. Demographic and post-code data were collected from female patients diagnosed with genital chlamydia infection in 2000. Townsend scores, as an index of socioeconomic status, were derived from post-codes from a subset of the cohort (from Birmingham). Comparison was made between those who were diagnosed by genitourinary medicine clinics and those diagnosed in the community and referred to genitourinary medicine clinics for further management. Data were collected from 1047 genitourinary medicine and 816 non-genitourinary medicine women, of whom 686 (84.1%) attended genitourinary medicine clinics following referral. After excluding those with incomplete data, 1614 (987 genitourinary medicine and 627 non-genitourinary medicine) patients were included in the study. Using logistic regression analysis, we were unable to demonstrate any significant differences in age or Townsend scores between genitourinary medicine and non-genitourinary medicine patients. However, significantly more Black Caribbean (odds ratio [OR] = 2.72, 95% confidence interval [CI]: 2.22, 3.20) and single women (OR = 1.97, 95% CI: 1.64, 2.29) self-referred to genitourinary medicine clinics compared with other health-care settings. This trend was consistent between Birmingham and Nottingham. In Sheffield, there was no difference in marital status. Ethnicity was not a factor as there were no Black Caribbean patients in the Sheffield cohort. Women who were diagnosed with genital chlamydia infection in genitourinary medicine clinics have some different demographic characteristics to those who were diagnosed in the community.

N-phosphoryl amino acids and biomolecular origins

The possible role of phosphoryl amino acids for biomolecular origins is briefly reviewed. Peptide formation, ester formation, ester exchange on phosphorus and N to O migration occurred when the N-phosphoryl amino acid was incubated at room temperature. Short nucleotides and peptides were formed when nucleoside was reacted with N-phosphoryl amino acid at room temperature. Serine and threonine residues in their conjugate with different nucleosides (mediated with phosphorus) showed different self-cleavage activities. N-phosphoryl Histine and Ser-His dipeptide could cleave nucleic acids, proteins and esters in neutral medium. Based on a simple model, a pathway of 'co-evolution of protein and nucleic acid' was proposed.

Adoptive immunotherapy with donor lymphocyte infusions and interleukin-2 after high-dose therapy and autologous stem cell rescue for multiple myeloma

In an attempt to induce a graft-versus-myeloma effect, we administered donor lymphocyte infusions (DLI) after high-dose therapy with autologous stem cell transplant rescue to seven patients with refractory or relapsed multiple myeloma. High-dose therapy consisted of melphalan, idarubicin and etoposide (days -9 to -6) followed by autologous stem cell infusion on day 0. DLI (five of seven donors with two or three HLA antigens mismatched) were administered on days +1, +5 and +10 along with IL-2 (from day +1 through +12). Six of the seven patients developed acute graft-versus-host disease (GVHD), which resolved spontaneously, coincidentally with autologous hematopoietic reconstitution. One patient failed to engraft and received a second autologous graft. One patient died from complications of a pulmonary hemorrhage after experiencing GVHD. With a minimum follow-up of 38 months, five patients remain without disease progression in complete remission or with minimal residual disease. In this setting, DLI/IL-2 is biologically active resulting in GVHD. A graft-versus-myeloma effect is suggested by the improved outcome of our small cohort of high-risk patients. The use of partially mismatched related donors makes this approach potentially available to nearly all patients.

A preliminary investigation into the ultrastructure of dental calculus and associated bacteria

INTRODUCTION

Though dental calculus is generally recognised as comprising mineralised bacteria, areas of non-mineralised bacteria may be present.

AIM

To investigate the ultrastructure of non-decalcified young and mature supragingival calculus and subgingival calculus, and the possible presence of internal viable bacteria.

MATERIALS AND METHODS

Supragingival calculus was harvested from five patients, 9-10 weeks after scaling and root debridement. Five samples of mature supragingival and subgingival calculus were taken from patients presenting with adult periodontitis. Specimens were fixed and embedded for transmission electron microscopy.

RESULTS

The ultrastructure of young and mature supragingival calculus was similar with various large and small crystal types. Non-mineralised channels were observed extending into the calculus, often joining extensive lacunae, both containing intact non-mineralised coccoid and rod-shaped microorganisms. Subgingival calculus possessed more uniform mineralisation without non-mineralised channels and lacunae.

CONCLUSION

Supragingival calculus contains non-mineralised areas which contain bacteria and other debris. The viability of the bacteria, and their identification could not be determined in this preliminary investigation. As viable bacteria within these lacunae may provide a source of re-infection, further work needs to be done to identify the bacteria in the lacunae, and to determine their viability.

The relationship between mediastinal lymph node attenuation with parenchymal lung parameters in silicosis

OBJECTIVE

Attenuation changes on computed tomography (CT) in mediastinal lymph nodes (LN) may be related to lung alterations and functional impairment in silicosis.

