bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison between two cord blood collection strategies
Authors: Solves P. , Mirabet V. , Larrea L. , Moraga R. , Planelles D. , Saucedo E. , Uberos F. C. , Planells T. , Guillen M. , Andres A. , Monleon J. , Soler M. A. , Franco E.
Published: December 2004

Background and objectives.  Collection strategy is the first step for collecting good quality cord blood (CB) units. There are two principal different techniques to collect CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB‐bank trained personnel. In this study, the benefits and disadvantages between two different CB collection strategies were evaluated in order to improve CB bank methodology.

Design and methods.  Valencia CB bank maintains the two different collection strategies aforementioned. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation, samples for cell counts, CD34 analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques.

Results.  Obstetric date and umbilical CB was obtained from 848 vaginal (484 collected in uterus and 364 collected ex uterus). The proportion of excluded CB units before processing was 33% for ex uterus and 25% for in uterus. The difference was statistically significant. A larger volume and a higher number of total nucleated cells, CD34+ cells and CFUs were harvested in the in uterus collection group.

Interpretation and conclusions.  Based on our findings, we conclude that the mode of collection influences the hematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimizing CB bank methodology.
Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation
Authors: Nieminen Kari , Huhtala Heini , Heinonen Pentti K.
Published: December 2004

Background.  To identify risk factors in recurrence and to evaluate anatomic and functional results of vaginal sacrospinous ligament fixation and pelvic floor reconstruction for genital prolapse.

Methods.  One hundred and thirty‐eight women underwent surgery for uterovaginal or vault prolapse. Follow‐up data were available for 122 cases; 83% were examined and others were interviewed by telephone. The median (range) follow‐up was 24 (1–141) months. Cox regression was used to identify risk factors associated with recurrence; uni‐ and multivariate regression was used to identify risk factors underlying postoperative infections because infections were found to be a risk factor of recurrence. Recurrence‐free survival was estimated using the Kaplan–Meier method.

Results.  Seven (5%) patients suffered severe cardiopulmonary complications including one postoperative death due to a pulmonary embolism. Twenty‐six (21%) patients suffered a recurrence, 14 with cystocele. Ten patients with recurrence were symptomatic and six underwent a re‐operation. The Cox regression model showed that vaginal cuff infection raised the odds ratio (OR) for recurrence to 6.13 [confidence interval (CI) 1.80–20.83] and urinary tract infection to 3.65 (CI 1.40–9.47). In both uni‐ and multivariate analysis, lack of intravenous antibiotic prophylaxis, age less than 73 years and vaginal ulcerations were statistically significant risk factors for postoperative infection. Eleven (33%) out of 33 sexually active women reported improvement and three (9%) complained of dyspareunia.

Conclusions.  Transvaginal sacrospinous ligament fixation with pelvic floor repair is an effective means of correcting both vault prolapse and uterine procidentia. Women who wish to preserve coital function will also benefit from this operation. Postoperative infection is an independent and most important individual risk factor underlying recurrence. Prophylactic antibiotics seem to be effective in reducing the rate of postoperative infections.
The use of general anesthesia for the tension‐free vaginal tape procedure and concomitant surgery
Authors: Lo Tsia‐Shu , Lin Cheng‐Tao , Huang Huei‐Jean , Chang Chia‐Lin , Liang Ching‐Chung , Soong Yung‐Kuei
Published: December 2004

Background. To study the efficacy of performing the TVT procedure and concomitant surgery under general anesthesia in the management of urinary stress incontinent patients.

Methods. Eighty‐six women with genuine stress incontinence without pelvic relaxation syndrome were surgically managed. TVT procedures were performed using vigorous manual pressure against the abdominal wall to position and adjust the vaginal tape and ensuring no lifting of the urethra by intraoperative introital ultrasonography. Concurrent gynecologic procedures were performed, if indicated. The urodynamic studies, 1‐h pad‐tests and introital ultrasonography were performed preoperative and 1 year after surgery.

Result. Six women were excluded for various reasons. Among 80 patients, 74 (92.5%) were cured, five improved and one failed. No major intra‐or postoperative complications occurred. After surgery, urine leakage observed on the pad‐tests was significantly reduced from a mean of 24 to 1.3 g. The operating time for the TVT procedure was 23 min, and postoperative hospital stay was 2.8 days. The position and mobility of the bladder neck showed no significant difference before and after surgery. De nova detrusor instability was observed in one patient. Spontaneous voiding with adequate volume of postvoid residual urine was noted for all patients by the fourth day postoperatively. Urodynamic parameters related to the voiding dysfunction showed no significant difference pre‐ and postoperatively.

Conclusion. With modifications of the technique and the aid of intraoperative ultrasonography, the TVT procedure can be performed under general anesthesia. The procedure is safe, effective, minimally invasive, and has an additional benefit of correcting various coexisting gynecologic disorders in a single operation.
Incidence, treatment and outcome of peripartum sepsis
Authors: Kankuri Esko , Kurki Tapio , Carlson Petteri , Hiilesmaa Vilho
Published: December 2004

Background and methods.  Clinical and microbiological features of maternal sepsis in the peripartum period (7 days before to 7 days after delivery) were analyzed to determine possible risk factors, optimal treatment and outcome. In 43 483 deliveries during 1990–98, laboratory‐confirmed bacteremia was found in 41 (5.1%) out of 798 clinically suspected septic infections.

