Optimization of prognosis and surgical prophylaxis of bleedings from esophageal varicose veins

New methods of prediction of bleeding from the esophageal varicose veins improve treatment outcomes. These methods consist of endoscopic assessment of varicose vein and mucous membrane with determination of thickness of the vein wall and mucosa, and also assessment of reflux-esophagitis with endoscopic ultrasonography. Original operation of azigoportal disconnection was performed in 13 patients followed-up after surgery from 1 to 4 years. The results obtained demonstrate high efficacy of this surgery for prophylaxis of repeated bleedings from esophageal varicose veins.     

1141644472Surface Enhanced Laser Desorption and Ionization (SELDI) mass spectrometry for investigation of human embryo conditioned IVF culture medium

Background:  Fetal programming is the notion that adverse environmental conditions in utero can cause short term survival adaptations that may have long-term consequences, such as chronic disease in subsequent lifetime. Recently, some authors reported that the increase of allergy prevalence in childhood may be linked with fetal immune development. In this regard, literature survey inspired to study the influence of two conjugated linoleic acid (CLA)-isomers (c9,t11 and t10,c12) on parameters of the immune system in pregnancy.
Methods:  Lymphocytes from allergic and non-allergic mothers, cord blood of their newborns, and the decidual layer of term placentae were isolated and cultured for 2 days and supplemented or not with relevant allergens, c9,t11 CLA, t10,c12 CLA or linoleic acid, respectively. Expression of CD69 (activation marker) and CD71 (transferrin receptor; proliferation marker) on B and T lymphocytes and T helper cell type 1 (Th1) and Th2 cytokines in culture supernatant were analyzed.
Results:  Both CLA isomers led to an increase of the IFN-γ/IL-10 ratio in supernatants of peripheral maternal and cord blood cells from allergic patients and non-allergic-control. CLA supplementation decreased IL-10 secretion of peripheral maternal and decidual lymphocytes and the portion of CD71⁺ maternal B cells. Linoleic acid induced a similar effect.
Conclusion:  An immunological effect of CLA on maternal and fetal lymphocyte responses could be demonstrated. It would be expected that further investigations could reveal differences in effects of CLA and linoleic acid.     

Follicular fluid of women with endometriosis stimulates the proliferation of endometrial stromal cells

The peritoneal environment in endometriosis is known to have growth- promoting effects on endometrial cells. To investigate whether follicular fluid, a contributor to the peritoneal fluid, stimulates endometrial cell proliferation, we incubated endometrial stromal cells in culture with various dilutions of follicular fluid obtained from women with or without endometriosis undergoing oocyte retrieval for in- vitro fertilization. Cell proliferation assays were performed using follicular fluid from 28 women (without endometriosis, n = 13; with endometriosis, n = 15) in eight different endometrial stromal cell culture set-ups. Cell proliferation was assessed by a colorimetric method. Maximum cell proliferation was detected when endometrial cells were incubated with 50% dilution of follicular fluid for 48 h. Follicular fluid from women with endometriosis induced significantly higher cell proliferation than follicular fluid from women without endometriosis (P < 0.05). Our findings indicate that follicular fluid contents may contribute to the growth-promoting factors in the peritoneal fluid of women with endometriosis.      

Maturation of human spermatozoa (from selected epididymides of prostatic carcinoma patients) with respect to their morphology and ability to undergo the acrosome reaction

Spermatozoa were recovered form three regions of the epididymisof six prostatic carcinoma patients. After washing and incubatingfor 3 h in Ham's F-10 medium, with or without 5 µM A23187for the last 30 min, spermatozoa were tested for vitality byhypotonic swelling and permeated with methanol to detect theacrosome with peanut agglutinin. Whereas the extent of spontaneousacrosome reactions was similar for spermatozoa from all regionsof the duct, 17 and 28% of spermatozoa from all regions of theduct, 17 and 28% of spermatozoa from the corpus and cauda epididymidisrespectively, responded to stimulation by A23187 with acrosomereactions but there was no stimulation by A23187 of spermatozoafrom the efferent ducts. The percentage of morphologically normalspermatozoa increased stepwise towards the distal regions, withabnormalities being mostly enlarged heads in more proximal regions:they were largely absent form the cauda epididymidis. Spermhead swelling was similarly observed in cynomolgus monkey spermatozoafrom the caput epididymidis but not the more distal regions.These forms were not observed when spermatozoa were fixed beforesmearing, indicating that they were artefacts of sperm preparation.The changes in the susceptibility of non-fixed epididymal spermatozoato produce morphological artefacts and the gain in their acrosomalresponse to ionophore demonstrate maturational changes of spermatozoain the human epididymis.     

