Maternal corticosterone during lactation permanently affects brain corticosteroid receptors, stress response and behaviour in rat progeny

The long-term consequences of a physiological-range increase of maternal corticosterone during lactation were investigated on the 15-month-old progeny. The offspring of rats drinking water supplemented with corticosterone (200 microgram/ml of corticosterone hemisuccinate) from day 1 postpartum to weaning exhibited: (i) better performance in a conditioned learning test; (ii) reduction of fearfulness in two conflict situations; (iii) lower stress-induced corticosterone secretion and (iv) higher number of corticosteroid receptors in the hippocampus. The results of this study show that the effects of maternal physiological-range hypercorticosteronemia during lactation are lifelong. Moreover, these data suggest that corticosteroids, secreted during neonatal life, may constitute a factor directing the neurobiological development of the infant. In line with this hypothesis, glucocorticoid-induced early events have consequences on the behavioral and physiological status of adulthood. These consequences may be either "beneficial" or "detrimental" depending on the plasma levels of corticosterone induced by the early life occurrences, as well as on the kind of the stimulus and the developmental stage at which the neonate experiences the event. The present study demonstrates that, when the increase of corticosterone in infancy is moderate, the adult rats show reduced anxiety, improved learning and a better coping strategy to deal with stressful situations.     

Menopause, mild psychological stress and salivary cortisol: influence of long-term hormone replacement therapy (HRT)

OBJECTIVE: Aim of the present study was to examine the adrenocortical activity in basal condition and following a mild stress exposure in long-term HRT-treated menopausal women. Menopausal women, long term users of HRT (14 subjects) were compared both to menopausal women who had never used HRT (14 subjects) and young pre-menopausal women (14 subjects). STUDY DESIGN: Morning and evening salivary cortisol secretion was measured in samples collected twice a day (08:00 in the morning and 08:00 in the evening). Mild stress response was evoked by administration of the Stroop color-word test (CWT). Salivary cortisol was measured immediately before the start, 15, 30 and 45 min after the completion of the test. RESULTS: Menopause appears not to be associated with an impairment of cortisol circadian fluctuation. Long-term use of HRT in menopause attenuated HPA activity either in basal condition or in response to mild stress exposure. With regard to the CWT performance, all menopausal women took significantly longer than young women to perform the test. However, long-term HRT significantly reduced the number of errors made during the test. CONCLUSIONS: The present study suggested that long-term HRT could help menopausal patients to cope with mild stress and to improve mental performances.     

The role of hypofractionation radiotherapy for diffuse intrinsic brainstem glioma in children： a pilot study

PURPOSE： Most children with a diffuse intrinsic brainstem glioma will die within 1 year after diagnosis. To reduce patient burden, we investigated the feasibility of a radical hypofractionation radiotherapy schedule, given over 3 weeks, as an alternative to the standard regimen （30 fractions over 6 weeks）. METHODS AND MATERIALS： Nine children, ages 3-13, were treated by 13 fractions of 3 Gy （n = 8） or 6 fractions of 5.5 Gy （n = 1） given over 3 weeks. All patients had symptoms for ≤3 months and ≥2 signs of the neurologic triad （long tract signs, ataxia, cranial nerve deficit）. Bilateral involvement of the pons （n = 8）, encasement of the basilar artery （n = 7） and extension into the eerebellar peduncle （n = 6） was visible on magnetic resonance imaging.     

Ureteric perforation after ureteroscopy: Conservative management

A good result was achieved by treating ureteric perforation conservatively following ureteroscopy.     

Peptide-induced deletion of CD8 T cells in vivo occurs via apoptosis in situ

The ultimate fate of T cells undergoing antigen-induced cell death in vivo remains controversial. Whereas apoptosis of CD4+ T cells driven by superantigen is readily detectable in lymphoid organs, CD8+ T cells have been reported to disappear from the lymphoid organs and accumulate in the liver where they undergo apoptosis. Using transgenic mice that produce large numbers of ovalbumin-specific CD8+ T cells (OT-I cells), we were able to investigate the events that follow soluble peptide administration in an independent CD8+ T cell system. Here we show that the OT-I cells undergo proliferation and apoptosis in situ in lymphoid organs in response to antigenic stimulation with no evidence for liver involvement. This is similar to the course of events found for CD4+ T cell activation and counters the view that the liver is a general site for CD8+ T cell clearance following antigen-specific activation.      

Tetralogy of Fallot: MR findings

Surgical treatment of patients with tetralogy of Fallot requires accurate definition of all anatomic structures, particularly the central pulmonary arteries. Magnetic resonance (MR) images of 22 patients with tetralogy of Fallot were studied to assess their usefulness in providing information regarding the spectrum of anatomic abnormalities in this condition. MR findings were compared with information obtained at catheterization (in 16 patients) and at surgery (in nine patients), both of which were performed within 3 months of MR imaging. Ventricular chamber enlargement and wall hypertrophy were clearly delineated in most of the 17 patients who were examined before definitive surgical repair, and ventricular septal defects were visualized in all 17. Palliative systemic-to-pulmonary shunts were visualized in 11 patients and could be evaluated for patency. Most important, the morphology and size of the right ventricular outflow tract and central pulmonary arteries could be accurately assessed. Pulmonary artery measurements obtained from MR images demonstrated excellent correlation with angiographic measurements. In six patients examined after complete surgical repair, MR images accurately reflected changes in pulmonary artery outflow tract morphology and complications, such as residual pulmonary artery stenosis and thrombosis. The findings suggest that MR imaging can complement or obviate catheterization in the evaluation of tetralogy of Fallot with regard to suitability for definitive surgical repair.     

Pancreatic pseudocysts drained through a percutaneous transgastric approach: further experience

Percutaneous transgastric placement of a drainage catheter under ultrasonographic and fluoroscopic guidance was performed in 12 patients with pancreatic pseudocysts. Complete resolution of the pseudocysts was obtained in eight patients, and the result was indeterminate in one patient due to early death from unrelated causes. Surgical intervention followed in two patients, one with a multiloculated pseudocyst that was incompletely drained and another with a pseudocyst that became infected following drainage. In one patient with metastatic tumor to the head of the pancreas the pseudocyst resolved initially, but a pseudocyst later recurred. There were no pancreaticocutaneous fistulas or other major complications. The transgastric route of pseudocyst drainage is safe and effective, and it offers a low risk of recurrence and fistula formation.