Pyrimidine metabolism in Tritrichomonas foetus.

The anaerobic parasitic protozoa Tritrichomonas foetus is found incapable of de novo pyrimidine biosynthesis by its failure to incorporate bicarbonate, aspartate, or orotate into pyrimidine nucleotides or nucleic acids. Uracil phosphoribosyltransferase in the cytoplasm provides the major pyrimidine salvage for the parasite. Exogenous uridine and cytidine are mostly converted to uracil by uridine phosphorylase and cytidine deaminase in T. foetus prior to incorporation. T. foetus cannot incorporate labels from exogenous uracil or uridine into DNA; it has no detectable dihydrofolate reductase or thymidylate synthetase and is resistant to methotrexate, pyrimethamine, trimethoprim, and 5-bromovinyldeoxyuridine at millimolar concentrations. It has an enzyme thymidine phosphotransferase in cellular fraction pelleting at 100,000 X g that can convert exogenous thymidine to TMP via a phosphate donor such as p-nitrophenyl phosphate or nucleoside 5'-monophosphate. Thymidine salvage in T. foetus is thus totally dissociated from other pyrimidine salvage.     

Management and outcome of primary vaginismus

Our objective was to access the success rate, and the factors affecting it, of treatment based on Masters and Johnson's sex therapy. For this prospective study, we enrolled 120 couples with unconsummated coitus due to vaginismus. We made a clinical diagnosis after taking a detailed history taking and conducting a clinical examination. Participants completed a questionnaire regarding characteristics of vaginismus after participating in a face-to-face interview. Both of these were done prior to treatment, after 3 months, and after 12 months. We provided sex therapy based on Masters and Johnson's method. Treatment results were then analyzed. After therapy, 93.3% of vaginismic women were successfully penetrated, and 83.3% had regular intercourse with orgasm. The abilities to reach orgasm and sexual desire were not different than that among normal women. There was a correlation between duration of unconsummation and success rate and also between severity of vaginismus, treatment sessions, and success rate. Because of our high success rate, we encourage vaginismic women and their partners to accept aggressive management.     

Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing

BACKGROUND: Fractures in the distal tibial metaphysis are more complicated to treat than diaphyseal fractures. We compared treatment with plating to treatment with shorted intramedullary (IM) nailing. METHODS: Patients with AO type 43A fractures were treated with plate fixation (group A, n=14) or shortened IM nailing (group B, n = 13). We compared postoperative radiographic deformities, functional results (Iowa ankle scores), and symptoms (Olerud and Molander ankle scores). RESULTS: All fractures had healed at final follow-up (mean, 33 month). Mean union times were 27.8 week (range, 18-36 week) in group A and 22.6 week (range, 18-30 week) in group B (P<0.05). Mean postoperative valgus angulations were larger in group B (3.7 degrees ) than in group A (0.5 degrees ) (P<0.05). However, malunions did not differ between groups (P<0.05). Functional results and postoperative symptoms were similar. CONCLUSIONS: Both plate fixation and shortened IM nailing were effective for treating distal tibial metaphyseal fractures.     

Discordant responses to progestin in a patient with uterine low-grade smooth-muscle tumors metastatic to the lung

A 58-year-old woman presented with pelvic, para-aortic masses and two isolated nodules in the right lung 6 years after hysterectomy and bilateral salpingo-oophorectomy for uterine leiomyoma. Laparotomy was carried out and all the intra-abdominal tumors were excised; pathology showed metastatic low-grade leiomyosarcomas. Immunohistochemical staining revealed a high expression level of estrogen and progesterone receptors in these tumors. The pulmonary nodules were left and the patient was given oral medroxyprogesterone acetate 200 mg daily after the operation. One of the pulmonary masses regressed progressively and had disappeared 7 months later on chest X-ray examination. However, the other was persistent. She then received wedge resection to excise the pulmonary nodule, which showed the same histologic pattern as the abdomen masses. However, the immunohistochemical staining on this nodule showed positive estrogen receptor expression but was negative for progesterone receptor expression. After the operation, she maintained progestin treatment and was tumor free for the following 12 months.     

Effect of automatic external defibrillator audio prompts on cardiopulmonary resuscitation performance

Methods: Untrained subjects were asked to perform CPR on a manikin with and without the assistance of audio prompts. All subjects were then trained in CPR, and retested them eight weeks later.