《亚洲男性学杂志》“21世纪精液分析特刊”后序

对这期特刊中各位作者讨论的主题予以总结和评论。     

Ineffectiveness of sun awareness posters in dermatology clinics

Background Although sun awareness posters have been used in doctors’ offices and clinics for decades to promote sun protective behaviour, there is no evidence of their usefulness. Objectives To investigate whether sun awareness posters lead to inquiry of skin cancer and sun protection measures. Method Patients considered at risk for skin cancer seen at a dermatology clinic were randomly asked to complete a questionnaire designed to assess the effectiveness of three different sun awareness posters placed in patient rooms. The posters were selected on the basis of their catchy slogan and eye‐appealing images, and included those featuring parental interest, sex appeal and informative advice. Results Only half of the patients noticed the posters (50.6%). The poster with sex appeal garnered the most attention (67.8%), followed by the informative poster (49.2%) and the parental interest poster (35.8%) (P < 0.001). Although patients who noticed the sun awareness poster inquired about cutaneous cancers and sun protection practices twice as often as those who did not notice the poster, only one‐tenth of such inquiries were attributed to the poster (～5% of the target population). As reported in the questionnaire, the posters themselves were less effective than the advice of physicians in influencing patient attitudes towards sun protection measures. Conclusion Organizations that produce and disseminate posters should consider beyond focus groups when they design their posters and should consider field testing their products to ensure that they are reaching the targeted audience and are having the expected beneficial effect, otherwise their posters are simply decorative.     

Differential effects of antigens from L. braziliensis isolates from disseminated and cutaneous leishmaniasis on in vitro cytokine production

Background  

Disseminated leishmaniasis is an emerging infectious disease, mostly due to L. braziliensis, which has clinical and histopathological features distinct from cutaneous leishmaniasis.     

Safety of hospitalized ventilator-dependent children outside of the intensive care unit

OBJECTIVE: Hospitalization of clinically stable ventilator-dependent children in an intensive care unit (ICU) remains the standard in most pediatric centers. The aim of this study was to determine whether chronically ventilator-dependent children could be hospitalized safely in a non-ICU setting. METHODS: All ventilator-dependent children who were hospitalized on the pediatric wards at Childrens Hospital Los Angeles from December 1992 through June 1996 were reviewed retrospectively (N = 63) and compared with the general pediatric ward population hospitalized during the same period. Data collected included the number of unexpected ICU transfers from the pediatric ward and the number of deaths that occurred on the ward. RESULTS: The ventilator-dependent children on the pediatric wards had 11 emergency readmissions to the ICU for unexpected deterioration. This represented an unexpected ICU transfer rate of 2.7 per 1000 patient-days on the wards. The general pediatric ward population had an unexpected ICU transfer rate of 3.3 per 1000 patient-days, which was not significantly different from that of ventilator-dependent children on the wards. There were three ward deaths among the ventilator-dependent children, but all of these patients had advance directive status (do not resuscitate). This represented a rate of seven deaths per 10,000 patient-days on the wards, which was not significantly different from those of nonventilator-dependent ward patients (eight deaths per 10,000 patient-days). CONCLUSIONS: We conclude that ventilator-dependent children hospitalized outside of the ICU do not have an increased incidence of deaths and unexpected ICU admissions compared with nonventilator-dependent inpatients. We speculate that hospital care of stable ventilator-dependent children can be provided safely outside of an ICU and at lower cost.