DESIGN

CT and clinical data of 41 (64.2 +/- 8.3 years) males with silicosis were retrieved. Attenuation type (calcified, hyperdense, normodense) and calcification pattern (central, eccentric, dense, eggshell, speckled) of mediastinal LN were evaluated; LN attenuation of uncalcified LNs quantified on CT in six LN stations. Nodular profusion (CT-NP) and progressive massive fibrosis (CT-PMF) were graded. Relationships between LN, CT, lung function and clinical parameters were determined.

RESULTS

LN sites were paratracheal (n = 39), subcarinal (n = 39), tracheobronchial (n = 37), aortopulmonary (n = 37), hilar (n = 27), and peri-oesophageal (n = 21). LNs were calcified, hyperdense and normodense in 107, 85 and 54 LN stations, respectively. Uniformly calcified LN was most common, followed by speckled calcification. Central, eccentric and eggshell calcification was rare. CT-NP scores > or = 16 were associated with higher LN attenuation and number of calcified LN stations than CT-NP scores < 16. PMF had no influence over LN morphology or calcification pattern. LN attenuation correlated with CT-PMF (r = 0.36, P = 0.01), CT-NP (r = 0.54, P < 0.001) and DLCO/VA (r = -0.33, P = 0.02).

CONCLUSION

Uniformly calcified and hyperdense LNs are common in silicosis, and eggshell LN calcification is rare. There are associations between LN attenuation and lung function impairment, and CT grades of nodular profusion and PMF.

Changes in tendon strength after partial cut and effects of running peripheral sutures

We performed a study to evaluate the tensile properties of partial tendon lacerations and the effects of peripheral sutures on the tendon strength. Seventy-two fresh pig flexor digitorum profundus tendons were divided equally into eight groups. Tendons in four of the groups were subjected to partial lacerations (60%, 70%, 80%, and 90%) and were not repaired. In the other four similar groups partial lacerations were repaired with running peripheral sutures. The tendons were subjected to load-to-failure tests in an Instron tensile machine to determine the initial, 1mm, 2mm gap formation forces and the ultimate strength. The tendons with lacerations of 80% and 90% had a remarkably lower tensile strength than those 60% and 70% lacerations. Running peripheral sutures increased the gap formation forces and the ultimate strength of all the tendons, though particularly those with 80% and 90% lacerations.

[Study of calcitonin gene methylation in chronic myeloid leukemia by using Hpa II-PCR]

To investigate the role of calcitonin(CT) gene hypermethylation in the transformation from the initial chronic phase to blast crisis of chronic myeloid leukemia, 31 CML patients were studied by using Hpa II-PCR. The results showed that the 10.52%(2/19) chronic phase, 71.4%(5/7) accelerated phase and 80.0%(4/5) blast crisis of patients had CT gene hypermethylation and that the increased methylation of the CT gene were related with the disease progression. The reports indicated that the hypermethylation of CT gene might be a useful marker for predicting the evolution of CML and selecting chronic phase patients for BMT.

Prevention of postsplenectomy sepsis: how much do patients know?

INTRODUCTION

Asplenia causes a deficiency in immunity with a long-term risk of fulminant infection, associated with significant mortality. Patient compliance requires an understanding of risks of infection and its prevention. The impact of patient education has been little studied.

MATERIALS AND METHODS

To ascertain the degree of knowledge held by patients who have undergone splenectomy, a comprehensive survey was designed. This also aimed to determine which group of health professionals was most successful in conveying information to patients. Patients who had undergone total splenectomy were interviewed by telephone, using a standardised list of questions to assess their understanding of the post-operation risks.

RESULTS

Of 40 consecutive patients, 32.5% had a good knowledge of the risks of asplenia and their prevention, 52.5% had a fair knowledge and 15% a poor knowledge. Haematologists were most successful in initially conveying information to patients, and general practitioners also played a critical role in patient education. In this survey, it appears that surgeons were not effective at educating patients.

CONCLUSION

Patient education postsplenectomy is poor. Measures to prevent infection in the asplenic patient are not being adequately implemented.

Aerobic demands of the dance simulation game

The purpose of this study was to assess the intensity and energy cost of dance simulation in relation to the American College of Sports Medicine (ACSM) recommendations on the quantity and quality of exercise for developing and maintaining cardiorespiratory fitness, and to assess its safety. Forty subjects (21 males and 19 females, age 17.5 +/- 0.7 years) had their heart rate (HR) and oxygen consumption (.VO(2)) measured during maximal treadmill exercise and during a dance simulation game at a self-selected level of difficulty. They were monitored for injuries during and after the study. The results showed a mean HR of 137 beats x min(-1) (139 beats x min(-1) for males and 136 beats x min(-1) for females) and a mean .VO(2) of 24.6 ml x kg(-1) x min(-1) (25.3 ml x kg(-1) x min(-1) for males and 23.8 ml x kg(-1) x min(-1) for females) during the dance simulation game test, with an estimated energy expenditure of 480 W (550 W for males and 410 W for females). The dance intensity only just meets the minimum ACSM guidelines, so dancer-players will need to play for extended periods to improve or maintain cardiorespiratory fitness or to lose weight. No injuries occurred during 201 hours of dance time.

