Prolactin synthetizing capacity of the human decidua during the first trimester of pregnancy

In vitro prolactin (PRL) synthesis by human decidua of early pregnancy (5-12 weeks gestation) was investigated. Tissues obtained during therapeutic abortions were incubated in oxygenated Gey's buffer supplemented with 20% fetal calf serum at 37 degrees C for 24 h. PRL production increased rapidly to 42.3 mU PRL/100 mg tissue wet weight until 8 weeks gestation and then slightly declined but these differences were not significant. There was not PRL production when chorion was incubated under similar conditions. A significant correlation was found when the initial PRL content in the decidua prior to incubation and the capacity of decidua to synthesize PRL were compared (r = 0.76, P less than 0.001). These data provide further evidence that human decidua can produce PRL in vitro. The finding that the rate of the PRL synthesis increases progressively in early pregnancy is in correlation with the intensive decidualization of the endometrium.     

Erythropoietin signaling promotes invasiveness of human head and neck squamous cell carcinoma

Erythropoietin (Epo) is used for managing anemia in cancer patients. However, recent studies have raised concerns for this practice. We investigated the expression and function of Epo and the erythropoietin receptor (EpoR) in tumor biopsies and cell lines from human head and neck cancer. Epo responsiveness of the cell lines was assessed by Epoetin-alpha-induced tyrosine phosphorylation of the Janus kinase 2 (JAK2) protein kinase. Transmigration assays across Matrigel-coated filters were used to examine the effects of Epoetin-alpha on cell invasiveness. In 32 biopsies, we observed a significant association between disease progression and expression of Epo and its receptor, EpoR. Expression was highest in malignant cells, particularly within hypoxic and infiltrating tumor regions. Although both Epo and EpoR were expressed in human head and neck carcinoma cell lines, only EpoR was upregulated by hypoxia. Epoetin-alpha treatment induced prominent JAK2 phosphorylation and enhanced cell invasion. Inhibition of JAK2 phosphorylation reduced both basal and Epo-induced invasiveness. Our findings support a role for autocrine or paracrine Epo signaling in the malignant progression and local invasiveness of head and neck cancer. This mechanism may also be activated by recombinant Epo therapy and could potentially produce detrimental effects in rhEpo-treated cancer patients.     

Association of systemic lupus erythematosus and Sjögren's syndrome

INTRODUCTION: Systemic lupus erythematosus and Sj?gren's syndrome are multisystemic autoimmune diseases which can be associated to each other. OBJECTIVE: To investigate if there are any distinct clinical, laboratory or serologic features due to the association of the two diseases that can influence the follow up of these patients. PATIENTS AND METHODS: The authors proved the association of these two autoimmune diseases in 56 patients, and these patients' clinical, laboratory and immunoserologic alterations. 50 patients with Sj?gren's syndrome and 50 patients with systemic lupus erythematosus were used as control groups. RESULTS: Compared with Sj?gren's syndrome alone, in the cases of the association of the diseases, rheumatoid factor was present less frequently, Ro/SS-A, La/SS-B and DNA antibodies were present more frequently, such as antiphospholipid autoantibodies and antiphospholipid syndrome. Anaemia, leukopenia and lymphopenia were detected more often and the patients were younger than in Sj?gren's syndrome. Also, affection of the lung, kidney, skin, central nervous system and serous membranes are more common. The group with systemic lupus erythematosus differs in being older, having thyroiditis, Ro/SS-A, La/SS-B and DNA more frequently. CONCLUSION: Definitive clinical, laboratory and serological features make the difference between the association of the two diseases and the diseases observed alone.     

Noninvasive measurement of aortic aneurysm sac tension with vibrometry

OBJECTIVE: Currently, the risk of aneurysm sac rupture after endovascular abdominal aortic aneurysm repair (EVAR) is estimated by using a group of anatomic variables. Available techniques for pressure monitoring include either direct measurement using catheter-based techniques or indirect measurement requiring implantation of a pressure sensor during aneurysm repair. None of these methods is without limitations. Radiation pressure, such as that generated by a modulated ultrasound (US) beam, can induce surface vibration at a distance. The velocity of the resulting surface waves depends on the tensile stress of the vibrated surface. By measuring the change in wave velocity, it is possible to detect the change in tensile stress and calculate the pressure through the vibrated surface. We tested this concept in an in vitro aneurysm model. METHODS: Rubber tubes and explanted porcine abdominal aortas were used to model an aneurysm sac. The surface of the model was vibrated with an amplitude-modulated US beam. The resulting motion was detected either by reflected laser light or by Doppler US. The phase of the propagating wave was measured to assess changes in velocity with different pressures. RESULTS: Increasing hydrostatic pressure in the rubber model correlated well with the cumulative phase shift (R(2) = 0.96-0.99; P < .0001). By using a pump to generate dynamic pressure (between 110 and 200 mm Hg), the cumulative phase shift correlated well with the square of the mean pressure (R(2) = 0.92; P < .0001); however, the correlation with pulse pressure was poor (24-36 mm Hg; r = 0.38; P < .02). In the porcine in vitro aortic sac model, the cumulative phase shift detected with both laser (r = 0.94-0.99; P < .0001) and Doppler (r = 0.96-0.99; P < .0001) correlated well with the aneurysm pressure. CONCLUSIONS: Application of vibrometry for noninvasive measurement of aortic aneurysm sac tension is feasible in an in vitro setting. The concept of vibrometry may be used to detect endotension noninvasively after EVAR. Vibrometry may also be used to estimate wall stress in native aneurysms, and it may predict the risk of aneurysm rupture. CLINICAL RELEVANCE: Vibrometry may offer a technique for completely noninvasive monitoring of aneurysm sac pressure after EVAR. Vibrometry is based on the following principles: radiation pressure, such as that generated by modulated US, can induce surface vibration at a distance; by measuring the change in wave velocity of vibration, it is possible to detect changes in tensile stress and calculate the pressure through the vibrated surface. We tested this concept in an in vitro model and found that application of vibrometry for noninvasive measurement of aortic aneurysm sac tension is feasible. Vibrometry may also be used to estimate wall stress in native aneurysms.     

