1141154113Expression of natural cytotoxicity receptors in peripheral blood NK cell subsets of women with recurrent spontaneous abortions (RSA) or implantation failures

Aim:  To determine if IgA is required for protection against Chlamydia infection in the male reproductive tract (MRT).
Materials and Methods:  Male polyimmunoglobulin receptor knockout mice (PIgR^-/-) and wild-type C57BL/6 (WT) mice were immunised intranasally with chlamydial major outer membrane protein (MOMP) and cholera toxin (CT). MOMP-specific IgG and IgA in serum and prostatic fluids were measured by ELISA. Serum and PF were also assayed for inhibition of in vitro chlamydial infection. Immunized WT and PIgR^-/- mice were challenged by direct inoculation of C. muridarum into the meatus urethra. Four weeks post challenge Chlamydia levels in the penile urethra, epididymis and testis were determined by PCR.
Results:  Equivalent levels of IgG were found in the serum of both WT and PIgR^-/- mice however IgA in serum of PIgR^-/- mice was 19- to 20-fold higher than in WT animals consistent with the lack of the PIgR IgA transport molecule. IgA levels were significantly lower in PIgR^-/- PF compared to WT PF after both immunization and infection. Only PF from WT but not PIgR^-/- animals was able to inhibit in vitro chlamydial infection. Following challenge significantly higher levels of Chlamydia were recovered from the MRT of PIgR^-/- mice compared to WT animals.
Conclusions:  Male mice lacking a functional PIgR were unable to clear a genital tract Chlamydia infection despite high levels of serum IgA. These data show that mucosal IgA plays a major role in preventing chlamydial infection of the male genital tract and suggest that immunization strategies to protect males should target a strong mucosal IgA response.     

人骨髓间充质干细胞分离培养及血管内皮生长因子对其产生的诱导分化作用

目的：目前有关骨髓间充质干细胞向内皮细胞诱导分化的研究较少。本实验分离和培养人骨髓间充质干细胞，用带有VEGF165的质粒转染人骨髓间充质干细胞，探讨血管内皮生长因子对其体外诱导分化的作用。 方法：实验于2005—04／2006—04在吉林大学人兽共患病教育部重点实验室完成。取成人的已排除血液系统肿瘤疾病的新鲜骨髓（自愿提供），采用Percoll梯度分离培养骨髓间充质干细胞，于倒置显微镜下观察细胞形态变化和生长情况。原代细胞培养至增殖接近融合状态时，单克隆培养法分离传代培养，扩增骨髓间充质干细胞。采用流式细胞术检测细胞免疫学表型。在原核细胞大肠杆菌DH5α中复制扩增和提取，纯化、克隆pcDNA3．0-VEGF165质粒。用脂质体转染法转染骨髓间充质干细胞：应用流式细胞术检测诱导后骨髓间充质干细胞免疫学表型变化j并采用免疫荧光染色鉴定转染情况，并设质粒空载和未转染的骨髓间充质干细胞为对照。 结果：人骨髓间充质干细胞原代培养1周后，造血细胞消失，贴壁细胞体积增大，呈现梭形外观，有粗大的细胞突起伸出。2周后细胞融合成单层，梭形突起变长，排列有明显的方向性，细胞排列成旋涡状、网状、辐射状。流式细胞术显示，人骨髓间充质干细胞免疫学表型CD44、CD29阳性，CD34、CD31、CD45阴性。VEGF165诱导骨髓间充质千细胞后CD44表达明显降低，CD31明显升高。免疫荧光染色显示，用FITC标记后的VEGF抗体使细胞显现绿色荧光，用cy3标记的CD31抗体使细胞显现了红色荧光。 结论：转染后的骨髓间充质干细胞细胞表型发生明显转变，CD31表达率明显增高，呈现典型的内皮细胞的表型特征，这说明骨髓间充质干细胞具有向内皮细胞分化的潜能。     