Human ABCA1 BAC transgenic mice show increased high density lipoprotein cholesterol and ApoAI-dependent efflux stimulated by an internal promoter containing liver X receptor response elements in intron 1

By using BAC transgenic mice, we have shown that increased human ABCA1 protein expression results in a significant increase in cholesterol efflux in different tissues and marked elevation in high density lipoprotein (HDL)-cholesterol levels associated with increases in apoAI and apoAII. Three novel ABCA1 transcripts containing three different transcription initiation sites that utilize sequences in intron 1 have been identified. In BAC transgenic mice there is an increased expression of ABCA1 protein, but the distribution of the ABCA1 product in different cells remains similar to wild type mice. An internal promoter in human intron 1 containing liver X response elements is functional in vivo and directly contributes to regulation of the human ABCA1 gene in multiple tissues and to raised HDL cholesterol, apoAI, and apoAII levels. A highly significant relationship between raised protein levels, increased efflux, and level of HDL elevation is evident. These data provide proof of the principle that increased human ABCA1 efflux activity is associated with an increase in HDL levels in vivo.

Role of calcitonin gene-related peptide in nitric oxide-mediated myocardial delayed preconditioning induced by head stress

AIM

To study the role of calcitonin gene-related peptide (CGRP) in nitric oxide (NO)-mediated myocardial delayed preconditioning induced by heat stress.

METHODS

The isolated rat heart was perfused in a Langendorff model. Hearts for all groups were subjected to 4 h hypothermia (4 degrees C) and 40 min reperfusion (37 degrees C). In the hyperthermia-treated group, rats were subjected to whole-body hyperthermia (rectal 42 degrees C, 15 min) 24 h before the experiment. Heart rate, coronary flow, left ventricular pressure, and its derivative (+/- dp/dtmax) were recorded, and calcitonin gene-related peptide-like immunoreactivity (CGRP-LI) in plasma and the activity of creatine kinase (CK) in the coronary effluent were measured.

RESULTS

Pretreatment with hyperthermia significantly improved the recovery of cardiac protection, reduced the release of CK, and increased plasma concentrations of CGRP. Pretreatment with L-NAME, an inhibitor of NOS, or capsaicin, which selectively depleted sensory neurotransmitter content, abolished the protective effects and the increased level of CGRP elicited by hyperthermia.

CONCLUSION

Endogenous NO is involved in the cardioprotection afforded by heat stress, and the beneficial effects of NO are mediated by CGRP in the rat.

Angular dispersion compensation for acousto-optic devices used for ultrashort-pulsed laser micromachining

Ultrashort pulsed laser material processing is a new micromachining method that is gaining interest. Its capability of submicrometer machining has been proved. To obtain high speed and highly flexible beam steering, a two-axis acousto-optic deflector is employed. However, dispersion associated with acoustic-optic interaction will cause serious spatial deformation on the writing spot. The compensation for dispersion is proposed and studied. Experiments show promising results. An additional advantage of the proposed compensation method is that it can also precisely control the pulse number, and, hence improve the quality of ablation.

Effects of plant growth regulators on survival and recovery growth following cryopreservation

Studies on the effects of plant growth regulators (PGRs) on survival, recovery and post-recovery growth of shoot apices following cryopreservation are limited. In this study, the effects of plant growth regulators in both the culture phase and the recovery phase of cryostorage were examined for the rare plant species, Anigozanthos viridis ssp terraspectans Hopper. Survival of shoot apices was not correlated to cytokinin or auxin treatments administered in culture media prior to cryostorage. In recovery media, the plant growth regulators, kinetin, zeatin (cytokinins), IAA, (auxin) and GA3 were examined for their effect following cryopreservation. It was found that the application of a combination of cytokinin and 0.5 microM GA3 from day zero was the most appropriate for obtaining vigorously growing plantlets following LN immersion. This combination proved to be more effective than basal medium, zeatin or kinetin treatments.

The effect of Rowland ghost on sub-micromachining using Femtosecond pulsed laser

The unique ability of the ultrafast lasers to perform sub-spot size machining has been proved to be advantageous over conventional lasers for sub-micron-machining. To achieve this, a Gaussian laser beam free of spatial defects is essential. In this research work, submicron holes with clear edge and symmetric shape on thin metal films using a Ti:Sapphire regenerative amplified femtosecond pulsed laser are produced. While analysing, it is observed that there are two shallow pits accompanying the produced hole, symmetrically located at the two sides of the hole, especially when the holes are in the sub-micron range. A careful study on the effects of these shallow pits and the methods to eliminate the same are presented in this letter. It has been concluded that the shallow pits are Rowland ghosts raised by deficiencies of grating space present in the two pairs of gratings used for pulse stretching and compressing. Methods of eliminating these ghosts to achieve features with better edge acuity and quality are also presented.