Results.  Preterm deliveries were associated with a crude 2.7‐fold risk for peripartum sepsis as compared to term deliveries. Antepartum sepsis was associated with a crude 2.6‐fold risk for cesarean section, while postpartum sepsis was 3.2 times more likely to occur after cesarean section than after vaginal delivery. A combination of cefuroxime and metronidazole was used in 80% (33/41) of all treatments. All mothers recovered well, and only one suffered from septic shock.

In total, 42 bacterial strains, representing 18 different bacterial species, were isolated from the blood cultures; 37 strains (88%, 37/42) were aerobic and five (12%, 5/42) were anaerobic. The most common species were betahemolytic streptococci, Escherichia coli and Staphylococcus aureus. Most microbes (81%, 34/42) were found to be susceptible to first‐ or second‐generation cephalosporins.

Conclusion.  Our analysis shows that peripartum sepsis is associated with preterm pregnancies and cesarean sections. Treatment of peripartum sepsis with second‐generation cephalosporin is usually effective, and the outcome is good.
Influence of temperature on corneas stored in culture medium. A comparative study using functional and morphological methods
Authors: Sandboe Frode D. , Medin Walther , Frøslie Kathrine Frey
Published: December 2004

Purpose: To investigate the influence of storage temperature on corneal swelling and on endothelial morphology in cultured corneas.

Material and methods: Forty‐eight rabbit corneas were separated into four groups of 12. The corneas were stored in culture medium at 37 ° (group 37), 34 ° (group 34), 31 ° (group 31) and 23 ° (room temperature) (group 23), respectively. All the corneas were monitored by weight recordings on days 0, 1, 2, 3, 4 and 7. On day 7, corneas were prepared for scanning electron microscopy and endothelial cell counts were performed.

Results: Lowering the temperature of the culture medium resulted in less swelling. Both temperature and storage time had significant effects on corneal swelling (p < 0.001). On day 7, the observed mean weight increase was 131.2%, 143.0%, 172.5% and 199.7% in groups 23, 31, 34 and 37, respectively. The estimated mean daily weight increase for the corneas were 2.6%, 4.0%, 9.1% and 16.0% in groups 23, 31, 34 and 37, respectively. Scanning electron microscopy showed an intact endothelial layer in all groups after 7 days and there were no statistically significant differences in endothelial counts between groups 23, 31 and 34. In group 37, the cell borders were difficult to distinguish after 7 days and no meaningful count could be performed.

Conclusions: The swelling rate of cultured corneas is significantly less at 23 ° and 31 ° than it is at 34 ° and 37 ° during the first week. This is most likely the result of a greatly increased barrier effect at lower temperatures. Whereas weight recording revealed profound differences between the groups, scanning electron microscopy and endothelial cell counting did not. The results support the hypothesis that storage at 37 ° is not optimal in culturing corneas. Lowering the temperature below body temperature, and even lower than 31 °, results in less corneal swelling.
Indocyanine green angiography in pigmented paravenous retinochoroidal atrophy
Authors: Yanagi Yasuo , Okajima Osamu , Mori Mikiro
Published: December 2004

Purpose:  To report long‐term follow‐up of patients with pigmented paravenous retinochoroidal atrophy (PPRCA) and to assess the involvement of the choroid and retinal pigment epithelium (RPE) in PPRCA.

Methods:  Clinical features of PPRCA were studied retrospectively in four patients followed for 6–26 years. Retinal pigment epithelium and choroidal changes were analysed with fluorescein and indocyanine green (ICG) angiography.

Results:  The two younger patients, aged 16 and 28 years and followed for 6 and 18 years, respectively, showed stationary RPE atrophy and pigmentation. Indocyanine green angiography visualized slight to modest atrophy of the choriocapillaris. The two older patients, aged 69 and 70 years and each followed for 26 years, showed slow progression of disease during follow‐up. Indocyanine green angiography revealed choriocapillaris atrophy partly extending into the areas shown as hyperfluorescent in fluorescein angiography.

Conclusion:  Pigmented paravenous retinochoroidal atrophy is probably a slowly progressive disease, particularly in older patients. The choriocapillaris atrophy in this disease is more properly evaluated by ICG angiography and can be underestimated by fluorescein anigiography.
Metastases in the ophthalmic region in Denmark 1969–98. A histopathological study
Authors: Fahmy Peter , Heegaard Steffen , Jensen Ove Aksel , Prause Jan Ulrik
Published: December 2004

Purpose:  To evaluate the patterns of origin and anatomical localization of histologically verified metastases in the ophthalmic region in Denmark during 1969–98, and to compare the findings with those of a similar study for the period 1944–68.

Methods:  All metastatic lesions presented at the Eye Pathology Institute, University of Copenhagen during the period 1968–98 were investigated.

Results:  Metastases were found in 81 specimens from the eye and eye region in 76 patients (32 men, 44 women). Five patients had bilateral involvement. The most frequent site of involvement was the uvea (63%), followed by the orbit (26%) and the eyelids (10%). Breast cancer accounted for the most frequent primary tumour (38%), followed by lung cancer (24%) and skin melanoma (14%).

Conclusion:  The pattern of anatomical location of metastases in the ocular region has not changed since 1944. The incidence of metastases has fallen significantly throughout the period.
The effects of aspirin and warfarin therapy on haemorrhage in vitreoretinal surgery
Authors: Narendran Niro , Williamson Tom H
Published: December 2004

Background:  No substantial recommendations exist regarding the management of anticoagulant drugs prior to ocular surgery. Stopping anticoagulation can cause fatal emboli, but sight‐threatening bleeds may occur if anticoagulation is continued. We examined the effects of anticoagulation on vitreoretinal surgery.

