Variations in the number of uterine angiotensin receptors following changes in plasma angiotensin levels

3H-labelled angiotensin II binding to receptor sites was studied in plasma membranes isolated from myometrial homogenates of uterine horns. Removal of the kidneys, which results in the disappearance of plasma angiotensin II, was followed by an increase in the number of uterine receptor sites without significant variation in the apparent dissociation constant, which became significant 15 h after nephrectomy. Acute pressor intravenous injection of angiotensin II into nephrectomized rats immediately before removing uteri, did not affect the number of uterine angiotensin receptors, whereas long-lasting angiotensin infusion did reduce the number of receptors. These results provided an explanation for the specific supersensitivity to angiotensin II, observed in uteri excised from nephrectomized rats, which cannot be accounted for by variations in the occupancy of receptor sites. These results also demonstrate that the number of angiotensin receptors, at least in uterine contractile cells, is affected by chronic variations of endogenous angiotensin levels.

Imaging of adductor-related groin pain

Groin pain is a common condition in athletes and results from various causes. Osteitis pubis, adductor dysfunction, inguinal hernia, or a combination of all three entities, generally explains the onset of symptoms. Adductor longus tendinopathy is the main cause of adductor-related groin pain. It leads to a significant reduction of sports participation and can require surgical management. Diagnosis is based on ultrasonography and magnetic resonance imaging. Asymptomatic findings (tendinosis, calcifications, cortical erosions) are common in athletes and care should be taken when assessing groin pain. The most specific sign of tendinopathy is an intratendinous tear of the adductor longus.

The effect of acute alcohol intoxication on gut wall integrity in healthy male volunteers; a randomized controlled trial

The aim of the study is to determine the effect of acute alcohol consumption on enterocytes. Chronic alcohol consumption has been known to induce a decrease in gut wall integrity in actively drinking alcoholics and patients with alcohol-induced liver disease. Data on the extent of the damage induced by acute alcohol consumption in healthy human beings is scarce. Studies show that heavy incidental alcohol consumption is a growing problem in modern society. Data on this matter may provide insights into the consequences of this behavior for healthy individuals. In a randomized clinical trial in crossover design, 15 healthy volunteers consumed water one day and alcohol the other. One blood sample was collected pre-consumption, five every hour post-consumption, and one after 24 h. Intestinal fatty acid binding protein (I-FABP) was used as a marker for enterocyte damage. Liver fatty acid binding protein (L-FABP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) were used as markers for hepatocyte damage. Lipopolysaccharide binding protein (LBP) and soluble CD14 (sCD14) were used as a measure of translocation. Interleukin-6 (IL-6) was used to assess the acute inflammatory response to endotoxemia. Alcohol consumption caused a significant increase in serum I- and L-FABP levels, compared to water consumption. Levels increased directly post-consumption and decreased to normal levels within 4 h. LBP, sCD14, and IL-6 levels were not significantly higher in the alcohol group. Moderate acute alcohol consumption immediately damages the enterocyte but does not seem to cause endotoxemia.

Microdamage in the alveolar process of rat maxillae after orthodontic tooth movement

OBJECTIVE

Playing a decisive role in bone remodeling, microdamage was recently associated with orthodontic tooth movement in pigs. The present study was conducted to evaluate microdamage and its potential association with orthodontic tooth movement in the alveolar process of rat maxillae.

MATERIAL AND METHODS

The upper right molars of 24 male Wistar rats (10 weeks old) were splinted and loaded against the (likewise splinted) upper incisors with 25 cN using a Nitinol coil spring. Four groups of 6 animals were treated in this fashion for 1, 2, 4, or 7 days. The upper left quadrants served as controls. The maxillae were halved, gently prepared, and stained en bloc with basic fuchsin. After embedding in resin, 80-μm-thick parasagittal sections were ground parallel to the mesial root of the first molar. These were used to assess microdamage under transmitted and epifluorescent light, also counting and measuring the length of microcracks. Differences between the loaded and unloaded side and between mesial and distal were checked using a Wilcoxon test and were considered significant at ≤ 0.05.

RESULTS

Microdamage (in the form of diffuse damage and microcracks) was observed in both the loaded and control jaw halves, as well as on the mesial and distal sides in all four groups. Microcracks averaged 30-100 μm in length and 0.3-1.7/mm(2) in density. While they were more prevalent in the loaded than the control jaw halves, this difference was not statistically significant.

CONCLUSION

The alveolar process of rat maxillae is characterized by microdamage (in the form of microcracks and diffuse damage) regardless of whether and for how long orthodontic loading has taken place. Within the limitations of this experimental study, our results do not confirm previous findings of significantly higher prevalence on the pressure side on the first day after initiating orthodontic tooth movement.

