Superovulatory response and embryo recovery after treatment with different gonadotrophins during induced luteal phase in Camelus dromedarius

Superovulation, embryo recovery and transfer were attempted in 19 dromedary camels of about 6-10 years of age, and having calved at least once. Superovulation was done using two commercially available porcine FSH preparations, FSH-I (II donors) and FSH-2 (8 donors) during a luteal phase created by inducing ovulation with hCG. The superovulatory response was assessed by ultrasonography. The embryo recovery was attempted non-surgically in sitting position on day 8 and day 7 after first mating in one FSH-1 and one FSH-2 group, respectively. Considerable individual variation in response to the superovulatory stimulus was observed. No significant difference was observed between the two groups in terms of superovulatory response and embryo recovery (p > 0.05). In total 30 embryos were recovered from 17 donors (1.51 embryos/donor). Recipients were synchronized with donors using hCG. Eight embryos were transferred, resulting in two pregnancies and live births.

Further observations on LKB1/STK11 status and cancer risk in Peutz-Jeghers syndrome

Germline mutations in the LKB1/STK11 tumour suppressor gene cause Peutz-Jeghers syndrome (PJS), a rare dominant disorder. In addition to typical hamartomatous gastrointestinal polyps and pigmented perioral lesions, PJS is associated with an increased risk of tumours at multiple sites. Follow-up information on carriers is limited and genetic heterogeneity makes counselling and management in PJS difficult. Here we report the analysis of the LKB1/STK11 locus in a series of 33 PJS families, and estimation of cancer risks in carriers and noncarriers. Germline mutations of LKB1/STK11 were identified in 52% of cases. This observation reinforces the hypothesis of a second PJS locus. In carriers of LKB1/STK11 mutations, the risk of cancer was markedly elevated. The risk of developing any cancer in carriers by age 65 years was 47% (95% CI: 27-73%) with elevated risks of both gastrointestinal and breast cancer. PJS with germline mutations in LKB1/STK11 are at a very high relative and absolute risk of multiple gastrointestinal and nongastrointestinal cancers. To obtain precise estimates of risk associated with PJS requires further studies of genotype-phenotype especially with respect to LKB1/STK11 negative cases, as this group is likely to be heterogeneous.

Coexisting chondroblastoma and osteochondroma: a case report

The coexistence of two different types of benign cartilaginous tumours of bone in the same patient has not been reported in literature. We report a case in which a sixteen-year-old male had a benign chondroblastoma of the proximal left humerus and an osteochondroma of the distal left femur. Both originated at the same time and had a progressive increase in size with growth.

Factors limiting the rate of living-related kidney donation to children in an inner city setting

A recent review of our center experience revealed that only 38% of our pediatric renal transplants come from living-related donors (LRD), which is 11% lower than the national average. The present study was designed to identify factors that limit the availability of LRD in our population pool. Retrospective chart reviews and subsequent telephone interviews were conducted with parents of all children who received renal replacement therapy (RRT) at our institution from 1990 to 1999. The availability of parents and their willingness to donate a kidney were noted. Self-reported willingness was defined as the verbal expression of a desire to donate. Firm willingness was defined as the completion of the steps necessary for donation, unless excluded by the medical team. Factors that may impact the ability to donate, such as donor age, ethnicity, religion, educational attainment, employment, and presence of other siblings younger than 18 yr of age, were evaluated. Statistical analyses were performed using the Student's t-test and chi-square analysis. Significant results were entered into a single-step multiple regression analysis. Sixty children were identified with RRT, of whom 60% were Blacks, 30% Hispanics, 7% Caucasians, and 3% Asian. Fifty-five mothers were available for interview. Forty-four mothers reported a desire to donate, nine were unwilling to donate, and two were undecided. However, only 35 attended for screening. Only 30 fathers were available and, of these, 27 reported willingness to donate, yet only 20 attended for screening. Seventy-four per cent (26 out of 35) of mothers screened and 55% (11 out of 20) of fathers screened were medically unsuitable for kidney donation. Nineteen potential donors had hypertension, diabetes and/or obesity, seven had renal disease, four had anemia, two had hepatitis C, and five had other conditions. Expressed unwillingness to donate was associated with a greater number of children (3.1 compared to 1.5 children in addition to the child with end-stage renal disease [ESRD]) (odds ratio 2.91, p < 0.05) and employment (26.3% vs. 4.0%, p < 0.05) (odds ratio 31.2, p = 0.05). Comparing mothers who were firmly willing to donate with mothers who did not complete screening and evaluation, unwilling mothers had, likewise, a greater number of children (2.9 vs. 1.2 in addition to the child with ESRD) (odds ratio 3.23, p < 0.01) and a greater number of years of education (12.4 vs. 10.4) (odds ratio 2.14, p < 0.05). Hence, the availability of living kidney donors for our inner city children is severely limited by a high rate of single parenthood and a high rate of comorbid conditions in the parental donor pool. Furthermore, there is a diminished capacity of the available parent, particularly the mother, to donate as she tends to have numerous other dependents.