Chemotherapy for human immunodeficiency virus-associated non-Hodgkin's lymphoma in combination with highly active antiretroviral therapy

PURPOSE

This study investigated the efficacy, toxicity, and pharmacokinetic interactions resulting from simultaneous combination chemotherapy and highly active antiretroviral therapy (HAART) for patients with human immunodeficiency virus (HIV)-associated non-Hodgkin's lymphoma (NHL). In addition, the effects on viral load, CD4 counts, and opportunistic infections were examined with the use of combination chemotherapy combined with HAART.

PATIENTS AND METHODS

Sixty-five patients with previously untreated and measurable disease at any stage of HIV-associated NHL of intermediate or high grade were entered onto this study at 17 different centers. The first 40 patients entered onto the study received reduced doses of cyclophosphamide and doxorubicin, combined with vincristine and prednisone (modified CHOP [mCHOP]), whereas the subsequent 25 patients entered onto the study received full doses of CHOP combined with granulocyte colony-stimulating factor (G-CSF). All patients also received stavudine, lamivudine, and indinavir.

RESULTS

The complete response rates were 30% and 48% among patients who received mCHOP and full-dose CHOP combined with HAART, respectively. Grade 3 or 4 neutropenia occurred in 25% of patients receiving mCHOP and 12% of those receiving full-dose CHOP combined with G-CSF (25% v 12%). There were similar numbers of patients with grade 3 or 4 hyperbilirubinemia (12% and 17%), constipation and abdominal pain (18% and 17%), and transaminase elevation (48% and 52%) on the modified and full-dose arms of the study, respectively. Doxorubicin clearance and indinavir concentration curves were similar among patients on this study and historical controls, whereas cyclophosphamide clearance was 1.5-fold reduced as compared with control values. Human immunodeficiency virus (HIV) load declined from a median baseline value of 29,000 copies/mL to a median minimum value on therapy of 500 copies/mL.

CONCLUSION

Either modified-dose or full-dose CHOP chemotherapy for HIV-NHL, delivered with HAART, is effective and tolerable.

Grip strength measurement in competitive ten-pin bowlers

BACKGROUND

In an attempt to find a more specific grip strength test for bowlers, the conventional grip strength test was modified such that only the fingers used in holding the ball are tested. The objective of this study was to assess the test-retest reliability of this modified bowling grip strength test, to assess the agreement between the bowling and the conventional grip strength tests, and to examine the correlation between the modified test and bowling performance in competitive bowlers. METHODS.

EXPERIMENTAL DESIGN

This research was conducted in two parts, each with a different study sample. Study I was a cross-sectional study to assess the correlation between the bowling grip strength and the bowling score. Study II was a comparative study to obtain the test-retest reliability for both the bowling and conventional grip strength tests, and to assess the agreement between the two tests.

SETTING AND SUBJECTS

for study I, the subjects were 39 members (26 males and 13 females) of the Singapore National Ten-Pin Bowling Training Squad. Bowling grip strength was measured within one month prior to the selection trials for the national squad, the results of which were used as a measure of bowling performance. For study II, the subjects were 21 members (12 males and 9 females) of the Singapore National Ten-Pin Bowling Squad that was formed after the selection trials.

INTERVENTIONS

none.

MEASURES

Bowling grip strength, conventional grip strength, and bowling score.

RESULTS

The test-retest reliability of the bowling grip strength measurement (r = 0.91, p < 0.01) was comparable to that of the conventional five-finger grip (r = 0.93, p < 0.01). The single measure intraclass correlation coefficient between the bowling and conventional grip strength tests was 0.77; the 95% confidence interval was 0.51 and 0.90. However, the correlation coefficient between the bowling grip strength test and bowling score (r = 0.27) was not significant.

CONCLUSIONS

The bowling grip strength test has a high test-retest reliability, and a moderate agreement with the conventional grip strength test. However, despite using only the bowling fingers, the test was unable to predict bowling performance in elite bowlers.