Methods:  Clinical details were prospectively entered on a database. The anticoagulant status of 541 consecutive patients undergoing vitreoretinal surgery was recorded.

Results:  Sixty patients in the study were taking aspirin and seven were taking warfarin. There were 11 cases of choroidal haemorrhage, one of which involved a warfarin user. Of 325 retinal detachment repairs, 21 (6.5%) had preoperative vitreous haemorrhages. Two of these patients were on aspirin and two were on warfarin. Sixty‐six vitrectomies were performed for diabetic vitreous haemorrhages, of which nine re‐bled postoperatively. One of these patients was taking warfarin. The association of warfarin with bleeding was statistically significant (relative risk 6.185).

Conclusion:  Anticoagulation had no effect on the number of significant perioperative (choroidal) haemorrhages. Aspirin had little effect on bleeding during vitreoretinal surgery. Warfarin, however, was associated with bleeding complications. We suggest that aspirin should not be stopped prior to surgery. Warfarin may be stopped if the patient's thromboembolic risk is low.
The Finnish evidence‐based guideline for open‐angle glaucoma
Authors: Tuulonen A. , Airaksinen P. J. , Erola E. , Forsman E. , Friberg K. , Kaila M. , Klemetti A. , Mäkelä M. , Oskala P. , Puska P. , Suoranta L. , Teir H. , Uusitalo H. , Vainio‐Jylhä E. , Vuori M‐L.
Published: December 2004

In most patients, chronic open‐angle glaucoma is a slowly progressive disease. Eyes with very high intraocular pressure (IOP > 30 mmHg) represent an exception to this and should be treated and followed extremely intensively. As lowering IOP is, so far, the only means of treating glaucoma, the majority of research reports deal with the IOP‐lowering effect of the treatment. The primary goal of treatment, however, is to prevent glaucomatous damage to the structures and function of the eye. The effectiveness of treatment is monitored with optic disc and retinal nerve fibre layer imaging and with visual field examinations. If the glaucomatous changes are progressing, more effective treatment should be given. In the course of follow‐up, it should be noted that the changes in the optic nerve structure and function appear and progress at different time‐points with delays of up to several years. The assessment of abnormalities is dependent on the examination method and requires a great deal of experience on the part of the examiner. The important risk factors in glaucoma are elevated IOP (even if IOP is within normal range in half of patients ), age, positive family history, exfoliation, race and myopia.
Vigabatrin‐associated visual field constriction in a longitudinal series. Reversibility suggested after drug withdrawal
Authors: Fledelius Hans C.
Published: December 2004

Purpose:  To evaluate through a longitudinal study the effects on visual fields of long‐term vigabatrin medication in patients with partial epilepsy and to discuss visual field screening strategies.

Methods:  A total of 26 patients aged 14–68 years with a mean history of vigabatrin medication of 8.5 years (range 2–14 years) were followed by manual kinetic Goldmann perimetry (objects IV,4 and I,4) for 6–26 months (mean value 12.3 months). At time zero and at follow‐up, each patient was assigned a ‘pooled’ averaged value, as a linear percentage of normal isopter position, for the two objects as tested nasally and temporally in the five most horizontal meridians on the Goldmann chart. Twelve eyes from nine adults (age 24–60 years) served as controls.

Results:  Constrictions were recorded in 24 of 26 patients at baseline. Averaged isopters ranged from 8% to 96% of the controls' averaged isopter positions. Median values of 71.5% and 60.5% for large and small objects, respectively, indicated that the smaller object was more sensitive to visual field constriction. There was no difference in the degree of constriction between nasal and temporal hemifields. Significant improvement in the visual field (mean gain 13.6% units) was seen in the eight patients who underwent full drug withdrawal. No similar improvement was seen in the 12 patients still on full dose or the six with reduced intake.

Conclusions:  Most Danish patients on long‐term vigabatrin medication have suffered some visual field loss. Contrary to most clinical evidence so far, the present follow‐up study indicates some reversibility of visual field loss after drug withdrawal. Kinetic Goldmann perimetry appears to be a fair alternative to computerized static perimetry techniques for screening and following vigabatrin‐treated patients.
Indocyanine green angiography in a case of unilateral recurrent posterior acute multifocal placoid pigment epitheliopathy
Authors: Schneider Ulrike , Inhoffen Werner , Gelisken Faik
Published: December 2004

Purpose:  To report a case of unilateral recurrent acute posterior multifocal placoid pigment epitheliopathy (APMPPE) imaged by indocyanine green (ICG) angiography.

Methods:  A complete ophthalmological evaluation, including fluorescein and ICG angiography, was performed.

Results:  Acute posterior multifocal placoid pigment epitheliopathy recurred 3 months after the initial disease in a 23‐year‐old male patient. On ICG angiography, both new, active and healed, inactive lesions demonstrated hypofluorescence throughout the study. The healed lesions were smaller in size and irregularly shaped, whereas the new, active lesions were larger in size, round and more confluent.

