Effect of chronic treatment with an estrogen-progestogen combination on beta adrenergic-induced thirst.

Rats chronically administered various doses of the estrogenic agent, ethinyl estradiol, combined with the progestogen, norethynodrel, showed an estrogen-related, dose-dependent decrease in water intake in response to acute SC administration of the beta adrenergic agonist, isoproterenol (200 μg/kg of body wt). Conversely, rats receiving a constant dose of ethinyl estradiol (16 μg/kg/day) combined with norethynodrel (233 μg/kg/day) for 7 weeks drank significantly less water in response to graded doses of isoproterenol (10, 25, 50, 100 and 200 μg/kg) than controls. The slope, but not the intercept, of the regression line relating water intake to dose of isoproterenol administered was reduced significantly in the steroid-treated group. Furthermore, water intake of the treated group in response to acute administration of either epinephrine (1 mg/kg) or serotonin (1 mg/kg) was significantly less than control. These data suggest that chronic treatment with ethinyl estradiol, combined with norethynodrel, reduced beta-adrenergic responsiveness. In addition, rats treated with the same combination of ethinyl estradiol and norethynodrel showed a reduced drinking response to an osmotic thirst stimulus, i.e., IP load of 1 M NaCl solution at 1% of body wt. The fact that the response to both types of thirst stimuli was attenuated in rats receiving an estrogen combined with a progestogen suggests the possibility that treatment may have affected thirst mechanisms at the level of the central nervous system.     

Fungal infections of the head and neck: an update

Despite the vast literature regarding fungal infections of the head and neck, little has changed in diagnosis or management of these infections except in the nose and sinuses. Three main points regarding fungal involvement in the paranasal sinuses are evident now. First, fungi may be important in a significant percentage of patients with chronic rhinosinusitis. Second, the pathophysiologic mechanism responsible for fungal rhinosinusitis remains unclear. It may represent an allergic IgE response, a cell-mediated reaction, or a combination of the two. Finally, there is certainly a spectrum of disease thus far defined: allergic fungal sinusitis as defined by Bent and Kuhn [35], eosinophilic mucin rhinosinusitis defined by Ferguson [50], and eosinophilic fungal rhinosinusitis as proposed by Ponikau [45]. Fungal infections of the head and neck are panoramic in distribution and pathophysiology. They represent a broad range of disease of which medical science has only recently begun to uncover the surface. As research begins to unravel the complex host defense mechanisms against these pathogens from a cellular and even genetic level, the body of knowledge will continue to increase exponentially and the ability to treat patients suffering from fungal infections will improve.     

An immune response after intraocular administration of an adenoviral vector containing a beta galactosidase reporter gene slows retinal degeneration in the rd mouse

BACKGROUND/AIMS: Retinal degenerations are a leading cause of blindness for which there are currently no effective treatments. This has stimulated interest in the investigation of gene therapy strategies for these diseases in a variety of animal models. A number of attempts have been made to prevent photoreceptor loss in the rd mouse model of retinal degeneration using adenoviral vectors containing either a copy of the missing functional gene or a gene encoding either a neurotrophic factor or an antiapoptotic factor. The authors have previously demonstrated that intraocular administration of an adenoviral vector containing a beta galactosidase gene (AV.LacZ) results in an immune response to viral gene products and beta galactosidase. Here the effect of the immune response on retinal degeneration is examined. METHODS: Juvenile rd mice were injected intravitreally with AV.LacZ and a proportion were depleted of either CD4+ or CD8+ T cells or both. Control animals were injected with PBS. The mice were sacrificed 10 and 20 days post-injection and their eyes embedded in paraffin wax and sectioned. RESULTS: 10 days after intravitreal injection of AV.LacZ, the outer nuclear layer contains an average of 2.5 rows compared with 1.5 in PBS injected animals (p<0.005). The protective effect of AV.LacZ is negated by immune suppression and does not extend beyond 20 days. CONCLUSION: An immune response to vector and transgene products is able to slow degeneration in the rd mouse. This phenomenon should be taken into account when analysing the degeneration in the rd mouse following gene transfer.     

A comparison of radical retropubic with perineal prostatectomy for localized prostate cancer within the Uniformed Services Urology Research Group

OBJECTIVE: To review and compare the outcome of patients undergoing radical retropubic prostatectomy (RRP) or radical perineal prostatectomy (RPP) for clinically localized prostate cancer. PATIENTS AND METHODS: From 1988 to 1997, 1382 men who were treated by RRP and 316 by RPP were identified from databases of the Uniformed Services Urology Research Group. The following variables were assessed; age, race, prostate-specific antigen (PSA) level before surgery, clinical stage, biopsy Gleason sum, estimated blood loss (EBL), margin-positive rate, pathological stage, biochemical recurrence rate, short and long-term complication rates, impotence and incontinence rates. To eliminate selection bias, the analysis was concentrated on pairs of patients matched by race, preoperative PSA level, clinical stage and biopsy Gleason sum. RESULTS: In the 190 matched patients there were no significant differences between the RRP and RPP groups in either organ-confined (57% vs 55%), margin-positive (39% vs 43%), or biochemical recurrence rates (12.9% vs 17.6% at a mean follow-up of 47.1 vs 42.9 months), respectively. The mean EBL was 1575 mL in the RRP group and 802 mL in the RPP group (P < 0.001). The only significant difference in complication rates was a higher incidence of rectal injury in the RPP group (4.9%) than in the RRP group (none, P < 0.05). CONCLUSIONS: In similar populations of patients, RPP offers equivalent organ-confined, margin-positive and biochemical recurrence rates to RRP, while causing significantly less blood loss.     

Lidocaine as a topical anesthetic for bladder biopsies

The use of lidocaine as a topical anesthetic in bladder biopsies is described. Lidocaine was used in 7 patients undergoing random bladder biopsies and serum lidocaine levels were measured 7 to 10 minutes after instillation. Adequate pain control was noted in each patient with negligible serum lidocaine levels even in the face of denuded bladder mucosa.     

Interhemispheric Stroop effects in partial and complete agenesis of the corpus callosum.

Previous research had demonstrated diminished interhemispheric Stroop effects in individuals with agenesis of the corpus callosum (ACC), suggesting an important role for the callosum in interhemispheric color-word and color-patch interactions. However, this outcome rested on the results of only 1 ACC participant, who had normal intelligence and a minimum of other neuropathology. In the research reported herein, the role of the corpus callosum in interhemispheric Stroop interference and facilitation was investigated in 9 individuals with complete or partial ACC and normal intelligence, and in non-ACC controls. Congruent, incongruent, or neutral stimulus pairs were presented either unilaterally (color-patch and color-word in the same visual field) or bilaterally (color-patch and color-word in different visual fields). Both unilateral and bilateral (interhemispheric) Stroop interference were found for both ACC and non-ACC groups, with no significant difference in magnitude, indicating that extracallosal pathways are sufficient for mediating this phenomenon. It is suggested that the anterior commissure is a more likely candidate for the interhemispheric transmission of the semantic information resulting in Stroop interference.