Oxygen free radicals and pelvic adhesion formation: I. Blocking oxygen free radical toxicity to prevent adhesion formation in an endometriosis model.

Intraperitoneal superoxide dismutase (SOD) and catalase were used to block the toxic effects of superoxide anion (O2) and hydrogen peroxide (H2O2), associated with the production of endometriosis and inflammation in a rabbit model. In a two-part animal study, the combined instillation of SOD and catalase significantly reduced the formation of intraperitoneal adhesions at endometriosis sites.     

Recognition and management of patients with high-risk vesicovaginal fistulas: Implications for teaching and research

Vesicovaginal fistulas (VVFs) occurring as a result of obstetric trauma are a vast problem in Nigeria and Ghana, where at least 20 000 women await repair, and fewer than 50 physicians have the necessary expertise. Through a series of conferences those VVFs that are at high risk and those at low-risk for repair failure, were identified. A clinic was established where repair of low-risk VVFs was done on an ongoing basis in a remote region of Ghana. A visiting surgical team was utilized to repair the difficult, or high-risk, VVFs, which included 4–6 cm VVFs (3), recurrent VVF (1), combined VVF and RVF (rectovaginal fistula), a large 5 cm juxtacervical VVF (1), and a vesicouterine fistula (1). Management of these patients and others with VVF repair complications is discussed.     

Identification and purification of a conserved heme-regulated hemoglobin-binding outer membrane protein from Haemophilus ducreyi.

A hemoglobin-binding protein (HgbA) from Haemophilus ducreyi was identified and purified. The 100-kDa HgbA was detected in all strains of H. ducreyi tested, and a somewhat larger hemoglobin-binding protein was found in one strain of Haemophilus influenzae. HgbA was purified and the amino acid sequence of the N terminus of HgbA revealed no significant homologies with known proteins. Two different antisera to HgbA from H. ducreyi 35000 recognized HgbA proteins from all tested H. ducreyi strains; they did not recognize proteins from the H. influenzae strain. Expression of HgbA was regulated by the level of heme but not by iron present in the medium. Animal species of hemoglobin competed with iodinated human hemoglobin for binding to whole cells of H. ducreyi and supported the growth of H. ducreyi. The lack of immunological cross-reactivity and the differences in hemoglobin specificities between the H. ducreyi and the H. influenzae hemoglobin-binding proteins suggest that they are unrelated.     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.