Reimplantation of the aortic valve at 20 years

Objective

To provide additional information on clinical and echocardiographic outcomes after reimplantation of the aortic valve (RAV) in patients with aortic root aneurysm.

Outcomes After Aortic Valve Replacement for Asymptomatic Severe Aortic Regurgitation and Normal Ejection Fraction

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A prospective randomized comparison of cefotaxime vs ampicillin and chloramphenicol for bacterial meningitis in children

Fifty children with bacterial meningitis were prospectively randomized to receive cefotaxime (50 mg/kg/dose every 6 hours) or ampicillin and chloramphenicol in standard doses. Twenty-three patients received cefotaxime and 27 received standard therapy. Bacterial isolates included: Haemophilus influenzae (29), Streptococcus pneumoniae (eight), Neisseria meningitidis (eight), group B streptococci (three), and Salmonella enteritidis (two). Ten (34%) of the H. influenzae isolates were resistant to ampicillin, nine on the basis of beta-lactamase production. All strains were susceptible to cefotaxime. Clinical cure rates for the cefotaxime (100%) and standard therapy (96%) groups were similar; survival without detectable sequelae was similar, at 78% and 77%, respectively. The duration of therapy, 11.1 +/- 2.4 days (range 10 to 21 days) vs 11.9 +/- 3.9 days (range 10 to 21 days), and days to defervescence, 4.7 +/- 2.6 days (range 1 to 14 days) vs 5.6 +/- 2.9 days (range 2 to 17 days), were similar in the cefotaxime and standard therapy groups, respectively. No adverse drug reactions or side effects were noted in either group. Cefotaxime was found to be as safe and effective as standard therapy for the treatment of bacterial meningitis in children.     

Somatization disorder in men

Somatization disorder is thought to be rare in men. This paper reviews five previously reported cases of somatization disorder in men and reports nine new cases referred from primary care physicians. These men have most of the associated features of the disorder, are of lower socioeconomic status, and have other significant psychiatric diagnoses. Eight of the nine men had a dramatic precipitating event at the onset of their illness. This diagnosis appears to be applicable to men and needs to be considered in men with multiple, recurrent unexplained medical symptoms.     

Aortic valvuloplasty in the fetus: technical characteristics of successful balloon dilation

OBJECTIVES: To describe technical aspects of successful fetal aortic valvuloplasty, with particular attention to balloon size. STUDY DESIGN: We retrospectively reviewed all procedural records and echocardiograms pertaining to 26 attempts at fetal aortic valve dilation performed at a single center over a period of 4 years. We assessed the effect of valvuloplasty as determined by echocardiographic appearance at the time of intervention and in follow-up. RESULTS: In 20 of 26 fetuses who had technically successful aortic valve dilation (median balloon:annulus ratio=1.1), all had improved antegrade flow and 12 had at least mild regurgitation after dilation. Use of an oversized balloon was associated with the onset of moderate or severe aortic regurgitation, seen in 5 fetuses. This aortic regurgitation was well tolerated and improved through the remainder of gestation. CONCLUSIONS: These data imply that fetal aortic valves can be dilated safely with larger balloons than are commonly used for postnatal dilation. The observation of spontaneous improvement in postdilation aortic regurgitation further suggests that fetal valve tissue behaves uniquely.     

Establishment and characterization of a primary androgen-responsive African-American prostate cancer cell line, E006AA