Conclusion:  New, active and healed, inactive lesions in APMPPE can both be imaged and differentiated by ICG angiography.
Suppressors of cytokine signalling: SOCS
Authors: LARSEN LYKKE , RÖPKE CARSTEN
Published: December 2004

The mechanism of positive regulation of cytokine signalling pathways has been well investigated, whereas our knowledge of negative regulation is relatively sparse. Here we review recent literature on important negative regulators: the family of suppressors of cytokine signalling, SOCS, consisting of eight members (SOCS‐1 to SOCS‐7 and CIS) all sharing a central SH2 domain and a C‐terminal SOCS box. Expression of CIS, SOCS‐1, SOCS‐2 and SOCS‐3 is induced by various cytokines, and overexpression studies in various cell lines have demonstrated their inhibitory roles. These family members have been implicated in the negative regulation of several pathways, particularly the JAK/STAT pathway, and since this signalling pathway is responsible for their induction, they form part of a classical negative feedback circuit. To date, at least three different modulating mechanisms have been demonstrated: through the SH2 domain they bind to phosphotyrosines on the target protein, leading to inhibition of signal transduction by N‐terminal inactivation of JAK, by blocking access of STAT to the receptor sites, or by SOCS box‐targeting bound proteins to proteasomal degradation. In gene modification studies in mice, it has been demonstrated that SOCS‐1 plays an important role in IFNγ‐regulation and T‐cell differentiation, while SOCS‐2 seems necessary for normal growth regulation. SOCS‐3−/− mice die during embryogenesis for a reason still not fully understood, but insufficient control of fetal erythropoiesis or defects in placental development may be involved. The physiological role for the other family members, as well as their molecular regulation mechanisms, remain to be revealed.
Defining the glycophenotype of squamous epithelia using plant and mammalian lectins. Differentiation‐dependent expression of α2,6‐ and α2,3‐linked N‐acetylneuraminic acid in squamous epithelia and carcinomas, and its differential effect on binding of the endogenous lectins galectins‐1 and ‐3
Authors: HOLÍKOVÁ ZUZANA , HRDLIČKOVÁ‐CELA ENKELA , PLZÁK JAN , SMETANA, JR. KAREL , BETKA JAN , DVOŘÁNKOVÁ BARBORA , ESNER MILAN , WASANO KOJIRO , ANDRÉ SABINE , KALTNER HERBERT , MOTLÍK JAN , HERCOGOVÁ JANA , KODET ROMAN , GABIUS HANS‐JOACHIM
Published: December 2004

A thorough characterization of the properties of squamous epithelial cells is necessary in order to improve our understanding of the functional aspects of normal development and malignant aberrations. Up to now, studies have focused almost exclusively on monitoring distinct protein markers. With our growing awareness of the coding function of glycan chains of cellular glycoconjugates and their interaction with receptors (lectins) in situ, defining the glycophenotype of these cells has become an important issue. Whereas the commonly applied plant lectins are tools used to map the presence and localization of biochemically defined saccharide epitopes, the introduction of endogenous (mammalian) lectins to this analysis enables us to take the step from monitoring the presence of glycan to understanding the functional implications by revealing ligand properties of the detected epitope for tissue lectin. Thus, in this study we investigated a distinct aspect of glycosylation using plant and mammalian lectins, i.e. the linkage type of sialylation. We first mapped the expression profile of the type of sialylation (α2,3‐ or α2,6‐linked) by plant lectins. Based on the hypothesis that this factor regulates accessibility of ligands for endogenous lectins we introduced two labeled galectins to this study. Galectin‐3 (but not galectin‐1) binding was related to cell differentiation in normal adult and developing epithelia, cultured epidermal cells, and carcinomas derived from these epithelia. The presented data suggest that α2,6‐linked N‐acetyl‐D‐neuraminic acid moieties could serve to mask galectin‐3‐reactive glycoepitopes. As a consequence, monitoring of the linkage type of sialic acid in glycans by plant lectins therefore has implications for the extent of glycan reactivity with endogenous lectins, pointing to a potential function of changes in sialylation type beyond these cell and lectin systems.
Lack of lipoprotein‐dependent effects on the cytotoxic interactions of Actinobacillus actinomycetemcomitans leukotoxin with human neutrophils
Authors: JOHANSSON A. , CLAESSON R. , BELIBASAKIS G. , MAKOVEICHUKI E. , HÄNSTRÖMI L. , OLIVECRONAI G. , KALFAS S.
Published: December 2004

A high odds ratio has been reported for hyperlipidemia and periodontal diseases in humans, and the severity of periodontitis seems to correlate with the hyperlipidemic status of the patients. Early studies indicated that the lipoprotein‐containing fraction of the serum enhances the leukotoxic activity of the periodontopathogen Actinobacillus actinomycetemcomitans against human polymorphonuclear leukocytes (PMNL). The protease inhibitors of normal serum account for this enhancement, while delipidated serum has no effect on the leukotoxin‐dependent PMNL cytolysis. No information exists for the effect of serum lipoproteins or hyperlipidemic serum. The aim of this study was to evaluate the role of serum lipoproteins in the interaction of the leukotoxin of A. actinomycetemcomitans with human PMNL. Purified leukotoxin was mixed with human PMNL prepared from venous blood of healthy subjects and various varying amounts of hyperlipidemic or delipidated serum, or purified serum lipoproteins. The cytolytic activity of leukotoxin was determined by activity of the cytosol enzyme lactate dehydrogenase released from injured PMNL. The degranulating activity of the toxin was measured through the release of the granule components elastase and lactoferrin. Normal human serum without leukotoxin‐neutralizing antibodies caused a 4–fold enhancement of the leukotoxic activity when present at concentrations of 5–10% in the reaction mixture. Serum lipoproteins had no effect when added at concentrations that occur normally in serum. At high concentrations, purified low density and very low‐density lipoproteins increased the leukotoxicity of the mixture. Nevertheless, hyperlipidemic serum prepared from a normal serum by the addition of autologous lipoproteins had no influence on the leukotoxin‐caused cytolysis compared to the normal serum. Pre‐incubation of PMNL for 1 h in hyperlipidemic or delipidated serum had no effect on the leukotoxin‐induced degranulation of PMNL. The results indicate that the cytotoxic interactions of A. actinomycetemcomitans leukotoxin against human PMNL are not influenced by the presence of serum lipoproteins.
Nosocomial Legionella pneumophila serogroup 5 outbreak associated with persistent colonization of a hospital water system
Authors: PEROLA O. , KAUPPINEN J. , KUSNETSOV J. , HEIKKINEN J. , JOKINEN C. , KATILA M. L.
Published: December 2004