Die Anwendungsbreite der Paravertebralen Injektion

Ohne Zusammenfassung     

Roundtable on Bioterrorism Detection: Information System–based Surveillance

During the 2001 AMIA Annual Symposium, the Anesthesia, Critical Care, and Emergency Medicine Working Group hosted the Roundtable on Bioterrorism Detection. Sixty-four people attended the roundtable discussion, during which several researchers discussed public health surveillance systems designed to enhance early detection of bioterrorism events. These systems make secondary use of existing clinical, laboratory, paramedical, and pharmacy data or facilitate electronic case reporting by clinicians. This paper combines case reports of six existing systems with discussion of some common techniques and approaches. The purpose of the roundtable discussion was to foster communication among researchers and promote progress by 1) sharing information about systems, including origins, current capabilities, stages of deployment, and architectures; 2) sharing lessons learned during the development and implementation of systems; and 3) exploring cooperation projects, including the sharing of software and data. A mailing list server for these ongoing efforts may be found at http://bt.cirg.washington.edu.Bioterrorism has quickly become a new and frightening part of life in America. A host of potential agents, with varying degrees of virulence and a confusing array of nonspecific symptoms, are now household words. The field of medical and public health informatics has long concerned itself with developing methods to represent, store, and analyze data that describe the complexities of individual and population-based health.¹ Now, informatics tools such as knowledge representation, controlled vocabularies, heterogeneous databases, security and confidentiality, clinical decision support, data mining, and data visualization are being applied with a new urgency to the task of early detection of intentional outbreaks of disease.In November 2001, as part of the activities of the Anesthesia, Critical Care, and Emergency Medicine Working Group, investigators from several research groups took part in the “Roundtable on Bioterrorism Detection” at the AMIA Annual Symposium. The session was subtitled “Information System–based Sentinel Surveillance.” These researchers, and others, are developing public health surveillance systems that make secondary use of data gathered during normal clinical workflow or that facilitate electronic case reporting by clinicians. These surveillance strategies are intended to enhance early detection of changes in the health of the community. This paper combines brief case reports of a number of existing systems with a discussion of some commonly employed techniques and approaches.Several bioterrorism-related posters and papers were presented at the Symposium.^2–7 A handful of systems, all in active development, are currently deployed. The utility of these systems in detecting bioterrorism events is unproven, and it is hoped that their full capabilities will never need to be tested directly. However, the value of monitoring and aggregating disease indicators across a population is clear, if intuitive, and such surveillance has a strong precedent in public health practice.^8–10There are strategies for indirectly measuring the performance of these systems and for improving their diagnostic accuracy and timeliness, even in the absence of bioterrorism cases. These strategies include measuring the accuracy of detection of components of case definitions, as opposed to detection of outbreaks. Other strategies involve the detection of surrogate diseases, such as influenza, whose symptoms are similar to the initial symptoms of inhalational anthrax. Espino et al.⁴ showed a 44percent sensitivity and 97percent specificity in detection of cases of acute respiratory illness, a common symptom prodrome of many illnesses spread by bio-aerosol agents. A companion study³ showed that time–series analysis of such cases in a population could detect an outbreak of influenza. McClung et al.¹¹ found relatively similar sensitivity and specificity (37 and 97percent, respectively) in a system detecting asthma visits, based on chief complaint on presentation to an emergency room.A number of federal and other agencies have funded the work on these surveillance systems. These include the Centers for Disease Control and Prevention (CDC), through State Bioterrorism Preparedness grants, the Health Alert Network program, and cooperative agreements; the Agency for Healthcare Research and Quality (AHRQ); the Defense Advanced Research Projects Agency (DARPA); the National Library of Medicine (NLM), both directly though grant funding and indirectly through support of NLM Fellowships in Informatics and Integrated Advanced Information Management System sites; and by state and local public health agencies using CDC and other funds.     

Growth and determinants of access in patient e-mail and Internet use

OBJECTIVES: To measure the rate of access to and use of the Internet and e-mail, to determine sociodemographic predictors of access, and to measure the change in Internet and e-mail access over a 1-year interval. DESIGN: Survey study. Comparison of data with those from a similar survey from 1998. SETTING: Emergency department of a large urban pediatric teaching hospital. PARTICIPANTS: Primary caretakers of pediatric patients or the patients themselves if aged 16 years or older. MAIN OUTCOME MEASURES: Use of and access to the Internet or e-mail. RESULTS: We surveyed 214 individuals: 72.8% use or have access to the Internet, e-mail, or both, an increase from 52.2% in the 1998 survey (P<.001), and 48.5% regularly use the Internet or e-mail, compared with 43.1% in 1998 (P = .32). Outside the home, access is primarily at work (52.2%), schools (8.9%), public libraries (11.5%), and friends' and relatives' houses (16.7%). Internet use and access are linearly correlated with income (r = 0.43; P<.001). White patients are more likely to have access (odds ratio, 2.6; 95% confidence interval, 1.3-5.4; P<.001) than black or Asian patients, whereas those of Hispanic ethnicity are less likely to have access (odds ratio, 0.20; 95% confidence interval, 0.09-0.43; P<.001). However, after adjustment for race and Hispanic ethnicity, only income was a significant predictor of family access to the Internet and e-mail. CONCLUSIONS: During the past year, many patients have gained access to the Internet and e-mail, although rates of regular use have remained steady. This access is often from outside the home. Furthermore, access is directly related to income and is unevenly distributed across racial and ethnic groups.     

Wert und Möglichkeit der Fremdhauttransplantation

Zusammenfassung Die Konservierung von Spalthauttransplantaten bei 4°C stellt eine einfache Aufbewahrungsart dar, bei der die Haut bis zu 14 Tagen vital bleibt. Unsere klinischen Erfahrungen mit dieser Methode bei bisher 55 F?llen und die Vorteile der Anwendung von Fremdhauttransplantaten in der plastischen Chirurgie werden dargelegt, diskutiert und an 2 klinischen Fallberichten demonstriert.

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Summary There is a growing need for split skin homografts and heterografts in plastic surgery. The storage of split skin grafts at 4°C in a humid chamber is a simple and non expensive method of skin graft conservation. The grafts remain vital up to 2 weeks. Our clinical experiences with this method on 55 cases are reported. The qualities and the advantages of application of homografts and heterogrofts are discussed and demonstrated on two clinical cases.