Structure of Thermotoga maritima stationary phase survival protein SurE: a novel acid phosphatase

BACKGROUND

The rpoS, nlpD, pcm, and surE genes are among many whose expression is induced during the stationary phase of bacterial growth. rpoS codes for the stationary-phase RNA polymerase sigma subunit, and nlpD codes for a lipoprotein. The pcm gene product repairs damaged proteins by converting the atypical isoaspartyl residues back to L-aspartyls. The physiological and biochemical functions of surE are unknown, but its importance in stress is supported by the duplication of the surE gene in E. coli subjected to high-temperature growth. The pcm and surE genes are highly conserved in bacteria, archaea, and plants.

RESULTS

The structure of SurE from Thermotoga maritima was determined at 2.0 A. The SurE monomer is composed of two domains; a conserved N-terminal domain, a Rossman fold, and a C-terminal oligomerization domain, a new fold. Monomers form a dimer that assembles into a tetramer. Biochemical analysis suggests that SurE is an acid phosphatase, with an optimum pH of 5.5-6.2. The active site was identified in the N-terminal domain through analysis of conserved residues. Structure-based site-directed point mutations abolished phosphatase activity. T. maritima SurE intra- and intersubunit salt bridges were identified that may explain the SurE thermostability.

CONCLUSIONS

The structure of SurE provided information about the protein's fold, oligomeric state, and active site. The protein possessed magnesium-dependent acid phosphatase activity, but the physiologically relevant substrate(s) remains to be identified. The importance of three of the assigned active site residues in catalysis was confirmed by site-directed mutagenesis.

Cervical incompetence: the use of transvaginal sonography to provide an objective diagnosis

OBJECTIVE

To investigate the use of transvaginal sonography in monitoring the cervix in women at high risk of a preterm delivery.

STUDY DESIGN

One hundred and six women at high risk of preterm labor had regular cervical monitoring by transvaginal ultrasound throughout pregnancy from the second trimester to delivery. The study was designed to be observational, but intervention was considered if the cervical length fell below 10 mm.

RESULTS

Eleven women demonstrated opening of the cervical canal at rest or with fundal pressure before 24 weeks' gestation. Between 2 and 17 days later all 11 cervices progressively shortened to a cervical length of < 10 mm. Nine women had a cervical cerclage. Seven women had fetal membranes visible within the cervical canal at the time of cerclage. One woman miscarried at 18 weeks, and the other 10 had live births at a median gestational age of 36 (range, 27-38) weeks.

CONCLUSIONS

Cervical length shortening in the second trimester, once started, progressed to a cervical length under 10 mm. Opening of the cervical os at rest or in response to fundal pressure detected by transvaginal ultrasound appears to be the early ultrasound feature of cervical incompetence.

Effect of environmental factors on the kinetics of insulin fibril formation: elucidation of the molecular mechanism