An outbreak of infections caused by Legionella pneumophila serogroup 5 was detected in a university hospital, and nosocomial reservoirs of the legionella epidemic were examined. Clinical isolates from two patients who had been affected by the L. pneumophila serogroup 5 outbreak, and from another patient with a legionella infection caused by the same serogroup 3 years later, were compared to L. pneumophila serogroup 5 isolates from the hospital water supply by two molecular methods, amplified fragment length polymorphism (AFLP) analysis and random amplified polymorphic DNA analysis (RAPD). Genotyping confirmed the epidemiological linkage of the first two patients, and linked their infections with the hospital water supply. The third clinical strain, which was also linked to the hospital water, was very similar to the epidemic strain. Even though the water distribution system was sanitized (superheat and flush sanitation), the epidemic strain was shown to be persisting in the hospital water outlets several years after its initial discovery.
Primary marginal zone B‐cell lymphoma of the lymph node resembling plasmacytoma arising from a plasma cell variant of Castleman's disease. A clinicopathological and immunohistochemical study of seven patients
Authors: KOJIMA MASARU , NAKAMURA SHIGEO , MOTOORI TADASHI , SHIMANO SHUNICHI , MURAYAMA KAYAKO , TAMAKI YOSHIO , SHIMIZU KAZUHIKO , OYAMA TETSUNARI , SUGIHARA SHIRO , SAKATA NORIYUKI , MASAWA NOBUHIDE
Published: December 2004

Nodal marginal zone B‐cell lymphomas (NMZBL) occasionally represent prominent plasma cell differentiation. Recently, we presented a patient with NMZBL who exhibited histological features that resembled plasmacytoma arising from a localized plasma cell variant of Castleman's disease. To further clarify the clinicopathological, immunohistochemical, and genotypical findings, we studied seven such patients. Clinically, these patients were characterized by localized disease and an indolent clinical course with a slowly growing bulky mass in the affected lymph node. Only one patient exhibited paraproteinemia. Histologically, the lesions were characterized by numerous evenly distrubuted germinal centers in extensive sheets of plasma cells. Various numbers of centrocyte‐like (CCL) cells arranged in a marginal zone distribution pattern occupied the peripheral region of the lymph node. The majority of the lymphoid follicles had atrophic or regressive germinal centers. A few lymphoid follicles were colonized by CCL cells. Immunohistochemistry showed that all of the lesions contained a monoclonal plasma cell population. In three tumors, a number of the CCL cells had a similar light chain restriction pattern to that observed in plasma cells. Two of the four patients evaluated exhibited clonal bands for the IgH gene by polymerase chain reaction assay. Moreover, the presence of surface IgM+, IgD− and CD27+ CCL− cells suggests that these tumors are derived from memory B‐lymphocytes.
Antibodies against β‐lactamase can improve ceftazidime treatment of lung infection with β‐lactam‐resistant Pseudomonas aeruginosa in a rat model of chronic lung infection
Authors: CIOFU OANA , BAGGE NIELS , HØIBY NIELS
Published: December 2004

To test the hypothesis that antibodies against the chromosomal β‐lactamase of Pseudomonas aeruginosa (aβab) might act as β‐lactamase inhibitors in patients with cystic fibrosis and chronic lung infection with P. aeruginosa, we compared in a rat model of chronic lung infection the efficacy of treatment with ceftazidime in β‐lactamase‐immunized (group I) and non‐immunized (group II) rats. Chronic lung infection was established with alginate‐embedded P. aeruginosa producing high amounts of β‐lactamase in 133 Lewis rats. Prior to infection, group I (66 rats) was immunized three times at 2‐week intervals with purified β‐lactamase in incomplete Freund's adjuvant (IFA) and group II (67 rats) received IFA. Ceftazidime treatment was initiated after challenge and continued for 10 days, after which the rats were sacrificed and the lung bacteriology and pathology were analysed. Rat serum was analysed for the β‐lactamase inhibitory activity and aβab‐specific IgG and IgG subclasses titres. β‐lactamase inhibitory activity was found only in sera of rats belonging to group I and it was used to divide these rats into two subgroups: rats whose sera inhibited ≥75% of β‐lactamase activity (responders) and rats whose sera inhibited ≤25% of β‐lactamase activity (non‐responders). The responder subgroup had significantly smaller pathological areas in the lungs and lower cfu/ml lung homogenate compared to the non‐immunized group (p=0.02 and p=0.01, respectively) and compared to the non‐responder subgroup (p=0.008 and p=0.0001, respectively). On the day of challenge, significantly higher titres of aβab‐specific IgG and IgG subclasses antibodies were found in the responders compared to the non‐responders (p < 0.0001). In the responder subgroup the avidity of IgG aβab was significantly higher than in the non‐responder subgroup (p=0.0003). Our study showed that aβab with β‐lactamase inhibitory activity raised by immunization with β‐lactamase can improve the outcome of treatment with ceftazidime of resistant P. aeruginosa in a rat model of chronic lung infection.
Oral fibroblasts produce more HGF and KGF than skin fibroblasts in response to co‐culture with keratinocytes
Authors: GRØN BIRGITTE , STOLTZE KAJ , ANDERSSON ANDERS , DABELSTEEN ERIK
Published: December 2004

