Troglitazone attenuates hypoxia-induced injury in cultured term human trophoblasts

OBJECTIVE: The purpose of this study was to test the hypothesis that the thiazolidinedione troglitazone, a peroxisome proliferator activated receptor-gamma ligand, attenuates hypoxia-induced trophoblast injury. STUDY DESIGN: Cytotrophoblasts from 4 term human placentas were cultured in the presence or absence of 10 mumol/L troglitazone in either 20% oxygen (standard conditions) or 1% oxygen (hypoxic conditions) for variable periods before cell harvest. Medium beta-human chorionic gonadotropin and human placental lactogen were analyzed by enzyme-linked immunosorbent assay. Apoptosis was quantified by cytokeratin-18 cleavage products staining; p53 expression was examined by Western blot analysis. RESULTS: beta-human chorionic gonadotropin and human placental lactogen levels were >/=2-fold higher in troglitazone-exposed cells at 16 hours of hypoxia, compared with vehicle control cells ( P <.05). The apoptotic index was reduced by >/=30% ( P <.001), and the expression of p53 was 2-fold lower ( P <.02) in troglitazone-exposed cells under hypoxia for 24 hours of low oxygen. CONCLUSION: Troglitazone attenuates the influence of acute hypoxia on cultured term human trophoblasts.     

Asmarines I, J, and K and nosyberkol: four new compounds from the marine sponge Raspailia sp

Five asmarines, the known A and F and three new ones, I, J, and K, and four diterpenes, the known chelodane, barekoxide, and zaatirin and a new one, nosyberkol, were isolated from the Nosy Be Islands (Madagascar) sponge Raspailia sp. The structures of all these compounds were established on the basis of MS and NMR data. A biogenesis for the various Raspailia sp. diterpenes is suggested.     

Anatomical basis for celiac trunk and superior mesenteric artery entrapment

Forty-six cadaveric specimens were dissected in order to study the anatomical relations between the median arcuate ligament (MAL), the celiac ganglion, and the origin of both the celiac and superior mesenteric arteries. We found that in 40 cases (87.5%) both vessels were held together by the ganglionic mass, and in 90.6%, the celiac trunk was covered, either partially or completely, by the MAL. These data indicated that this is a normal occurrence. In 10% of the cases both vessels were covered by the MAL. These anatomical findings may possibly contribute to the understanding of the socalled “median arcuate ligament syndrome.”     

Ultrasonography in patients without trauma in the emergency department: impact on discharge diagnosis.

OBJECTIVE: The aim of this study was to examine to what extent findings on ultrasonography performed in the emergency department (ED) after hours confirm or alter the referral diagnosis in patients without trauma as reflected in the discharge diagnosis. METHODS: In this prospective study, data from 136 ultrasonographic examinations performed in patients without trauma after hours in the ED during January and February 2002 were evaluated against the suspected preimaging diagnosis of the referring ED physician and the actual discharge diagnosis from the ED or after hospitalization. The rate of preimaging and postimaging concordance was statistically analyzed and compared by calculation of confidence intervals and by the McNemar test. RESULTS: Normal ultrasonographic findings were documented in 54 patients (40%), and pathologic findings were documented in 82 (60%). Thirty-four (25%) of the 136 examinations were concordant with the initial referring physician's diagnosis. Of the 102 studies that were not concordant with the initial referral suspected diagnoses, that is, being either a study with normal findings or offering an alternative diagnosis, 81 (79.4%) were concordant with the discharge diagnosis. CONCLUSIONS: After-hours ultrasonographic findings in patients without trauma seen in the ED seem to have a high impact on the discharge diagnosis and are concordant with it in more than 80% of cases.     

Cultural systemic therapy on the kibbutz: Community and family-based treatment of anorexia nervosa

A cultural approach to therapy assumes that community organization and social ideology can contribute to the genesis and maintenance of mental health problems, and also to their resolution. Cultural systemic therapy applies this insight to all relevant levels of the family-community ecosystem. This is demonstrated by focusing on the treatment of anorexia nervosa in the Israeli kibbutz. We analyze the confluence of cultural characteristics with the anorectic syndrome and then illustrate in a case study of how these characteristics can be employed in therapy. Two particular interventions are delineated to document the powerful impact that can be achieved when this approach is applied to severe and long-term disorders: the establishment and ongoing collaboration with an expanded community/family team and a home confinement program.     

Collecting system involvement by renal tumor: are CT measurements reliable enough?

OBJECTIVES: Smaller kidney lesions which are more often detected recently by accidental imaging are amenable for nephron sparing approach whether at open surgery, laparoscopy or ablative techniques. The pretreatment planning is based on multiplanner CT expected to well define the relationship of the lesion to the major renal blood vessels and collecting system (CS). This study is aimed to compare the pre-surgical CT measurements of the distance from tumor to CS to the actual distances observed on radical nephrectomy specimens. PATIENTS AND METHODS: Contrast CT of 39 patients with renal cell carcinoma (RCC) underwent measurements of the distance between CS and renal tumor. All measurements were confronted with the measurements performed on radical nephrectomy specimens of the same patients. RESULTS: Of all 39 patients in 34 (87%) CT showed a contact relation between the tumor and the CS. In fact, the CS involvement has been histologically proven only in three (7.6%) cases. Cutting off the measurements at thresholds of 2 and 5 mm also showed a significant discrepancy between CT and specimen measurements. CONCLUSIONS: The trend of NSS and ablative techniques stressed out the importance of pretreatment measurements of the distance between the tumor and the CS. This study as performed on radical nephrectomy specimens points out the overestimated proximity of the tumor to the CS. These data if confirmed by other studies, may play a role while planning the management of NS approaches.     

Isolated noncompaction of the ventricular myocardium: contemporary diagnosis and management

Noncompaction of the ventricular myocardium is a rare form of cardiomyopathy that has been described since the early 1990s. However, noncompaction remains frequently overlooked, in part due to the limited awareness of its unique clinical and imaging characteristics. Contemporary diagnosis has been facilitated by the introduction of specific morphologic criteria by echocardiography and cardiac magnetic resonance. Management issues revolve around the management of heart failure, arrhythmias, and thromboembolic events in order to prevent the significant morbidity and even mortality that has been associated with this entity. Finally, the genetics of noncompaction have been diverse and an issue of clinical importance as it relates to screening of first-degree relatives of affected patients. Two recent cases are presented and many of the contemporary issues in diagnosis and management, based on an extensive review of the literature, are addressed. Copyright (c) 2007 Wiley Periodicals, Inc.