In the search for the molecular mechanism of insulin fibrillation, the kinetics of insulin fibril formation were studied under different conditions using the fluorescent dye thioflavin T (ThT). The effect of insulin concentration, agitation, pH, ionic strength, anions, seeding, and addition of 1-anilinonaphthalene-8-sulfonic acid (ANS), urea, TMAO, sucrose, and ThT on the kinetics of fibrillation was investigated. The kinetics of the fibrillation process could be described by the lag time for formation of stable nuclei (nucleation) and the apparent rate constant for the growth of fibrils (elongation). The addition of seeds eliminated the lag phase. An increase in insulin concentration resulted in shorter lag times and faster growth of fibrils. Shorter lag times and faster growth of fibrils were seen at acidic pH versus neutral pH, whereas an increase in ionic strength resulted in shorter lag times and slower growth of fibrils. There was no clear correlation between the rate of fibril elongation and ionic strength. Agitation during fibril formation attenuated the effects of insulin concentration and ionic strength on both lag times and fibril growth. The addition of ANS increased the lag time and decreased the apparent growth rate for insulin fibril formation. The ANS-induced inhibition appears to reflect the formation of amorphous aggregates. The denaturant, urea, decreased the lag time, whereas the stabilizers, trimethylamine N-oxide dihydrate (TMAO) and sucrose, increased the lag times. The results indicated that both nucleation and fibril growth were controlled by hydrophobic and electrostatic interactions. A kinetic model, involving the association of monomeric partially folded intermediates, whose concentration is stimulated by the air-water interface, leading to formation of the critical nucleus and thence fibrils, is proposed.

Health problems among workers of iron welding machines: an effect of electromagnetic fields

The possible effects of EMFs on 100 workers were studied by means of structured interview and rating of subjective symptoms. As control 41 sewing machine operators and assembly workers were chosen, interviewed and likewise tested. The present Indian ceiling value of 250 Tesla for the equivalent power density was exceeded in more than 50% of the machines. The highest leakage fields, for EMFs, were found near machines, which gave a high exposure to the hands. Eye irritation complaints were reported by 40% of the workers. The fertility outcome did not show any significant result.

Real-time ultrasonography of ovaries and breeding of the one-humped camel (Camelus dromedarius) during the early postpartum period

Ovaries of 17 adult, pleuriparous, and lactating one-humped she-camels (Camelus dromedarius) were examined per rectum for uterine involution and for presence of follicles (>/=1.0 cm diameter) by real-time ultrasonography at the National Research Centre on Camel at Bikaner, India at 30, 45, 60, 75, and 90 days postpartum. Involution was completed from 25 to 30 days postpartum and follicles (>/=1.0 cm diameter) could be found in only nine camels (52.7%) from 34 to 70 days postpartum. These nine camels were mated with virile studs. Four conceived and were confirmed pregnant at 60 days.

Caspase-3: A vulnerability factor and final effector in apoptotic death of dopaminergic neurons in Parkinson's disease

Caspase-3 is an effector of apoptosis in experimental models of Parkinson's disease (PD). However, its potential role in the human pathology remains to be demonstrated. Using caspase-3 immunohistochemistry on the postmortem human brain, we observed a positive correlation between the degree of neuronal loss in dopaminergic (DA) cell groups affected in the mesencephalon of PD patients and the percentage of caspase-3-positive neurons in these cell groups in control subjects and a significant decrease of caspase-3-positive pigmented neurons in the substantia nigra pars compacta of PD patients compared with controls that also could be observed in an animal model of PD. This suggests that neurons expressing caspase-3 are more sensitive to the pathological process than those that do not express the protein. In addition, using an antibody raised against activated caspase-3, the percentage of active caspase-3-positive neurons among DA neurons was significantly higher in PD patients than in controls. Finally, electron microscopy analysis in the human brain and in vitro data suggest that caspase-3 activation precedes and is not a consequence of apoptotic cell death in PD.

Complete necrosis of the renal pelvis and ureter after cadaveric renal transplantation

Urological complications of transplantation, in particular, necrosis of the transplanted ureter, are rare. We report on a 20-yr-old boy who received a well-matched cadaveric kidney transplant that was complicated by poor graft function and subsequent exploratory laparotomy for complete necrosis of the renal pelvis and ureter.

Outcome of twin pregnancy in a renal transplant recipient treated with tacrolimus

Our report describes the outcome of a twin pregnancy in a woman who was maintained on tacrolimus after a living related renal transplant. Both babies born at 32 weeks of gestation developed severe respiratory distress requiring ventilator assistance and went on to develop congestive heart failure. Echocardiograms on both babies showed dilated heart chambers. Twin A succumbed to complications, but twin B, who was treated more aggressively with vasopressors, recovered. Autopsy findings on twin A revealed a thrombotic cardiomyopathy with degeneration of cardiac muscle. We believe that the unusual outcome in this set of twins may have been a result of cardiomyopathy secondary to tacrolimus used by the mother during her pregnancy.