The production of hepatocyte growth factor (HGF) and keratinocyte growth factor (KGF) in subepithelial fibroblasts from buccal mucosa, periodontal ligament, and skin was determined after co‐culture with keratinocytes. The purpose was to detect differences between the fibroblast subpopulations that could explain regional variation in epithelial growth and wound healing. Normal human fibroblasts were cultured on polystyrene or maintained in collagen matrix and stimulated with keratinocytes cultured on membranes. The amount of HGF and KGF protein in the culture medium was determined every 24 h for 5 days by ELISA. When cultured on polystyrene, the constitutive level of KGF and HGF in periodontal fibroblasts was higher than the level in buccal and skin fibroblasts. In the presence of keratinocytes, all three types of fibroblasts in general increased their HGF and KGF production 2–3 times. When cells were maintained in collagen, the level of HGF and KGF was decreased mainly in skin cultures. However, in oral fibroblasts, induction after stimulation was at a similar level in collagen compared to on polystyrene. Skin fibroblasts maintained in collagen produced almost no HGF whether with or without stimulation. The results demonstrate that the secretion of KGF and HGF in both unstimulated fibroblasts and in fibroblasts co‐cultured with keratinocytes is dependent on the type of fibroblasts. In general, the periodontal fibroblasts had the highest level of cytokine production. This high level of growth factor production may influence the proliferation and the migration of junctional epithelium and thereby influence the development of periodontal disease.
Early dissemination rates of Friend murine leukaemia virus variants correlate with late pathogenesis
Authors: BRULAND TORUNN , DAI HONG YAN , LAVIK LISS ANNE S. , DALEN ARE
Published: December 2004

FIS‐2, a less oncogenic, immunosuppressive variant of the Friend murine leukaemia virus (F‐MuLV), was used to explore whether the differences in biological features were related to early virus dissemination rates or sites of replication. We found that erythroblasts were the primary target cells for both F‐MuLV and FIS‐2, while B‐ and T‐cells were infected later in the infection. Although FIS‐2 replicated to similar titres as F‐MuLV, we observed a delay in peak viraemia titre and in the number of virus‐positive cells in bone marrow and spleen. Studies including the chimeric viruses RE3 (FIS‐2 LTR with a F‐MuLV background) and RE4 (F‐MuLV LTR with a FIS‐2 background) indicated that the delay in dissemination was due to mutations in FIS‐2 LTR. The kinetics for early virus replication correlated with previously reported mean latency time for virus‐induced erythroleukaemia in mice inoculated as newborns and with the onset of immunosuppression in adult mice. In addition, F‐MuLV‐induced late immunosuppression coincided with signs of erythroleukaemia and persistent viraemia. FIS‐2 induced a more moderate late immunosuppression without persistent viraemia or signs of erythroleukaemia. Overall, our findings indicated that early viral replication is a prognostic factor in murine retrovirus‐induced pathogenesis.
Predictive factors of developing diabetes mellitus in women with gestational diabetes
Authors: ÅBerg Anders E. B. , Jönsson Eva K. , Eskilsson Inger , Landin‐Olsson Mona , Frid Anders H.
Published: December 2004

Background.  To investigate which factors during gestational diabetes pregnancies correlate with the risk of developing impaired glucose tolerance or diabetes 1 year postpartum and to compare this risk in women with gestational diabetes and women with a normal oral glucose tolerance test during pregnancy.

Methods.  Of 315 women with gestational diabetes, defined as a 2‐hr blood glucose value of at least 9.0 mmol/l at a 75‐g oral glucose tolerance test, who delivered in Lund 1991–99, 229 (73%) performed a new test 1 year postpartum. We compared maternal and fetal factors during pregnancy with the test value at follow up. A control group of 153 women with a 2‐hr test value below 7.8 mmol/l during pregnancy were invited to a new test 1 year postpartum and 60 (39%) accepted.

Results.  At 1 year follow up, 31% of the women with gestational diabetes but only one of the 60 controls showed pathologic glucose tolerance and one had developed diabetes. The following factors in women with gestational diabetes were identified as predicting impaired glucose tolerance or diabetes at 1 year follow up: maternal age over 40 and – in a multiple regression analysis, independent of each other – a high 2‐hr value at oral glucose tolerance test during pregnancy and insulin treatment during pregnancy.

