The management of vulval pain syndromes

Vulval problems are common in gynaecological practice. Pain syndromes of the vulva should be considered once infection and dermatological causes of vulval symptoms have been excluded. This article covers vulval vestibulitis and dysaesthetic vulvodynia, the two subgroups of vulval pain syndromes.     

Defense of zebrafish embryos against Streptococcus pneumoniae infection is dependent on the phagocytic activity of leukocytes

Severe community acquired pneumonia caused by Streptococcus pneumoniae is the most common cause of death from infection in developing countries. Serotype specific conjugate vaccines have decreased the incidence of invasive infections, but at the same time, disease due to non-vaccine serotypes have increased. New insights into host immune mechanisms against pneumococcus may provide better treatment and prevention strategies. Zebrafish is an attractive vertebrate model for studying host immune responses and infection biology. Here we show that an intravenous challenge with pneumococcus infects zebrafish embryos leading to death in a dose dependent manner. Survival rates correlate with the bacterial burden in the embryos. The production of proinflammatory cytokines is induced in zebrafish after pneumococcal exposure. Importantly, morpholino treated embryos lacking either myeloid cells or the ability to phagocytose bacteria have lowered survival rates compared to wild type embryos after pneumococcal challenge. These data suggest that the survival of zebrafish embryos upon intravenous infection with S. pneumoniae is dependent on the clearance of the bacteria by phagocytosing cells. Additionally, we demonstrate that mutant pneumococci lacking known virulence factors are attenuated in the zebrafish model. Our data demonstrate that zebrafish embryos can be used for study innate immune responses as well as virulence determinants in pneumococcal infections.     

Molecular fingerprint of neuropeptide S-producing neurons in the mouse brain

Neuropeptide S (NPS) has been associated with a number of complex brain functions, including anxiety‐like behaviors, arousal, sleep‐wakefulness regulation, drug‐seeking behaviors, and learning and memory. In order to better understand how NPS influences these functions in a neuronal network context, it is critical to identify transmitter systems that control NPS release and transmitters that are co‐released with NPS. For this purpose, we generated several lines of transgenic mice that express enhanced green‐fluorescent protein (EGFP) under control of the endogenous NPS precursor promoter. NPS/EGFP‐transgenic mice show anatomically correct and overlapping expression of both NPS and EGFP. A total number of ～500 NPS/EGFP‐positive neurons are present in the mouse brain, located in the pericoerulear region and the Kölliker‐Fuse nucleus. NPS and transgene expression is first detectable around E14, indicating a potential role for NPS in brain development. EGFP‐positive cells were harvested by laser‐capture microdissection, and mRNA was extracted for expression profiling by using microarray analysis. NPS was found co‐localized with galanin in the Kölliker‐Fuse nucleus of the lateral parabrachial area. A dense network of orexin/hypocretin neuronal projections contacting pericoerulear NPS‐producing neurons was observed by immunostaining. Expression of a distinct repertoire of metabotropic and ionotropic receptor genes was identified in both NPS neuronal clusters that will allow for detailed investigations of incoming neurotransmission, controlling neuronal activity of NPS‐producing neurons. Stress‐induced functional activation of NPS‐producing neurons was detected by staining for the immediate‐early gene c‐fos, thus supporting earlier findings that NPS might be part of the brain stress response network. J. Comp. Neurol. 519:1847–1866, 2011. © 2011 Wiley‐Liss, Inc.     

Glycosaminoglycans increase levels of free and bioactive IGF-I in vitro

BACKGROUND: It is unclear how IGFs become separated from their IGF-binding proteins (IGFBPs) in vivo. However, the IGFBPs possess binding sites for glycosaminoglycans (GAGs) and interaction with GAGs alters IGFBP ligand affinity. Accordingly, GAGs may control IGF bioavailability. To test this hypothesis, we investigated the effect of GAGs on serum levels of free and bioactive IGF-I, total IGF-I, and IGFBPs in vitro. METHODS: Serum was incubated with increasing concentrations of six different GAGs (heparin, tinzaparin (Innohep), dermatan sulfate, heparan sulfate, non-anticoagulant (nac) heparin, and nac low-molecular weight heparin). To investigate for reversibility, heparin was co-incubated with protamine sulfate (PS). Finally, the effect of heparin was studied in serum from pregnant and post partum women, normal subjects and patients with type 1 diabetes. RESULTS: All GAGs increased free IGF-I in a dose-dependent manner (P<0.0001), whereas total IGF-I and IGFBP levels remained unchanged. However, the potency of the GAGs differed significantly (P<0.0001) and did not relate to their anti-coagulating activity. The effect of heparin on free IGF-I was fully reversed by PS. Heparin increased free and bioactive IGF-I in all tested sera (P<0.0001), but the increase was most pronounced in samples from pregnant women (P<0.0001). CONCLUSION: All tested GAGs stimulated the release of free and bioactive IGF-I in several types of serum, most likely by reversible interaction with the IGFBPs. The effect was most pronounced in pregnancy sera, which are characterized by extensive IGFBP-3 proteolysis. Our findings support the view that GAGs localized in the vessel wall and attached to the extracellular matrix control IGF-I tissue accessibility and bioactivity.     

Paratesticular papillary serous cystadenocarcinoma--a case report

A case of paratesticular papillary serous cystadenocarcinoma in a six year old child is presented. The occurrence of these epithelial tumours of the ovarian type, in the paratesticular region is extremely rare and only six cases have been reported so far. They are thought to arise from Mullerian metaplasia of the peritoneal lining of the tunica vaginalis, appendix testis or mullerian remnants between the testis and spermatic cord.     

Anaemia neonatorum

Ohne Zusammenfassung