Stereochemical arrangement of hydroxyl groups in sugar and polyalcohol molecules as an important factor in effective cryopreservation

The efficacy of several sugars and polyalcohols in preculture medium was investigated using Anigozanthos viridis ssp terraspectans Hopper (Haemodoraceae), a threatened plant species endemic to the south west of Western Australia. A vitrification protocol involving preculturing of shoot apices for 3 days on different concentrations of sugars and polyalcohols, followed by incubation in plant vitrification solution 2 (PVS2) for 25 min, prior to immersion in liquid nitrogen (LN) and warming resulted in shoot tip survival ranging from 34 to 84%. High levels of survival were obtained with polyalcohols, compared to sucrose, glucose, trehalose and raffinose when used at the same molarity (0.4 M) or at the equivalent concentration of total hydroxyl (OH) groups present in molecules. In both cases glycerol proved more effective. When polyalcohols (ribitol and erythritol) with similar stereochemical arrangement of OH groups as glycerol were examined, at the same molarity (0.4 M) and with equivalent OH numbers, higher survival was achieved when the total number of OH groups present was the same as glycerol. Additionally, when the structural isomers mannitol/sorbitol and ribitol/xylitol were compared at the same molarity (0.4 M), the isomer with the higher number of OH groups along the same side resulted in significantly higher levels of post-LN survival. We propose that the mode of action of polyalcohols is based not on molarity, but on the total number of OH groups present in the medium. Furthermore, based on these results we propose that the orientation of OH groups is a determining factor in effective cryopreservation.

Sodium hyaluronate enhances colorectal tumour cell metastatic potential in vitro and in vivo

BACKGROUND

Sodium hyaluronate has been used intraperitoneally to prevent postoperative adhesions. However, the effect of sodium hyaluronate on tumour growth and metastasis in vitro and in vivo is still unknown.

METHODS

Human colorectal tumour cell lines SW480, SW620 and SW707 were treated with sodium hyaluronate (10-500 microg/ml) and carboxymethylcellulose (0.125-1 per cent), and tumour cell proliferation and motility were determined in vitro. For the in vivo experiments male BD IX rats were randomized to a sodium hyaluronate group (n = 11; intraperitoneal administration of 0.5 x 10(6) DHD/K12 tumour cells and 5 ml 0.4 per cent sodium hyaluronate) or a phosphate-buffered saline group (n = 11; 0.5 x 10(6) DHD/K12 tumour cells and 5 ml phosphate-buffered saline intraperitoneally). Four weeks later the intraperitoneal tumour load was visualized directly.

RESULTS

In vitro sodium hyaluronate increased tumour cell proliferation and motility significantly. Sodium hyaluronate-induced tumour cell motility appeared to be CD44 receptor dependent, whereas sodium hyaluronate-induced tumour cell proliferation was CD44 receptor independent. In vivo there was a significantly higher total tumour nodule count in the peritoneal cavity of the sodium hyaluronate-treated group compared with the control (P = 0.016).

CONCLUSION

Sodium hyaluronate enhances tumour metastatic potential in vitro and in vivo, which suggests that use of sodium hyaluronate to prevent adhesions in colorectal cancer surgery may also potentiate intraperitoneal tumour growth. Presented to the Patey Prize Session of the Surgical Research Society and the annual scientific meeting of the Association of Surgeons of Great Britain and Ireland, Brighton, UK, 4-7 May 1999

Effects of dietary vitamin K on survival, growth, and tissue concentrations of phylloquinone (PK) and menaquinone-4 (MK-4) for juvenile abalone, Haliotis discus hannai Ino

The experiment was conducted to investigate the effects of dietary vitamin K on survival, growth and tissue vitamin K concentrations of abalone, Haliotis discus hannai. Eight purified diets were formulated to provide a series of graded levels of menadione sodium bisulfite (MSB) (0-320 mgkg(-1) diet). The brown alga, Laminaria japonica, was used as a control diet. Abalone juveniles of similar size (mean weight 1.18+/-0.04 g; mean shell length 18.65+/-0.18 mm) were distributed in a flow-through system using a completely randomized design with nine treatments and three replicate groups per treatment. Animals were hand-fed the appropriate diets once daily at 17:00 for a 120-day period. Survival and carcass composition were not significantly affected by the dietary treatments (P>0.05). Significantly lower growth rate was found in abalone fed diet supplemented with antibiotic (suphaguanidine) than in those fed the other diets, but no significant difference in growth rate related to dietary level of MSB was observed. The concentrations of menaquinone-4 (MK-4) in muscle and viscera increased with increasing dietary MSB up to 10 mgkg(-1). No phylloquinone (PK) was detected in tissues except that the abalone fed the control diet, Laminaria japonica, produced a relatively high level of PK. It seemed to be that the 10-mg MSBkg(-1) diet is sufficient to that allowing the maintenance of 'steady-state' tissue concentration in juvenile abalone. Dietary MSB was converted to MK-4 in abalone. Either MK-4 or PK deposited in the body is derived from food.