Results: Untrained subjects who performed CPR first without audio prompts performed poorly, with only (mean (SD)) 24.5% (32%) of compressions at the correct site and depth, a mean compression rate of 52 (31) per minute, and with 15% (32%) of ventilatory attempts adequate. Repeat performance by this group with audio prompts resulted in significant improvements in compression rate (91(12), p = 0.0002, paired t test), and percentage of correct ventilations (47% (40%), p = 0.01 paired t test), but not in the percentage correct compressions (23% (29%)). Those who performed CPR first with audio prompts performed significantly better in compression rate (87 (19), p = 003, unpaired t test), and the percentage of correct ventilations (51 (34), p = 0.003 unpaired t test), but not in the percentage of correct compressions (18 (27)) than those without audio prompts. After training, CPR performance was significantly better than before training, but there was no difference in performance with or without audio prompts, although 73% of subjects commented that they felt more comfortable performing CPR with audio prompts.

Conclusions: For untrained subjects, the quality of CPR may be improved by using this device, while for trained subjects the willingness to perform CPR may be increased.

     

Primary peritoneal carcinosarcoma (malignant mixed mullerian tumor): Report of a case with five-year disease free survival after surgery and chemoradiation and a review of literature

Malignant mixed mullerian tumors (MMMTs), also known as carcinosarcoma because they contain both carcinomatous and sarcomatous elements are aggressive tumors, which usually arise in the uterus and ovary. Extragenital carcinosarcomas are extremely rare and most cases develop from the peritoneum. To our knowledge, only 29 cases have been described in English literature. Here we report a case of a primary carcinosarcoma of the pelvic peritoneum with five-year disease-free survival after managing the patient with surgery, chemotherapy and radiotherapy.     

Anti-inflammatory activities of flavonoids isolated from Caesalpinia pulcherrima

The anti-inflammatory activities of five flavonoids, namely 5,7-dimethoxyflavanone (1), 5,7-dimethoxy-3′,4′-methylenedioxyflavanone (2), isobonducellin (3), 2′-hydroxy-2,3,4′,6′-tetramethoxychalcone (4) and bonducellin (5), all of them isolated from Caesalpinia pulcherrima L. was studied in lipopolysaccharide (LPS) and interferon (IFN)-γ activated murine peritoneal macrophages. These five compounds significantly and dose-dependently inhibited the inflammatory mediators; nitric oxide (NO), and cytokines [tumor necrosis factor (TNF)- and interleukin (IL)-12]. According to their inhibitory results, the order of anti-inflammatory potency was compounds 3 > 5 > 4 > 2 > 1. Furthermore, peritoneal macrophages were pre-activated with LPS/IFN-γ for 24 h, and determined the inhibitory effects of the above-mentioned isolates on the production of NO after a further 24 h. The present study supports the use of Caesalpinia pulcherrima for the treatment of inflammatory diseases in traditional medicine. This is the first study on compounds 1–5 about their anti-inflammatory activities.     

Highly sensitive analysis of the anti-tumor agent 1-[4-(furo[2,3-b]-quinolin-4-ylamino)phenyl]ethanone in rat plasma by high-performance liquid chromatography using electrochemical detection

A sensitive high-performance liquid chromatography method with electrochemical detection was developed for the purpose of determining the concentration of the new anti-tumor agent 1-[4-(furo[2,3-b]-quinolin-4-ylamino)phenyl]ethanone (FQPE) in rats. The plasma samples were spiked with the internal standard diclofenac and extracted using dichloromethane. A C(18) 250 mm x 4mm column was used for the separation of analyte with a mobile phase consisting of 50% acetonitrile and 50% pH 3.0 of sodium 1-pentansulfonate solution at a flow rate of 1.0 mL/min. FQPE was detected by electrochemical detector at 1.0 V and 20 nA. Intra-day and inter-day precision and accuracy were acceptable down to the limit of quantization of 1 ng/mL. The lower limit of detection (LOD) was 0.5 ng/mL. The pharmacokinetic parameters of FQPE in rats after intravenous administration of 2.1 and 4.2 mg/kg were determined. The apparent volume of distribution, half-life of elimination, and clearance showed no significant difference between the two dosages. The area under the plasma concentration time curve increased proportionally with dose. The half-life of FQPE was prolonged about 2.4-fold, compared with amsacrine.