Expression of epidermal growth factor receptor and transferrin receptor by human trophoblast populations

Epidermal growth factor (EGF) has several roles, including stimulation of cell division and differentiation. EGF receptor (EGFR) has been localized to villous syncytiotrophoblast, but expression by other human trophoblast populations has not been reported. EGFR expression was examined in normal and pathological placental tissues using a streptavidin-biotin-peroxidase technique; results were compared with expression of transferrin receptor (Tf-R) in similar tissues. EGFR was detected on villous syncytiotrophoblast in early and term pregnancy with labelling of the apical membrane, focal cytoplasmic reactivity, and patchy labelling of the trophoblast basement membrane. In contrast with other reports, EGFR was also consistently localized to villous cytotrophoblast, chorion laeve, and extravillous trophoblast populations in maternal uterine tissues. Maternal decidua showed diffuse labelling of stromal cells, particularly in the superficial zones. The reaction pattern in ectopic tubal pregnancy was similar to that in early intrauterine pregnancy. In molar pregnancy, EGFR was detected on villous syncytiotrophoblast and cytotrophoblast. In contrast, in normal, ectopic, and molar pregnancies labelling for Tf-R was confined to syncytiotrophoblast and to the proximal portions of the cytotrophoblast columns. Expression of EGFR by all trophoblast cells may represent a mechanism of placental growth and proliferation control. EGFR may also be involved with establishment of differentiated trophoblast functions including hormone secretion.     

Malignancy may adversely influence the quality and behaviour of oocytes

A case series of eight cycles of in-vitro fertilization (IVF) in five women diagnosed with malignant disorders is presented. These patients chose to defer definitive treatment for a chance for preservation of potential fertility. The response of these patients to ovarian stimulation, and the outcome, was compared with 17 IVF cycles in 12 age- matched patients with isolated tubal infertility. An apparent adverse influence of malignant disease on the quality and behaviour of oocytes was observed. Despite a comparable total number of oocytes per cycle in the two groups, a significantly reduced percentage of mature oocytes was retrieved per cycle from patients with malignant diseases. The oocytes from patients with malignant disorders were of a poorer quality and exhibited a significantly impaired fertilization rate compared to the controls. We propose that neoplastic processes, irrespective of the site or cell of origin, may have a detrimental impact on the biology of oocytes, an effect akin to that seen on spermatozoa in men with certain malignancies.      

Predicting adolescents' longitudinal risk for sexually transmitted infection: results from the National Longitudinal Study of Adolescent Health

BACKGROUND: Influencing adolescents' sexual behaviors has the potential to influence trajectories of risk for sexually transmitted infections (STIs) among young adults. OBJECTIVE: To determine whether family, school, and individual factors associated with increased duration of virginity also protect against STIs in young adulthood. DESIGN: Prospective cohort study. Wave I of the National Longitudinal Study of Adolescent Health occurred in 1995 when participants were in grades 7 through 12. Six years later, all wave I participants who could be located were invited to participate in wave III and provide a urine specimen for STI testing. SETTING: In-home interviews in the continental United States, Alaska, and Hawaii. PARTICIPANTS: Population-based sample. Of 18,924 participants in the nationally representative weighted wave I sample, 14,322 (75.7%) were located and participated in wave III. Test results for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis were available for 11,594 (81.0%) of wave III participants. MAIN OUTCOME MEASURE: Positive test result for C. trachomatis, N. gonorrhoeae, or T. vaginalis. RESULTS: Controlling for biological sex, age, race/ethnicity, family structure, and maternal education, adolescents who perceived that their parents more strongly disapproved of their having sex during adolescence were less likely to have STIs 6 years later (adjusted odds ratio, 0.89; 95% confidence interval, 0.81-0.99). Those with a higher grade point average during adolescence were also less likely to acquire STIs (adjusted odds ratio, 0.84; 95% confidence interval, 0.71-0.99). Stratified analyses confirmed these findings among female, but not male, adolescents. Feelings of connection to family or school, reported importance of religion, attending a parochial school, and pledges of virginity during adolescence did not predict STI status 6 years later. CONCLUSIONS: Perceived parental disapproval of sexual intercourse and higher grades in school during adolescence have protective influences on the trajectory of risk for acquiring STIs, primarily among female adolescents. Most factors associated with increased duration of virginity in adolescence do not influence the trajectory of STI risk.     