Discordant sex in monozygotic XXY/XX twins: a case report

We report a case of discordant phenotypic sex in monozygotic twins mosaic 47,XXY/46,XX: monozygotic heterokaryotypic twins. The twins presented with cognitive and comprehension delay, behavioural and language disorders, all symptoms frequently reported in Klinefelter syndrome. Molecular zygosity analysis with several markers confirmed that the twins are in effect monozygotic (MZ). Array comparative genomic hybridization found no evidence for the implication of copy number variation in the phenotypes. Ultrasound scans of the reproductive organs revealed no abnormalities. Endocrine tests showed a low testosterone level in Twin 1 (male phenotype) and a low gonadotrophin level in Twin 2 (female phenotype) which, combined with the results from ultrasound examination, provided useful information for potentially predicting the future fertility potential of the twins. Blood karyotypes revealed the presence of a normal 46,XX cell line and an aneuploïd 47,XXY cell line in both patients. Examination of the chromosome constitutions of various tissues such as blood, buccal smear and urinary sediment not surprisingly showed different proportions for the 46,XX and 47,XXY cell lines, which most likely explains the discordant phenotypic sex and mild Klinefelter features. The most plausible underlying biological mechanism is a post-zygotic loss of the Y chromosome in an initially 47,XXY zygote. This would result in an embryo with both 46,XX and 47,XXY cells lines which could subsequently divide into two monozygotic embryos through a twinning process. The two cell lines would then be distributed differently between tissues which could result in phenotypic discordances in the twins. These observations emphasize the importance of regular paediatric evaluations to determine the optimal timing for fertility preservation measures and to detect new Klinefelter features which could appear throughout childhood in the two subjects.

Stroke volume variation and indexed stroke volume measured using bioreactance predict fluid responsiveness in postoperative children

BACKGROUND

Postoperative fluid management can be challenging in children after haemorrhagic surgery. The goal of this study was to assess the ability of dynamic cardiovascular variables measured using bioreactance (NICOM®, Cheetah Medical, Tel Aviv, Israel) to predict fluid responsiveness in postoperative children.

METHODS

Children sedated and mechanically ventilated, who require volume expansion (VE) during the immediate postoperative period, were included. Indexed stroke volume (SVi), cardiac index, and stroke volume variation (SVV) were measured using the NICOM® device. Responders (Rs) to VE were patients showing an increase in SV measured using transthoracic echocardiography of at least 15% after VE. Data are median [95% confidence interval (CI)].

RESULTS

Thirty-one patients were included, but one patient was excluded because of the lack of calibration of the NICOM® device. Before VE, SVi [33 (95% CI 31-36) vs 24 (95% CI 21-28) ml m(-2); P=0.006] and SVV [8 (95% CI 4-11) vs 13 (95% CI 11-15)%; P=0.004] were significantly different between non-responders and Rs. The areas under the receiver operating characteristic curves of SVi and SVV for predicting fluid responsiveness were 0.88 (95% CI 0.71-0.97) and 0.81 (95% CI 0.66-0.96), for a cut-off value of 29 ml m(-2) (grey zone 27-29 ml m(-2)) and 10% (grey zone 9-15%), respectively.

CONCLUSIONS

The results of this study show that SVi and SVV non-invasively measured by bioreactance are predictive of fluid responsiveness in sedated and mechanically ventilated children after surgery.

[Mitochondrial neurogastrointestinal encephalopathy disease]

Mitochondrial neurogastrointestinal encephalopathy disease (MNGIE) is a rare autosomal-recessive syndrome, resulting from mutations in the TYMP gene, located at 22q13. The mutation induces a thymidine phosphorylase (TP) deficit, which leads to a nucleotide pool imbalance and to instability of the mitochondrial DNA. The clinical picture regroups gastrointestinal dysmotility, cachexia, ptosis, ophthalmoplegia, peripheral neuropathy, and asymptomatic leukoencephalopathy. The prognosis is unfavorable. We present the case of a 14-year-old Caucasian female whose symptoms started in early childhood. The diagnosis was suspected after magnetic resonance imaging (MRI), performed given the atypical features of mental anorexia, which revealed white matter abnormalities. She presented chronic vomiting, postprandial abdominal pain, and problems gaining weight accompanied by cachexia. This diagnosis led to establishing proper care, in particular an enteral and parenteral nutrition program. There is no known specific effective treatment, but numerous studies are in progress. In this article, after reviewing the existing studies, we discuss the main diagnostic and therapeutic aspects of the disease. We argue for the necessity of performing a cerebral MRI given the atypical features of a patient with suspected mental anorexia (or when the clinical pattern of a patient with mental anorexia seems atypical), so that MNGIE can be ruled out.

[General recommendations for medical treatment after heart transplantation]

Heart transplantation remains the treatment of choice in selected patients with severe heart failure (HF) despite optimal medical therapy. Since long-term survival after HTX is improving, there is a growing need for evidence-based strategies that reduce long-term mortality resulting from both immunological and non-immunological risk. This manuscript summarizes recommendations for treatment of transplant vasculopathy, malignancy after transplantation, and prevention of corticosteroid induced bone disease. Based on actual understanding of cardiovascular risk factors in the population, preservation of renal function, prevention and treatment of hyperlipidemia and diabetes, as well as blood pressure control play an important role in the long-term follow-up after heart transplantation.