Significance of p53 overexpression in bone marrow biopsies from patients with bone marrow failure: aplastic anemia, hypocellular refractory anemia, and hypercellular refractory anemia

Among patients with bone marrow failure, differentiating acquired aplastic anemia (AA) from hypocellular refractory anemia (hypo RA) can be a difficult and challenging task. Morphological, cytochemical, immunocytochemical, and cytogenetic studies may provide tools for discriminating between both entities. In addition, differences in the pattern of proliferation and apoptosis of bone marrow cells in AA and in the myelodysplastic syndrome have been reported. Because of the correlation between p53 and apoptosis, we examined the overexpression of p53 on bone marrow biopsies in RA and AA. Our study included 14 patients with hypo RA, 14 patients with hypercellular (hyper) RA, ten patients with classic acquired AA, and 37 hematologically normal individuals. p53 was overexpressed in eight (57%) hypo RA patients and 11 (79%) hyper RA patients. All normal individuals and patients with AA showed no overexpression of p53 in their marrow. These results were statistically significant:p < 0.01 (AA vs hypo RA), p<0.001 (AA vs hyper RA), while the difference between hypo RA and hyper RA was not statistically significant. We conclude that p53 overexpression in bone marrow biopsies is a valuable tool for studying bone marrow failure and may provide additional information to help differentiate hypo RA from acquired AA.

Wandering spleen causing splenic flexure volvulus and obstruction

A 48-year-old woman presented with symptoms of distal bowel obstruction. On examination she had abdominal distension and a lump in the left lumbar and iliac regions. X-ray revealed distension of the colon with dilated small bowel. Exploration revealed an enlarged ptotic spleen whose pedicle caused obstruction of the colon. There was concomitant partial volvulus of the splenic flexure around the splenic pedicle. The splenic vein was thrombosed. Splenectomy was performed.

A double-blind, placebo controlled study of postmenopausal oestrogen replacement therapy and carotid artery pulsatility index

OBJECTIVE

To determine whether postmenopausal oestrogen replacement therapy affects carotid artery pulsatility index.

DESIGN

A prospective double-blind placebo controlled trial.

SETTING

University associated teaching hospital.

PARTICIPANTS

Twenty-eight postmenopausal women who were more than 12 months postmenopausal and who had not taken exogenous oestrogen.

INTERVENTIONS

Independent randomisation to receive oral oestradiol (2 mg daily) or placebo for 20 to 24 weeks.

MAIN OUTCOME MEASURES

Internal carotid artery Doppler pulsatility index, measured within one centimetre of the carotid bifurcation.

RESULTS

Replicate data were available from 27 women. The mean pulsatility index decreased by -0.11 in 15 women receiving oestradiol, compared with a mean rise of 0.05 in the 12 women who received placebo (P = 0.006, 95% CI for treatment difference 0.06-0.31).

CONCLUSIONS

Oestrogen replacement decreases postmenopausal carotid artery pulsatility index, probably reflecting decreased peripheral vascular resistance. This is a further mechanism whereby hormone replacement therapy may impart cardiovascular protection.

Seroprevalence of toxoplasmosis in Jodhpur, India

Toxoplasma gondii specific IgG and IgM antibody levels were determined in sera of 135 healthy human volunteers comprising of students (85), staff (50) and 115 patients comprising of 65 adults and 50 children whose blood was taken for some other investigations. None of the subjects had congenital disease or any other sign or symptom suggestive of Toxoplasmosis. None of the women had had obstetric history or gave birth to infants with congenital defects. Toxoplasma gondii specific IgG and IgM antibodies were assayed by ELISA. Sero positivity to one or both classes of antibodies was observed in 17.2%. However, active infection i.e. IgM positive or high (> 210 Eu/ml) level, IgG was observed only in 4.4%. Antibody levels and seropositivity rate increased with age. No statistically significant differences in the levels of antibodies were observed in relation to sex, socioeconomic status, place of living (rural/urban) and dietary habit (vegetarian/non vegetarian). However, relatively higher prevalence of seropositivity was observed in males and villagers.