Garment Therapy does not Improve Function in Children with Cerebral Palsy: A Systematic Review

Aims: To conduct a systematic review asking, does garment therapy improve motor function in children with cerebral palsy? Methods: A systematic review with meta-analysis was conducted to review the literature. Inclusion criteria involved the wearing of therapy suits/garments in children with cerebral palsy. The primary outcome of interest was movement related function and secondary outcomes included impairment, participation, parental satisfaction and adverse outcomes of garment wear. Results: 14 studies with 234 participants were included, of which 5 studies were included for meta-analysis. Garment therapy showed a nonsignificant effect on post-intervention function as measured by the Gross Motor Function Measure when compared to controls (MD = ?1.9; 95% CI = ?6.84, 3.05). Nonsignificant improvements in function were seen long-term (MD = ?3.13; 95% CI = ?7.57, 1.31). Garment therapy showed a significant improvement in proximal kinematics (MD = ?5.02; 95% CI = ?7.28, ?2.76), however significant improvements were not demonstrated in distal kinematics (MD = ?0.79; 95% CI = ?3.08, 1.49). Conclusions: This review suggests garment therapy does not improve function in children with cerebral palsy. While garment therapy was shown to improve proximal stability, this benefit must be considered functionally and consider difficulties associated with garment use.     

Nonsurgical Transurethral Collagen Denaturation for Stress Urinary Incontinence in Women: 12-Month Results from a Prospective Long-term Study

Study ObjectiveTo assess efficacy of nonsurgical transurethral collagen denaturation (Renessa) in women with stress urinary incontinence (SUI) caused by bladder outlet hypermobility.DesignContinuing, prospective, 36-month, open-label, single-arm clinical trial. Twelve-month results from intent-to-treat (ITT) analysis are reported. Canadian Task Force classification II-2.SettingThirteen physician offices or ambulatory treatment centers.PatientsWomen with SUI secondary to bladder outlet hypermobility for 12 months or longer who failed earlier conservative treatment and had not received earlier surgical or bulking agent therapy.InterventionsWomen were treated as outpatients and received an oral antibiotic and local periurethral anesthesia before undergoing treatment with transurethral radiofrequency collagen denaturation.Measurements and Main ResultsVoiding diaries and in-office stress pad weight tests yield objective assessments. Subjective measures include the Incontinence Quality of Life (I-QOL), Urogenital Distress Inventory (UDI-6), and Patient Global Impression of Improvement (PGI-I) instruments. In total, 136 women received treatment (ITT population). Patients experienced significant reductions versus baseline in median number of leaks caused by activity/day and activity/week (p <.0026 for both), with 50% of patients reporting 50% or more reduction. Pad weight tests revealed that 69% of women had 50% or more reduction in leakage (median reduction 15.2 g; p <.0001); 45% were dry (29% no leaks; 16% < 1-g leakage). Significant improvements occurred in median scores on the I-QOL (+9.5 [range –66.0 to 91.0]; p <.0001) and mean scores on the UDI-6 (–14.1 ± 24.7; p <.0001). Furthermore, 71.2% showed I-QOL score improvement, including 50.3% with 10-point or greater improvement, and 49.6% reported on the PGI-I that they were “a little,” “much,” or “very much” better.ConclusionAt 12 months, treatment of SUI with nonsurgical transurethral collagen denaturation resulted in significant improvements in activity-related leaks and quality of life.     

A successful strategy for preimplantation genetic diagnosis of myotonic dystrophy using multiplex fluorescent PCR

The most common form of inherited muscular dystrophy in adults is myotonic dystrophy (DM), an autosomal-dominant disease caused by the expansion of an unstable CTG repeat sequence in the 3' untranslated region of the myotonin protein kinase (DMPK) gene. Expanded (mutant) CTG repeat sequences are refractory to conventional PCR, but alleles with a number of repeats within the normal range can be readily amplified and detected. Preimplantation genetic diagnosis (PGD) of DM has been successfully applied. However, a misdiagnosis using the reported protocol was recently documented. Two new PGD protocols for DM have been developed which utilise multiplex fluorescent PCR. Ideally a linked polymorphic marker, APOC2, is amplified in addition to the normal DMPK alleles, thus providing a back-up diagnostic result. However, the two couples reported in the present study were not fully informative at the APOC2 locus and so an unlinked short tandem repeat (STR) marker, D21S1414, was substituted. The highly polymorphic nature of the D21S1414, DMPK and APOC2 loci means that a very simple genetic fingerprint can be generated by analyses of these loci. This allows most DNA contaminants to be detected. Contamination is a significant problem for PGD and is the primary reason for the inclusion of D21S1414 and APOC2 in this protocol. This paper reports the first clinical experience and pregnancies following PGD for DM using a multiplex fluorescent PCR protocol.     