Intravenous oxytocin alone for cervical ripening and induction of labour

BACKGROUND

Oxytocin is the commonest induction agent used worldwide. It has been used alone, in combination with amniotomy or following cervical ripening with other pharmacological or non-pharmacological methods. Prior to the introduction of prostaglandin agents oxytocin was used as a cervical ripening agent as well. In developed countries oxytocin alone is more commonly used in the presence of ruptured membranes whether spontaneous or artificial. In developing countries where the incidence of HIV is high, delaying amniotomy in labour reduces vertical transmission rates and hence the use of oxytocin with intact membranes warrants further investigation. This review will address the use of oxytocin alone for induction of labour. Amniotomy alone or oxytocin with amniotomy for induction of labour has been reviewed elsewhere in the Cochrane Library. Trials which consider concomitant administration of oxytocin and amniotomy will not be considered. This is one of a series of reviews of methods of cervical ripening and labour induction using a standardised methodology.

OBJECTIVES

To determine the effects of oxytocin alone for third trimester cervical ripening or induction of labour in comparison with other methods of induction of labour or placebo/no treatment.

SEARCH STRATEGY

The Cochrane Pregnancy and Childbirth Group Trials Register, the Cochrane Controlled Trials Register and bibliographies of relevant papers. Last searched: May 2001.

SELECTION CRITERIA

The criteria for inclusion included the following: (1) clinical trials comparing vaginal prostaglandins used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random allocation to the treatment or control group; (3) adequate allocation concealment; (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions.

DATA COLLECTION AND ANALYSIS

A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. The initial data extraction was done centrally, and incorporated into a series of primary reviews arranged by methods of induction of labour, following a standardised methodology. The data is to be extracted from the primary reviews into a series of secondary reviews, arranged by category of woman.

MAIN RESULTS

In total, 110 trials were considered; 52 have been excluded and 58 included examining a total of 11,129 women. Comparing oxytocin alone with expectant management: Oxytocin alone reduced the rate of unsuccessful vaginal delivery within 24 hours when compared with expectant management (8.3% versus 54%, relative risk (RR) 0.16, 95% confidence interval (CI) 0.10,0.25) but the caesarean section rate was increased (10.4% versus 8.9%, RR 1.17, 95% CI 1.01,1.36). This increase in caesarean section rate was not apparent in the subgroup analyses. Women were less likely to be unsatisfied with induction rather than expectant management, in the one trial reporting this outcome (5.5% versus 13.7%, RR 0.43, 95% CI 0.33, 0.56). Comparing oxytocin alone with vaginal prostaglandins: Oxytocin alone was associated with an increase in unsuccessful vaginal delivery within 24 hours (52% versus 28%, RR 1.85, 95% CI 1.41, 2.43), irrespective of membrane status, but there was no difference in caesarean section rates (11.4% versus 10%, RR 1.12, 95% CI 0.95, 1.33). Comparing oxytocin alone with intracervical prostaglandins: Oxytocin alone was associated with an increase in unsuccessful vaginal delivery within 24 hours when compared with intracervical PGE2 (51% versus 35%, RR 1.49, 95% CI 1.12,1.99). For all women with an unfavourable cervix regardless of membrane status, the caesarean section rates were increased (19.0% versus 13.1%, RR 1.42, 95% CI 1.11, 1.82).

REVIEWER'S CONCLUSIONS

Overall, comparison of oxytocin alone with either intravaginal or intracervical PGE2 reveals that the prostaglandin agents probably overall have more benefits than oxytocin alone. The amount of information relating to specific clinical subgroups is limited, especially with respect to women with intact membranes. Comparison of oxytocin alone to vaginal PGE2 in women with ruptured membranes reveals that both interventions are probably equally efficacious with each having some advantages and disadvantages over the others. With respect to current practice in women with ruptured membranes induction can be recommended by either method and in women with intact membranes there is insufficient information to make firm recommendations.

The important role of residue F268 in ligand binding by LXRbeta

Liver X receptors (LXRs) are nuclear receptors that regulate the metabolism of cholesterol and bile acids. Despite information on the specificity of their natural ligands, oxysterols, relatively little is known about the ligand binding site in LXRs. The helix 3 region in the ligand binding domain (LBD) of peroxisome proliferator-activated receptors (PPARs) has been implicated in ligand entry. Sequence alignment of LXRs, farnesoid X receptor (FXR), and PPARs identified the corresponding helix 3 region in the LXRbeta LBD. Residues F268 and T272, which are conserved in all the aligned sequences and only in LXRs and FXR, respectively, were replaced with alanine. The effects of these mutations on ligand binding and receptor activation were examined using an in vitro ligand binding assay and a cell based reporter assay, respectively. The LXRbeta mutant F268A did not bind ligand. In contrast, conversion of T272 to alanine has no effect on ligand binding. By transiently expressing a chimeric receptor containing Escherichia coli tetracycline repressor (TetR) and LXRbeta LBD and a reporter with a TetR binding site, we show that mutant F268A lost the ability to activate transcription of the reporter, whereas mutant T272A still has an activity similar to that of the wild-type LXRbeta. These data, consistent with the findings in the in vitro ligand binding assay and our 3D modeling, are the first study that identifies a residue critical for ligand binding in LXRbeta.