AneuRx Device Migration: Incidence, Risk Factors, and Consequences

Success after endovascular abdominal aortic aneurysm repair (EVAR) is dependent on device positional stability. The quest for such stability has motivated different endograft designs, and the risk factors entailed remain the subject of debate. This study aims at defining the incidence, risk factors, and clinical implications of device migration after EVAR with the AneuRx® endograft. In this study we included all consecutive 109 patients submitted to primary AneuRx placement for infrarenal aortic or aortoiliac aneurysms. Preoperative computed tomography (CT) scans were reviewed for the following anatomic characteristics: neck length, diameter, angulation, calcification, and thrombus load; and sac diameter and thrombus load. Percentage of device oversizing relative to the proximal neck diameter was determined. All postoperative CT scans were reviewed, and the distance between the lowest renal artery and the craniad end of the device was measured. A 5-mm increase in such distance was considered indicative of device migration. Migration cumulative incidence was estimated by the Kaplan-Meier method, and its association with any of the preoperative anatomical characteristics was tested using Cox proportional hazards models. Median follow-up time was 9 (range, 1-31) months. Migration occurred in nine patients, corresponding to a 15.6% estimated probability of migration at 30 months (SE=5.1%). Migration was associated with the risk of proximal type I endoleak (hazard ratio=3.39, 95% confidence interval=1.46-7.87; p=0.007). This type of endoleak occurred in three of the migration-affected patients (33.3%); all of them were resolved by additional cuff placement at the proximal landing zone. No other migration-related reinterventions were performed. The only significant associations between anatomic factors and device migration probability were the protective effects of longer necks (odds ratio [OR]=0.71 for each additional 5 mm, p=0.045) and longer overlapped portions of neck and device (OR=0.56 for each additional 5 mm, p=0.003). There was a trend toward higher probability of migration among reverse-tapered necks (OR=1.75, p=0.109). Percentage of device oversizing correlated with early neck dilation (between preoperative and first postoperative diameters, correlation coefficient=0.4, p < 0.0001), but not with late neck dilatation (between first postoperative and 1.5-year scan diameters, correlation coefficient=0.29, p=0.112). There was a trend toward higher mean percentage of late dilation among migrators (11.4%, standard error of the mean [SEM] 2.6) than nonmigrators (5.7%, SEM=1) (p=0.08), but both groups had similar mean percentages of early dilation (3%, SEM=1.6%, vs. 5.5%, SEM=0.6%; p=0.365). This result indicates that device migration is not a rare event after AneuRx implantation. This phenomenon is associated with proximal type I endoleaks. Deployment of the endograft immediately below the renal arteries might help to prevent migration, since use of greater lengths of overlapped device relative to the proximal neck has a protective effect. Migration seems to be independent of the degree of device oversizing.Presented at the 29th Annual Meeting of the Peripheral Vascular Surgery Society, Anaheim, CA, June 4-5, Sergio M. Sampaio is a recipient of the Edward S. Rogers Clinical Research Fellowship in Vascular Surgery.     

An anterograde degeneration study of the tangential spread of axons in cortical areas 17 and 18 of the squirrel monkey (Saimiri sciureus).

In area 17 of squirrel monkey, lamina IVB of Brodmann is divided into three sublaminae by a thin, dense row of cell bodies, the largest of which have apical poles. Study of the 17/18 border suggests that these are a group of pyramidal cells, continuous with the large border pyramids in the depth of layer III in area 18. In contrast, the densely packed granule cells of layers IVA and IVC appear to be continuous with those of layer IV of area 18. It is thus proposed that in area 17, the third and fourth neocortical layers not only divide into sublaminae, but that these in turn interdigitate and intermingle their cell types. The tangential extent of intracortical fibers has been studied by making perpendicular slits in both areas and measuring the spread of anterograde degeneration to each side of the lesion. In area 17, this spread is always the same whatever the orientation of the fibers with respect to visual field representation. Degenerating fibers are few in number and found mainly in layers I, IVB and VI. In layers IVB and VI they extend for 0.5–1.0 mm. In layer I, some reach as far as 2.0 mm. In area 18, degenerating fibers are more numerous and longer. They are plentiful in layer I, diminish considerably in layer II, increase again in number till the depth of III, are slightly less numerous in layer IV and are again plentiful in layers V and VI. Their length varies with orientation. In a direction corresponding to a visual field sector, they extend for 1.5–2.0 mm, a distance representing only a fraction of the total representation of a sector in the cortex. In a direction corresponding to a visual field zone, they extend further and the combined degeneration of the two sides spans the whole distance of area 18 from the vertical to the horizontal meridian (6 mm). It is suggested that at least some of the fibers of the stria of Gennari subserve binocular interaction and that the differential fiber lengths in area 18 are related to foveal acquisition or to a directional anisotropy of visual movement perception along sector-zone axes.