Human endometrial receptivity: gene regulation

Endometrial receptivity is a self-limited period in which the endometrial epithelium (EE) acquires a functional and transient ovarian steroid-dependent status that allows blastocyst adhesion. Termed as "the window of implantation", this specific period opens 4-5 days after progesterone production or administration and closes after 9-10 days. Scientific knowledge on the endometrial receptivity process is fundamental for the understanding of human reproduction, but so far none of the proposed biochemical markers for endometrial receptivity has been proven to be clinically useful. In this work, we present strategies of cDNA analysis technologies that aim to clarify the fragmented information in this field. Specifically, the objective is the differential identification, cloning and sequencing of genes linked to endometrial receptivity in humans, combining differential display PCR and cDNA microarray analysis of endometrial epithelial-derived cell lines and endometrial samples obtained in the same patient 2 and 7 days after the luteinizing hormone (LH) surge (day LH+2) and (day LH+7), respectively.     

Olfactory Ensheathing Glia: Drivers of Axonal Regeneration in the Central Nervous System?

Olfactory ensheathing glia (OEG) accompany olfactory growing axonsin their entry to the adult mammalian central nervous system (CNS).Due to this special characteristic, considerable attention has beenfocused on the possibility of using OEG for CNS regeneration. OEGpresent a large heterogeneity in culture with respect to theircellular morphology and expressed molecules. The specificcharacteristics of OEG responsible for their regenerativeproperties have to be defined. These properties probably resultfrom the combination of several factors: molecular composition ofthe membrane (expressing adhesion molecules as PSA-NCAM, L1 and/orothers) combined with their ability to reduce glial scarring and toaccompany new growing axons into the host CNS. Their capacity toproduce some neurotrophic factors might also account for theirability to produce CNS regeneration.     

Idiopathic nodular glomerulosclerosis is a distinct clinicopathologic entity linked to hypertension and smoking

Idiopathic nodular glomerulosclerosis (ING) is an enigmatic condition that resembles nodular diabetic glomerulosclerosis but occurs in nondiabetic patients. We reviewed clinicopathologic features, immunohistochemical profiles, and outcomes in 23 patients with ING diagnosed from among 5,073 native renal biopsy samples (0.45%) at Columbia University from January 1996 to March 2001. This cohort, in which diabetes mellitus was excluded, consisted predominantly of older (mean age, 68.2 years) white (73.9%) men (78.3%). Clinical findings at presentation included renal insufficiency in 82.6% (mean serum creatinine = 2.4 mg/dL), proteinuria (> 3 g/d in 69.6%; mean 24-hour urine protein = 4.7 g/d), and-less frequently-full nephrotic syndrome (21.7%). There was a high prevalence of hypertension (95.7%; mean = 15.1 +/- 3.4 years), smoking (91.3%; mean = 52.9 +/- 6.9 pack-years), hypercholesterolemia (90%), and extrarenal vascular disease (43.5%). All 23 patients had prominent diffuse and nodular mesangial sclerosis, glomerular basement membrane thickening, arteriosclerosis, and arteriolosclerosis. Immunohistochemical staining for CD34, a marker of endothelial cells, showed an increased number of vascular channels within ING glomeruli compared with normal controls. Follow-up data were available for 17 patients, 6 of whom reached end-stage renal disease (ESRD) (35.3%). By Kaplan-Meier estimates, the median time after biopsy to ESRD was 26 months. Predictors of progression to ESRD included continuation of smoking (P =.0165), lack of angiotensin II blockade (P =.0007), degree of tubular atrophy and interstitial fibrosis (P =.0517), and degree of arteriosclerosis (P =.0096). In conclusion, ING is a progressive vasculopathic lesion linked to hypertension and cigarette smoking.     

Extensive aganglionosis. Treatment and long term results

Extensive aganglionosis (EA) that affects the total colon (including or not part of the small intestine), shows more diagnostic problems and it is associated to higher morbidity and mortality rates than the classic cases of Hirschsprung disease (ED). This study takes into account last years cases and their results in the medium and long term.     

Opinions of students and educators concerning health: the public school perspective in a peripheral area of the city of São Paulo

This study focused on prevailing concepts in society concerning adolescents' health problems and needs. Based on concerns in the field of Collective Health in relation to public policies for social protection, the study attempted to grasp the public school perspective concerning these issues. The study's theoretical reference was the social determination of the health-disease process and the view that health needs are translated into demands for changes in the harmful processes resulting from relations in the production process. Data were gathered through interviews with pedagogical coordinators and focus groups with adolescents in public schools from the Raposo Tavares School District (Municipality of S o Paulo). The results showed that the participants recognized: (1) the sphere of social determinants at the base of adolescents' health problems and (2) in addition to disease processes, a set of social problems impacting the health-disease process, highlighting drug use and violence. Health needs are translated as demands for cross-sector public social policies.     

Variability of the International Prostate Symptom Score in men with lower urinary tract symptoms

OBJECTIVE: The variability of the International Prostate Symptom Score (I-PSS) was tested in patients with benign prostatic hyperplasia (BPH) by comparing questionnaire results obtained in the physician's office and, 1 week later, in the patient's home. MATERIAL AND METHODS: A total of 210 consecutive men with lower urinary tract symptoms (LUTS) completed the I-PSS questionnaire in the physician's office. One week later the questionnaire was mailed to each patient's home, completed by the patient and then returned. Scores were compared specifically in terms of clinically significant differences defined by a total symptom score difference of > or = 6 points and/or a difference of > or = 2 points in the quality-of-life (QOL) measure. RESULTS: The mean patient age was 67 years. Questionnaires were completed and returned by 127/210 (60%) men. Pearson's correlation coefficient for the I-PSS and QOL results was 0.81 and 0.74, respectively. Clinically significant differences in results were seen in 33/127 (26%) patients. When grouping patients into mild, moderate and severe symptom categories based on the I-PSS results, 31/127 (24%) changed categories when comparing "office" and "home" results. CONCLUSIONS: Clinically significant variations in I-PSS and QOL results may exist and may affect treatment decisions in > 25% of men.     

Chromosomal translocation 3;22 in an infertile man

Objective: To present the first case of an infertile male with a normal phenotype and chromosomal translocation 3;22.

Design: Case report.

Setting: POVISA Medical Center.

Patient(s): A 45-year-old man with primary infertility for 13 years and with different partners; the patient has a family history of recurrent miscarriages and low fertility.

Intervention(s): Lymphocytic karyotype and electron microscopy.

Main Outcome Measure(s): Physical examination and semen analysis.

Result(s): The semen analysis revealed oligoasthenoteratospermia. The lymphocytic karyotype detected a translocation 3;22, and electron microscopy showed a lack of the central microtubule pair and peripheral doublet.

Conclusion(s): An association between translocation 3;22 and other abnormalities in infertile males has been reported, but no such association has ever been described in men whose only clinical manifestation is infertility.     

Report of a case: non-Hodgkin's lymphoma of the hypopharynx in a patient with HIV infection. Remission without lymphoma-specific treatment

Non-Hodgkin's lymphomas (NHL) are common in HIV patients, although it is rare for primary lymphomas to develop in the larynx or hypopharynx. We present the case of a patient that was diagnosed of a high degree NHL, following a biopsy of the piriform sinus' lesion, taker by direct laryngoscopy. Simultaneously he was diagnosed as HIV. The interest of this paper is the total remission of the lymphoma seen after specific HIV treatment only.