BACKGROUND: Establishment of human prostate cancer cell lines is essential to advance our understanding of complex processes associated with the initiation and progression of the disease. In the present study, we report the establishment of a primary African-American prostate cancer cell line (E006AA) as well as its associated stromal cells (S006AA). METHODS: E006AA cell line was established as a spontaneously immortalized cells from a patient with a clinically localized prostate cancer. Extensive characterization of the cells was accomplished using androgen-dependent growth and sensitivity assays, Western analyses, RT-PCR/real-time PCR, cytogenetic analyses, and tumorigenicity in nude mice. RESULTS: E006AA cell line shows androgen-dependent growth, expresses PSA and the androgen receptor (AR) with 26 CAG repeats in exon 1 of AR. Cytogenetic analyses revealed a hypertriploid karyotype with additional numerical gains in chromosomes 5, 6, 8, 10, 17, 20, 21 and a marker chromosome of unknown origin as well as structural abnormalities in chromosomes 4, 5, 8, 9, 11-14, 18, and 20. This cell line is not tumorigenic in nude mice. S006AA cell line, isolated from the same tumor specimen, also expresses AR and shows the morphological characteristics of smooth muscle cells of prostatic stroma. CONCLUSIONS: These cell lines are the first available primary epithelial and stromal cells derived from an African-American patient with organ-confined prostate cancer and in conjunction with other established cell lines, could provide an in vitro model system to investigate early transforming events in prostate cancer.     

Genetic polymorphisms and prostate cancer risk

The identification of common genetic polymorphisms that influence susceptibility to PC would allow an early risk assessment with earlier and therefore potentially more effective intervention by chemopreventive means. In this review we focus on published case-control studies and meta-analyses of the following polymorphic genes that may play a role in etiology of the androgen receptor (AR), the prostate-specific antigen (PSA), 5-reductase type II gene (SRD5A2), cytochrome P450c17 (CYP17), cytochrome P4503A4 (CYP3A4) and a putative hereditary PC susceptibility gene, ELAC2.Abbreviations PC Prostate cancer - BPH Benign prostatic hyperplasia - SNP Single nucleotide polymorphism - AR Androgen receptor - PSA Prostate-specific antigen - ARE Androgen responsive element - SRD5A2 5-reductase type II gene - CYP17 Cytochrome P450c17 - CYP3A4 Cytochrome P4503A4 - DHT Dihydrotestosterone - CL Confidence limit - OR Odds ratio - SD Standard deviation     

Normal range and variation of the zona pellucida-induced acrosome reaction in fertile men

OBJECTIVE: To investigate the normal range of the zona pellucida (ZP)-induced acrosome reaction (AR) in fertile men. DESIGN: A study of normative data. SETTING: Academic research and teaching tertiary hospital.None.Fertile men (n = 111) who had children or whose female partner was currently pregnant. MAIN OUTCOME MEASURE (S): Semen analysis, sperm-ZP binding, and the ZP-induced AR. RESULT(S): There was wide range for the ZP-induced AR: 20%-98% with a mean of 48%. The ZP-induced AR was significantly correlated with sperm concentration and normal morphology. The ZP-induced AR was significantly lower in men with sperm concentration 60 x 10(6)/mL. Similarly, men with normal sperm morphology >or=15% had significantly higher ZP-induced AR than men with normal morphology <15%. CONCLUSION(S): There is a wide range of the ZP-induced AR in fertile men that is correlated with sperm concentration and normal morphology.     

男性不育症患者外周血白细胞雄激素受体的改变及意义

目的：探讨男性不育与外周血白细胞雄激素受体表达的关系。方法：根据精液分析及睾丸活检病理检查结果,将67例男性不育症患者分成少精子症组(n=21)、弱精子症组(n=15)、阻塞性无精子症组(n=14)和非阻塞性无精子症组(n=17),采用放射配体结合分析法检测不育症患者外周血白细胞雄激素受体(AR),同时采用放射免疫法检测血清睾酮(T)和雌二醇(E_2)水平,并以22例正常生育男性为对照。结果：外周血白细胞AR含量少精子症组、弱精子症组、阻塞性无精子症组与对照组比,均无统计学差异(P＞0．05)；非阻塞性无精子症组(782±98)与对照组(913±104)相比,差异有统计学意义(P＜0．01)。男性不育症各组与对照组相比,E_2和T水平差异均无统计学意义(P＞0．05)；而男性不育症患者精子密度与白细胞AR含量呈正相关(r=0．233,P=0．010)。结论：一部分男子不育的发生、发展过程可能与AR表达下调有密切关系。