Reducing the incidence of sudden infant death syndrome in the Delta region of Mississippi: a three-pronged approach

Since the "Back to Sleep" campaign in 1994, which encouraged positioning infants on their backs for sleeping, the incidence of sudden infant death syndrome (SIDS) has decreased dramatically in the United states but remains high in some rural Mississippi communities. We discuss some of the hypotheses and etiologic factors of SIDS. The high incidence of SIDS in the Delta region of Mississippi could be dramatically reduced, primarily through an intensified Back to Sleep campaign. Furthermore, the importance of health education in increasing breast-feeding rates and reducing passive smoke exposure rates in this community is emphasized.     

Process evaluation of an integrated model of discharge planning

In this study, a new, empirically-derived model of discharge planning for acutely-ill elderly was evaluated to determine (a) whether it could be implemented in a hospital setting, and (b) what facilitated or challenged the implementation. The process evaluation involved four case studies conducted on three in-patient units of two acute-care hospitals. Data were analyzed using explanation-building and case comparison methods. Three main study results emerged: (a) The integrated model had the potential to be implemented in a hospital setting when certain conditions were in place, (b) use of the integrated approach to discharge planning contributed to patient satisfaction, and (c) the materials developed as part of the discharge planning protocol required only minor formatting modifications in order to be rendered user-friendly. In this article, recommendations are made that will facilitate the model's implementation and utilization in other clinical settings and ongoing and future process evaluations.     

A morphological classification of ganglion cells in the zebrafish retina

We examined the distribution and morphological types of ganglion cells in the retina of the zebrafish, a model vertebrate genetic organism. Using cresyl violet and methylene blue staining, a prominent central area was observed in the ventral temporal retina. The density of ganglion cell layer neurons averaged from approximately 12,000/mm2 in the dorsal-nasal retina to a peak of approximately 37,000/mm2 in the ventral-temporal retina. Individual zebrafish ganglion cells were labeled by backfilling with DiI through the optic nerve followed by reconstruction using confocal microscopy. The dendritic stratification and branching pattern of each labeled ganglion cell was examined in relation to the borders of the inner plexiform layer (IPL). We identified 11 different morphological types of ganglion cell. The most commonly labeled ganglion cells were two types termed Type III or IV, which displayed highly stratified dendritic arborizations in their respective ON-, OFF-sublaminae of the IPL. Their dendritic branching patterns were highly asymmetric with many thorn-like varicosities that profusely filled the area of arborization. In contrast, Type V cells formed a small simply branching dendritic field in the innermost portion of the ON-sublamina of the IPL. Two large ganglion cell types (Types I and II) with wide monostratified dendritic fields were found in both the ON- and OFF-sublamina of the IPL. Three different types of multistratified/bistratified ganglion cells were found (Types, IX, X, and XI.) whose dendrites occupied different regions of the IPL. The multistratified dendrites of IX cells occupied the whole width of the IPL, while the dendrites of Type XI cells formed vertical claw-like endings in only the ON-sublamina of the IPL. We conclude that zebrafish ganglion cells display a rich variety of types and branching patterns. This study establishes a series of baseline measurements of zebrafish ganglion cells to facilitate examination of genes playing a role in the specification and stratification of ganglion cell types.     

Attitudes of men toward contraception.

This report describes a pilot study conducted to determine the attitudes of men toward contraception. A questionnaire elicited responses from 436 males regarding: Personal data; contraceptive responsibility; contraceptive knowledge; use of contraception and preference for future methods. Results include attitudes toward contraceptive responsibility, assistance to pregnant partners and knowledge regarding eight common contraceptives. Usage of contraceptives in general and condoms and withdrawal specifically is reported. Preference for eight common contraceptive methods is also presented, along with data on delay of intercourse due to lack of contraceptives, partners' requests for male use of condoms/withdrawal and attitudes toward dissemination of contraceptive material to the public. Also reported are attitudes toward development of new contraceptives, use of male sterility shots or pills and the prices that men would pay for newly developed male contraceptives. The most preferred male contraceptive for future development is reported. It was concluded that the survey form and methodology were valid; that men desired to participate in family regulation; that the majority of men placed a low economic value on male contraceptives and finally that the overwhelming majority of men wanted contraceptive information to be widely disseminated in the public.