Conclusion.  The risk of developing manifest diabetes after gestational diabetes may be high enough to justify a general screening or diagnostic procedure in all pregnant women to identify women with gestational diabetes and a postpartum follow up program for them. This study did not identify any particular factor during pregnancy with enough precision to predict a later progression to diabetes.
Normal cervical changes in parous women during the second half of pregnancy – a prospective, longitudinal ultrasound study
Authors: Bergelin Ingrid , Valentin Lil
Published: December 2004

Objective. To determine what constitutes normal cervical changes during the second half of pregnancy in parous women delivering at term.

Design. The study comprises 21 healthy, pregnant parous women who all gave birth at term. They were examined with transvaginal ultrasound every two weeks from 24 gestational weeks until delivery. Cervical length and width were measured. The inner cervical os was assessed as being closed or open, the length and width of any opening were measured, and dynamic cervical changes (i.e. opening and closing of the inner cervical os during examination) were noted.

Results. Median cervical length was 41 mm (range 26–55) at the first examination and 29 mm (range 8–56) at the last examination. The corresponding figures for cervical width were 38 mm (range 29–47) and 46 mm (range 38–64). Cervical length decreased in 18 women but remained unchanged in three. Three patterns of change in cervical length were observed: in 12 women there was a steady, continuous decrease in cervical length (median decrease rate 1.1 mm/week, range 0.6–2.4); in four women the decrease rate accelerated towards the end of pregnancy, the median decrease rate after the change being 3.0 mm/week (range 1.5–4.8); and in two women there was a sudden drop in cervical length at term. Cervical width increased in 16 women but remained unchanged in five. Two patterns of change in cervical width were seen: 14 women manifested a steady continuous increase in cervical width (median 0.8 mm/week, range 0.4–1.8); in two women the increase rate accelerated from around 34 gestational weeks, the increase rate after the change being 4.1 and 5.9 mm/week, respectively. Opening of the internal cervical os was observed at least once in 11 (52%) women and was seen as early as at 24 and 25 gestational weeks in two women. The opening was always V‐shaped (median length 6 mm, range 4–17; median width 7 mm, range 3–20). Dynamic changes of the internal cervical os were seen in three women (14%) at 25, 30 and 41 gestational weeks, respectively.

Conclusion. The cervix of parous women decreases in length and increases in width from midpregnancy to term, but the pattern of change varies between individuals. Knowledge of the different patterns of normal change forms the basis of transvaginal ultrasound studies of pathological cervical changes during pregnancy.
A prospective observational study on tears during vaginal delivery: occurrences and risk factors
Authors: Samuelsson Ellen , Ladfors Lars , Lindblom Britta Gåreberg , Hagberg Henrik
Published: December 2004

Background. To ascertain the occurrence and distribution of various types of I‐IV degree tears, during childbirth, and analyze risk factors for perineal II degree tears.

Materials and methods. A total of 2883 consecutive vaginal deliveries, during 1995–97 at Sahlgrenska University Hospital in Göteborg Sweden, were included. All tears were classified according to an especially designed protocol, and risk factors for II degree tears were evaluated by use of univariate and logistic regression analysis.

Results. Only 6.6% of nulliparous parturients had no detectable tear as compared to 34.2% in parous women. Almost half of the women suffered from a II degree tear during birth, and a higher proportion of nulliparous (16.6%) than parous (9.4%) women had extensive perineal lacerations. In addition, nulliparous were more likely than parous parturients to be subjected to a perineotomy (18.1% versus 5.6%). Stepwise logistic regression analysis revealed that the following factors remained independently associated with II degree tear: slight perineal edema, high infant weight, excellent visualization of perineum, increasing age of the mother, excellent cooperation of the women, protracted second phase (> 60 min) and duration of second phase < 30 min.

Conclusions. The majority of women (78%) undergoing childbirth had a tear and 47.1% suffered from perineal lacerations. Nulliparous women were more likely to have severe perineal lacerations or episiotomies. Similar risk factors were found for II degree tears as previously shown for III/IV degree tears.
Effect of α‐trinositol on secretion induced byEscherichia coliST‐toxin in rat jejunum
Authors: Lahti A.‐M. , Cassuto J. , Yregård L. , Lindblom L. , Sinclair R. , Tarnow P.
Published: December 2004

Aim: d‐myo‐inositol‐1,2,6‐trisphosphate (α‐trinositol, PP56), is a synthetic isomer of the intracellular second messenger,d‐myo‐inositol‐1,4,5‐trisphospahate. The pharmacological actions ofα‐trinositol include potent anti‐inflammatory properties and inhibition of the secretion induced by cholera toxin and obstructive ileus. In the present study, we investigated whetherα‐trinositol was able to influence the secretion induced by heat‐stable ST‐toxin fromEscherichia coliin the rat jejunum.

Methods: A midline abdominal incision was performed in anaesthetized male Sprague–Dawley rats and a 6–7 cm long jejunal segment was isolated with intact vascular supply and placed in a chamber suspended from a force displacement transducer connected to a Grass®polygraph. Intestinal net fluid transport was continuously monitored gravimetrically. Crystalline ST‐toxin (120 mouse units) was introduced into the intestinal lumen and left there for the rest of the experiment. When a stable secretion was observed,α‐trinositol (60 mg kg−1 h−1) or saline were infused during 2 h, followed by a 2‐h control period.

Results: α‐Trinositol induced a significant (P < 0.001) inhibition of ST‐toxin secretion within 30 min, lasting until 2 h after infusion had stopped. The agent also moderately increased (P < 0.05) net fluid absorption in normal jejunum. Mean arterial pressure (P < 0.001) and heart rate (P < 0.001) were reduced byα‐trinositol.

