Effects of intestinal stasis on intercellular adhesion molecule 1 expression in the rat: Role of enteric bacteria

BACKGROUND & AIMS: The mechanisms underlying the inflammatory changes associated with intestinal stasis are poorly understood. The objective of this study was to assess whether endothelial expression of intercellular adhesion molecule 1 (ICAM-1) and leukocyte recruitment are altered after intestinal stasis. METHODS: ICAM-1 expression and granulocyte recruitment were quantified in different tissues of Sprague- Dawley rats using the double-radiolabeled monoclonal antibody technique and peroxidase activity, respectively. RESULTS: Both constitutive and endotoxin-induced ICAM-1 expression were significantly higher in the cecum than in distal colon, a finding that cannot be explained by a difference in endothelial surface area between the two organs. Surgical procedures to improve cecal stool flow (cecostomy, ileocecostomy) elicited a significant decrease in constitutive ICAM-1 expression in both cecum and distal colon. Tissue peroxidase activity was normally higher in cecum than in distal colon, and this difference was significantly reduced by ileocecostomy. Oral administration of antibiotics (kanamycin and/or metronidazole for 2 days) significantly reduced constitutive ICAM-1 expression in the cecum, but not in the distal colon. CONCLUSIONS: This study indicates that intestinal stasis is associated with an increased expression of ICAM-1 and granulocyte infiltration, which may be mediated by enteric bacteria. (Gastroenterology 1997 Jun;112(6):1971-8)     

Severe perinatal thrombosis in double and triple heterozygous offspring of a family segregating two independent protein S mutations and a protein C mutation

Molecular genetic and phenotypic analyses were performed in a highly unusual case of combined protein S and protein C deficiency manifesting in a family in which a child had died perinatally from renal vein thrombosis. Antenatal diagnosis in a second pregnancy was initially performed by indirect restriction fragment length polymorphism (RFLP) tracking using a neutral dimorphism within the PROS gene and served to exclude severe protein S deficiency. Am umbilical vein blood sample at 22 weeks gestation showed isolated protein C deficiency. This pregnancy proceeded to a full-term delivery without thrombotic complications. Molecular genetic analysis of the PROC and PROS gene segregating in the family then yielded one PROC gene lesion in the father and two PROS gene lesions, one in each parent. These lesions were shown to segregate with the respective deficiency states through the family pedigree. Analysis of DNA from paraffin-embedded liver tissue taken from the deceased child showed the presence of both PROS mutations, as well as the PROC mutation. Genotypic analysis of the second child showed a PROC mutation, but neither PROS mutation consistent with its possession of normal protein S levels and a low/borderline protein C level. Antenatal diagnosis was then performed in a third pregnancy by direct mutation detection. However, although the fetus carried only the paternal PROS and PROC gene lesions, the child developed renal thrombosis in utero. It may be that a further genetic lesion at a third locus still remains to be defined. Alternatively, the intrauterine development of thrombosis in this infant could have been caused, at least in part by a transplacental thrombotic stimulus arising in the protein S-deficient maternal circulation. This analysis may, therefore, serve as a warning against extrapolating too readily from genotype to phenotype in families with a complex thrombotic disorder.     

Association study of single-nucleotide polymorphisms in FASLG, JMJDIA, LOC203413, TEX15, BRDT, OR2W3, INSR, and TAS2R38 genes with male infertility

Infertility is a major health problem today, affecting about 15% of couples trying to conceive a child. Impaired fertility of the male factor is causative in 20% of infertile couples and contributory in up to another 30%-40%. Based on association studies, an increasing number of gene polymorphisms have been proposed to modulate the efficiency of spermatogenesis. Here, we have investigated the possible association of 9 single-nucleotide polymorphisms (SNP) in 8 different genes-FASLG, JMJDIA, LOC203413, TEX15, BRDT, OR2W3, INSR, and TAS2R38--with male infertility. We analyzed a total of 136 men with idiopathic infertility (60 azoospermic and 76 oligozoospermic) and 161 fertile controls. Our study group included individuals of different ethnic origin: 93 of the infertile men were Macedonians, 32 were Albanians, and 11 were of other origin. The control group was composed of 125 Macedonian and 36 Albanian men. The methodology included multiplex polymerase chain reaction/SNaPshot analyses, followed by capillary electrophoresis on an ABI3130 Genetic Analyzer. Of the 9 SNPs evaluated, 3 are significantly associated (P < .05) with male infertility: SNPs rs5911500 in LOC203413, rs3088232 in BRDT, and rs11204546 in OR2W3. SNP rs5911500 showed the strongest association with infertility among Albanians (P = .0001), whereas rs3088232 was most significantly associated with azoospermia among Macedonians (P = .0082). Moreover, the frequency of co-occurrence of LOC203413 minor T allele with either homozygosity or heterozygosity for the BRDT minor G allele was significantly higher among both azoospermic (6 of 60 [10%]; P = .0057; odds ratio [95% confidence interval], 8.83 [1.73-45.08]) and oligozoospermic (10 of 76 [13.2%]; P = .0002; odds ratio [95% confidence interval], 12.04 [2.57-56.47]) men in comparison with fertile controls (2 of 161 [1.2%]).     