Cryopreservation of the australian species Macropidia fuliginosa (Haemodoraceae) by vitrification

Somatic embryos were used to develop a cryopreservation protocol for Macropidia fuliginosa, a commercially-important species endemic to the south-west of Western Australia. Somatic embryos were allowed to develop from embryogenic callus for three weeks on an kinetin medium prior to processing. These were transferred and cultured on a agar solidified basal medium supplemented with 0 to 0.6 M sorbitol for 2 d prior to incubation in Plant Vitrification Solution Two (PVS2). Following this, embryos were then washed in 1 M sucrose solution (treated controls) or cooled in liquid nitrogen (LN). Cooled embryos were then warmed and washed in sucrose solution. Highest survival for cooled treatments (67.3%) was achieved by preculture with 0.4 M sorbitol, then incubation in PVS2. Further experimentation varying pre-culture duration (2 or 3 d) and incubation on either glycerol (0.8 M) or sorbitol (0.4 M) indicated that very high survival (90.6%) of embryos was achievable by adopting a 2 d preculture period on 0.8 M glycerol. The phenotype and growth rates of plants obtained using this protocol were similar to those of parent plants. This optimised procedure was then applied to tissue culture-derived shoot apices of the same clone also resulting in a high survival rate (84.4%).

Arginine vasopressin gene expression in supraoptic nucleus and paraventricular nucleus of hypothalamous following cerebral ischemia and reperfusion

BACKGROUND

Our previous studies indicated that the increased arginine vasopressin (AVP) in ischemic brain regions of gerbils could exacerbate the ischemic brain edema. This experiments is further clarify the relation between AVP and cerebral ischemia at the molecular level.

METHODS

The contents of AVP, AVP mRNA, AVP immunoreactive (ir) neurons in supraoptic nucleus(SON) and paraventricular nucleus (PVN) after cerebral ischemia and reperfusion were respectively determined by radioimmunoassay (RIA), immunocytochemistry (II C), situ hybridization and computed image pattern analysis.

RESULTS

The contents of AVP in SON, PVN were increased, and the AVP ir positive neurons in SON and PVN were also significantly increased as compared with the controls after ischemia and reperfusion. And there were very light staining of AVP ir positive neurons in the other brain areas such as suprachiasmatic nucleus (SC) and periventricular hypothalamic nucleus (PE), but these have no significant changes as compared with the controls. During different periods of cerebral ischemia (30 approximately 120 min) and reperfusion (30 min), AVP mRNA expression in SON and PVN were more markedly increased than the controls.

CONCLUSIONS

The transcription of AVP gene elevated, then promoting synthesis and release of AVP in SON, PVN. Under the specific condition of cerebral ischemia and reperfusion, the activity and contents of central AVP increased abnormally is one of the important factors which causes ischemia brain damage.

Multidrug resistance transporters and modulation

Multidrug resistance (MDR), whereby tumor cells simultaneously possess intrinsic or acquired cross-resistance to diverse chemotherapeutic agents, hampers the effective treatment of cancer. Molecular investigations in MDR resulted in the isolation and characterization of genes coding for several proteins associated with MDR, including P-glycoprotein (P-gp), the multidrug resistance associated protein (MRP1), the lung resistance protein (LRP), and, more recently, the breast cancer resistance protein (BCRP). These transmembrane proteins cause MDR either by decreasing the total intracellular retention of drugs or redistributing intracellular accumulation of drugs away from target organelles. These proteins are expressed at varying degrees in different neoplasms, including the AIDS-associated non-Hodgkin lymphoma and Kaposi sarcoma and are generally associated with poor prognosis. Several MDR-reversing agents are in various stages of clinical development. First-generation modulators such as verapamil, quinidine, and cyclosporin required high doses of drugs to reverse MDR and were associated with unacceptable toxicities. Second- and third-generation MDR inhibitors include PSC 833, GF120918, VX-710, and LY335979, among others. Limitations to the use of these modulators include multiple and redundant cellular mechanisms of resistance, alterations in pharmacokinetics of cytotoxic agents, and clinical toxicities. Studies to validate the role of MDR reversal in the treatment of various malignancies are underway. A potential use of these agents may be to enhance intestinal drug absorption and increase drug penetration to biologically important protective barriers, such as the blood-brain, blood-cerebrospinal fluid, and the maternal-fetal barriers. The use of MDR modulators with drugs such as the antiviral protease inhibitors and cytotoxics may enhance drug accumulation in sanctuary sites that are traditionally impenetrable to these agents.