Conclusion: The inhibition byα‐trinositol of ST‐toxin induced intestinal secretion is primarily secondary to inhibition of secretory mechanisms and only to lesser extent due to increased absorption. The detailed mechanisms of action have not been clarified but may involve suppression of inflammation possibly by means of cellular signal transduction.
Renal and hepatic expression of the ammonium transporter proteins, Rh B Glycoprotein and Rh C Glycoprotein
Authors: Weiner I. D. , Verlander J. W.
Published: December 2004

A family of ammonium transporter proteins was recently identified. Members of this family, Rh B Glycoprotein (RhBG) and Rh C Glycoprotein (RhCG) are expressed in the kidney and the liver, important tissues for ammonium metabolism. Immunohistochemical studies demonstrate basolateral RhBG immunoreactivity in the connecting segment (CNT) and collecting ducts, but not in the proximal tubule or the loop of Henle. Colocalization with thiazide sensitive cotransporter and carbonic anhydrase II confirms expression in the CNT, initial collecting tubule (ICT), and throughout the collecting duct. Colocalization with AE1 and pendrin demonstrates expression is greatest in A‐type intercalated cells in the cortical collecting duct (CCD), outer medullary collecting duct (OMCD) and inner medullary collecting duct (IMCD), present in the CCD principal cell, and not detectable in either pendrin‐positive CCD intercalated cells or in non‐intercalated cells in the OMCD and IMCD. RhCG immunoreactivity has a similar axial distribution as RhBG. However, RhCG immunoreactivity is apical, and is detectable in all CCD and outer stripe of OMCD cells. The liver, a second organ involved in ammonia metabolism, also expresses both RhBG and RhCG. Basolateral RhBG immunoreactivity is present in the perivenous hepatocyte, but is not present in either the periportal or mid‐zonal hepatocyte. Hepatic RhCG mRNA is expressed at lower levels than RhBG, and RhCG protein is detected in bile duct epithelium. These findings indicate that RhBG and RhCG are involved in at least two organs that transport ammonia, and that they are located in sites where they are likely to mediate important roles in ammonia transport.
Novel Ca2+ signalling mechanisms in vascular myocytes: symposium overview*
Authors: Li P.‐L. , Lee H. C. , Nelson M. T. , Meininger G. A. , Van Breemen C.
Published: December 2004

This commentary presents the proceedings of the symposium sponsored by Cardiovascular Section of American Physiological Society in San Diego, CA on 12 April 2003. The major focus of this symposium was on the actions and physiological relevance of several novel Ca2+ signalling mechanisms in vascular smooth muscle (VSM) cells. Five important topics were presented in this symposium including the discovery and roles of cyclic ADP‐ribose (cADPR) and nicotinic acid adenine dinucleotide phosphate (NAADP) in mediating Ca2+ release, Ca2+ sparks and activation of plasma membrane KCa channels in VSM cells, the role of cADPR‐mediated activation of ryanodine receptors in the control of vascular tone, the role of [Ca2+]i in mechanotransduction in the arterioles, and interactions of mitochondrial Ca2+ release and SR Ca2+ mobilization. The purpose of this symposium was to promote discussions and exchange of ideas between scientists with interests in Ca2+ signalling mechanisms and those with interests in vascular physiology and pharmacology. The cross‐fertilization of ideas is expected to greatly advance our understanding of the physiological and pharmacological relevance of these new Ca2+ signalling mechanisms.
Effects of prolonged exercise and recovery on sarcoplasmic reticulum Ca2+ cycling properties in rat muscle homogenates
Authors: Schertzer J. D. , Green H. J. , Fowles J. R. , Duhamel T. A. , Tupling A. R.
Published: December 2004

Aim:  To examine the effects of exercise and exercise plus active and passive recovery on sarcoplasmic reticulum (SR) Ca2+‐handling properties.

Methods:  Crude muscle homogenates were prepared from adult rat gastrocnemius muscle from two experiments. In one experiment, the muscle was extracted immediately after prolonged treadmill running (RUN), after a 45 min period of reduced exercise intensity (RUN+) following RUN and compared with controls (CON). In the second experiment, muscle was extracted during passive recovery following the same run protocol at 10 min (REC10), 25 min (REC25) and 45 min (REC45) and compared with CON.

Results:  Sarcoplasmic reticulum Ca2+‐uptake was 31% higher (P < 0.05) in RUN+ compared with CON and RUN. Higher values (P < 0.05) were also found in REC25 (48%) and REC45 (50%) compared with CON. Maximal Ca2+‐ATPase was increased by 23% (P < 0.05) in RUN+ compared with CON and RUN and by 65–68% (P < 0.05) in REC25 and REC45 compared with CON. A higher (P < 0.05) Hill coefficient for Ca2+‐ATPase activity was observed in RUN+ (2.3 ± 0.2) compared with CON (1.7 ± 0.2) or RUN (1.6 ± 0.2), but not for any REC conditions. In addition, the coupling ratio (Ca2+‐uptake/Ca2+‐ATPase activity) was higher (P < 0.05) in RUN+ (2.2 ± 0.10) compared with CON (1.9 ± 0.05) and RUN (1.9 ± 0.08).

Conclusions:  It is concluded that in crude homogenates, SR Ca2+‐uptake and Ca2+‐ATPase activity are elevated in recovery following prolonged running and that the elevation in these properties is more pronounced during passive compared with active recovery.