Fibrosing alveolitis: CT-pathologic correlation

Computed tomography (CT) was performed within 10 days of open lung biopsy in nine patients with fibrosing alveolitis. One-centimeter collimation contiguous scans through the chest were obtained in all patients. Additional 1.5-mm collimation scans were obtained in the area in which lung biopsy was later performed in six patients. In seven patients, CT demonstrated patchy involvement of the lung parenchyma, areas with a reticular pattern being intermingled with areas of normal lung. The reticular pattern was associated with cystic spaces 2-4 mm in diameter and was more severe in the lung periphery. Histologically, the reticular pattern corresponded to areas of irregular fibrosis. One patient had diffuse honeycombing (2-20-mm cysts), and one had honeycombing only in the lung periphery. In all patients, CT clearly defined the architectural changes seen on open lung biopsy. These changes were much better seen on the 1.5-mm than on the 10-mm collimation scans. CT may be helpful in determining the pattern and distribution of lung involvement in patients with fibrosing alveolitis and in guiding the surgeon to the most appropriate area(s) for biopsy.     

The changing academic role of the nurse teacher in the United Kingdom

This paper presents findings from a national study conducted over a 3-year period (1991–94) which examined the changing role of the nurse teacher The study used multiple methods to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) This paper presents the findings relating to the development of the nurse teacher's academic role following the introduction of Project 2000 The issues presented and discussed include specialization within the nurse teacher's role, the nature of this specialization and the development of academic credibility and scholarship The implications of these changes in terms of the development of nursing as an academic subject area and the opportunity to contribute to the establishment of research based practice are explored     

A pilot scheme for an integrated falls prevention service

The National Service Framework for the Older Person (Department of Health 2001) set standards for reducing the number of falls and serious injury. One way this might be achieved is through provision of a Specialist Falls Service. This paper describes a 3 year pilot project to introduce an Integrated Falls Service using money obtained from the local Health Authority Health Improvement fund.The article describes a partnership approach with the local council, therapy services and other agencies. The target group and referral mechanisms are discussed and costings given. A variety of interventions will be employed to include assessment and targeted exercises with education sessions. Hip protectors are available for high risk patients. Several indices will be used to evaluate this pilot scheme including balance measurements, confidence scales, supported interviews and diaries. Final evaluation will be in March 2004.     

Interpersonal mental health nursing: research issues and challenges

Since Peplau outlined her perceptions of psychiatric/mental health nursing in (1952) interpersonal relationships has been considered by many as the core of practice. In the intervening period of almost a half century many researchers and theorists have endeavoured to develop and integrate Peplau's framework into day-to-day nursing activity. However, more recently, as a result of the fusion between the professional nursing agenda and the wider political agenda, the importance of interpersonal relationships and the individuality of psychiatric/mental health nursing is being questioned. This questioning is represented in the debate about the aetiology of mental illness, the choice of research methods to determine treatment outcomes and by association the role and value of the psychiatric/mental health nurse. This paper will focus on the interpersonal nature of psychiatric/mental health nursing and explore possible research approaches aimed at explicating its core. Attention will be given to the necessity of using pluralistic methodology in order to do so.     

Mutant oligonucleotide extension amplification: a nonlabeling polymerase-chain-reaction-based assay for the detection of point mutations

We have developed a new nonradioactive method for the identification of mutations causing beta-thalassemia and cystic fibrosis. The method is based on the priming of polymerase chain reaction (PCR) by an oligonucleotide complementary to the DNA sequence containing the mutation of interest, which anneals only to the perfectly matched sequence under high stringency conditions. A more upstream oligonucleotide primer is also included in the reaction to discriminate between homozygosity and heterozygosity for a particular mutation and serves as a control for the efficiency of the amplification.