Correlations between physiological parameters and performance in elite ten-pin bowlers

The increasing acceptance of ten-pin bowling as a sport, as well as the keen competition amongst bowlers, necessitates the identification of performance indicators to aid training. The aim of this cross-sectional study was to determine if age, height, weight, aerobic power index, bowling grip strength, 10-RM leg press performance, and the sit-and-reach distance correlated with bowling performance in 42 elite bowlers (26 males and 16 females). At the same time, the physiological profiles of bowlers classified as heavy ball strokers, heavy ball crankers, and light ball spinners were compared. The results showed that for the male bowlers, none of the parameters correlated with performance, while for the female bowlers, the only parameter that correlated with performance was the aerobic power index. Bowlers using the three different releases had similar anthropometric and physiological profiles. The implications from this study are that bowlers of diverse age and build can be equally competitive in the sport; that aerobic capacity (as reflected by the aerobic power index) may, to a certain extent, contribute to bowling performance; and that strength and flexibility measures do not seem to be useful performance indicators amongst elite bowlers.

[Solution of inverse problem of therman equation in quantitative X-ray fluorescence analysis. Theoretical effect coefficient method and fundamental parameter method]

In this paper, firstly the algorithmic relation between the weight fraction Ci, X-ray fluorescence relative intensity Ri and matrix effect factor Fi is created for the multi-element specimen on theoretical basis. Secondly, according to this algorithm relation, the typical method to solve inverse problem of Therman equation can be developed that is the theoretical influence coefficience method and the fundamental parameter method. Six standards are analysed by these two methods respectively, and results are good agree with the certified values.

Quantitative analysis of thymosin alpha1 in human serum by LC-MS/MS

A high performance liquid chromatography with tandem mass spectrometry (LC-MS/MS) method was developed to measure the thymosin alpha 1 (Talpha1) concentration in human serum. Tá1 in human serum was determined by solid phase extraction and reverse phase LC-MS/MS. The high-performance liquid chromatography (HPLC) system interfaced with the MS/MS system with a Turbo Ion spray interface. Positive ion detection and multiple reaction monitoring (MRM) mode were used for this human serum quantitation. Eight different concentration standards were used to establish the detection range. Six quality control (QC) and 2 matrix blanks were checked by calibration curves performed on the same day. The lower quantitation limit was 0.5 ng/mL Talpha1 in human serum. Calibration curves were established between 0.5 to 100 ng/mL by weighted linear regression. The correlation coefficients for different days were 0.9955 or greater. Quantitation of Talpha1 by the LC-MS/MS method is fast, accurate, and precise.

[Detection of interleukin-2 receptor in patients with idiopathic thrombocytopenic purpura]

Using ELISA and indirect fluorescent antibody techniques(IFAT), the serum soluble inter-leukin-2 receptor(sIL-2R) and membrane IL-2R (mIL-2R) on lymphocyte cells induced by phyto-hemagglutinin (PHA) were studied in patients with idiopathic thrombocytopenic purpura (ITP). The results showed that the level of sIL-2R increased significantly before treatment and decreased after treatment; the percentages of mIL-2R induced by PHA decreased. There was no correlation between the level of serum sIL-2R and that of mIL-2R. Our observations suggest that increased level of serum sIL-2R in ITP patients may be one of causes evoking cellular immunological abnormalities.

Scanning laser differential-heterodyne interferometer for flying-height measurement

With conventional optical interferometry flying-height testing, a stationary measurement beam and a two-axis moving stage are used to measure slider-disk spacing at different points on the slider. Pitch angle or roll angle is calculated on the basis of the measurement results. We report on a scanning differential-heterodyne interferometer, which measures the continuous flying-height variation along the edge of a slider with two continuously scanning laser beams. Pitch angle or roll angle can be obtained directly from the scanning measurement. The system can also measure points individually to obtain the absolute flying height at different locations on the slider. Experiments were performed to demonstrate the concept of scanning measurement. The flying-height variation along the slider edge was measured by continuous scan and by point-to-point moving. The measurement results from continuous scan coincided with those of conventional methods.

The effects of EMLA and a topical formulation of 4% amethocaine (Ametop) on pain associated with retrobulbar injection

Retrobulbar block is commonly performed to provide anaesthesia for cataract extraction. This technique can cause significant discomfort. A prospective, randomised, placebo-controlled trial was carried out to investigate the efficacy of a eutectic mixture of local anaesthetics (EMLA) and a 4% amethocaine topical formulation (Ametop) in reducing the pain of retrobulbar injection. Ametop and EMLA proved to be of similar efficacy, both being superior to a placebo in alleviating the discomfort of retrobulbar block. No significant side-effects were observed with the use of either formulation.

Distinct human immunodeficiency virus strains in the bone marrow are associated with the development of thrombocytopenia

We analyzed bone marrow and blood from human immunodeficiency virus type 1 (HIV-1)-infected individuals and described the HIV-1 quasispecies in these cellular compartments. HIV-1 isolates from the bone marrow of thrombocytopenic patients contained distinct amino acids in the V3 loop and infected T-cell lines, implicating this virus in the development of thrombocytopenia.