Are we overlooking obsessive-compulsive disorder during and after pregnancy? Some arguments for a peripartum onset specifier

Archives of Women's Mental Health - The peripartum period appears to be a potent trigger of obsessive-compulsive disorder in women; however, due to the lack of awareness and routine screening,...     

Facial symmetry detection ability changes across the menstrual cycle

The effects of menstrual cycle phase and hormones on women's visual ability to detect symmetry and visual preference for symmetry were examined. Participants completed tests of symmetry detection and preference for male facial symmetry at two of three menstrual cycle phases (menses, periovulatory, and luteal). Women were better at detecting facial symmetry during the menses than luteal phase of their cycle. A trend indicated the opposite pattern for dot symmetry detection. Similarly, change in salivary progesterone levels across the cycle was negatively related to change in facial symmetry detection scores. However, there was no clear evidence of a greater preference for facial symmetry at any cycle phase, despite an overall preference for facial symmetry across phases. These findings suggest a menses phase advantage and a low progesterone advantage in women's ability to detect facial symmetry. The results are discussed in the context of hormonal, evolutionary mate selection, and functional neurocognitive theories.     

Prognostic indicators for survival in head and neck squamous cell carcinomas: analysis of a series of 621 cases

BACKGROUND: We sought to study the influence of pT classification, pN status, tumor volume, and number of lymph nodes invaded on survival of patients with head and neck cancers to improve therapeutic indications. METHODS: This was a retrospective study of 621 consecutive patients treated from 1990 to 1997 by a single team. RESULTS: In univariate analysis, pT classification (p < .0001), pN status (p < .0001), capsule rupture (p < .0001), the number of lymph nodes invaded (0, 1-3, 4-9, > or =10) (p < .0001), and the tumor volume (p < .0001) were significantly associated with overall survival. A Cox model identified as independent prognostic indicators age (p < .0001), pT classification (p < .0001), and pN status (p < .0001). CONCLUSIONS: Not only pT classification and pN status but also the number of the lymph nodes invaded and the tumor volume should be considered as essential prognostic indicators, and any clinical trial developed should stratify accordingly.     

Heterotopic en bloc tracheobronchial transplantation with direct revascularization in pigs

OBJECTIVE: This article describes the application of a novel aortic tube technique for directly revascularized tracheobronchial transplantation with dual blood supply in pigs. METHODS: Eleven adult Large White pigs underwent heterotopic tracheal transplantation with a dual revascularization technique (inferior thyroid artery and bronchial artery). Seven tracheobronchial grafts were perfused ex vivo, and hemodynamic data were collected. RESULTS: At the last evaluation, 6 pigs had normally epithelialized mucus-producing allografts with correct morphologic conformation and cartilage viability. The histopathologic examination revealed homogeneous tissue regardless of biopsy site (trachea, carina, or bronchi), demonstrating the efficacy of the revascularization procedure. Four animals had early ischemic necrosis develop, 2 from acute rejection and 2 from technical mishap. One additional pig had acute rejection starting on the 14th postoperative day. The CD4(+)/CD8(+) ratio was maintained close to or above 0.8 in the subgroup with rejection and below 0.6 in the animals that were correctly immunosuppressed. Pressure-flow curves in 7 ex vivo tracheobronchial grafts showed a nonsignificant difference (P <.12) in vascular resistance between the bronchial artery territory (lower resistance) and the inferior thyroid artery territory. CONCLUSIONS: For the first time, a transplantation technique encompassing the entire trachea, carina, and stem bronchi has been made possible. By means of the dual inferior thyroid and bronchial artery axis, we were able to obtain a structurally healthy and functional graft to replace the main airway.     

Low molecular weight dextran sulfate prevents complement activation and delays hyperacute rejection in pig-to-human xenotransplantation models

Dextran sulfate of 5000 molecular weight (DXS 5000) is known to block complement activation as well as the intrinsic coagulation cascade by potentiation of C inhibitor. The effect of DXS 5000 on hyperacute rejection (HAR) was tested in pig-to-human xenotransplantation models. For in vitro testing, a cytotoxicity assay was used with the pig kidney cell line PK15 as target cells and fresh, undiluted human serum as antibody and complement source. Ex vivo pig lung perfusion was chosen to assess DXS 5000 in a physiologic model. Pig lungs were perfused with fresh, citrate-anticoagulated whole human blood to which 1 or 2 mg/ml DXS 5000 were added; the lungs were ventilated and the blood de-oxygenated. Pulmonary vascular resistance (PVR) and blood oxygenation (deltapO2) were monitored throughout the experiment. Autologous pig blood and human blood without DXS 5000 served as controls. In the PK 15 assay DXS 5000 led to a complete, dose-dependent inhibition of human serum cytotoxicity with an average IC50 of 43 +/- 18 microg/ml (n=8). Pig lungs perfused with untreated human blood (n=2) underwent HAR within 105 +/- 64 min, characterized by increased PVR, decrease of deltapO2, and generalized edema. Microscopically, capillary bleeding as well as deposition of human antibodies, complement and fibrin could be observed. Addition of DXS 5000 (n=4) prolonged lung survival to 170 +/- 14 min for 1 mg/ml and 250 +/- 42 min for 2 mg/ml. and PVR values as well as edema formation were comparable to control lungs that were perfused with autologous pig blood (n=2). Activation of complement (activation products in serum, deposition on lung tissue) and the coagulation system (fibrin monomers) were significantly diminished as compared to human blood without DXS 5000. Binding of anti-Gal antibodies was not influenced, and in vitro experiments showed no evidence of complement depletion by DXS 5000. In conclusion, DXS 5000 is an efficient complement inhibitor in pig-to-human xenotransplantation models and therefore a candidate for complement-inhibitory/anti-inflammatory therapy either alone or in combination with other substances and warrants further investigation.     

Effects of oral contraceptives on daily self-ratings of positive and negative affect.

OBJECTIVES: The relationship between affect and duration of oral contraceptive (OC) use was investigated. METHOD: Ninety-six women (17 first-time OC users, 34 long-time users, and 45 never-users) completed the Positive and Negative Affect Schedule (PANAS) and the Menstrual Distress Questionnaire (MDQ) daily for 35 days. This study was the first to examine positive affect variability; and personal family psychiatric history; and to compare early-, late-, and never-users of OCs. RESULTS: Triphasic users experienced greater variability in positive affect across the cycle, likely due to the variable hormone levels. Withdrawal of a constant level of hormones (monophasics) during early use was associated with greater variability in positive affect than withdrawal of changing hormonal levels (triphasics). Furthermore, personal and family psychiatric history may mediate an effect of OCs on negative affect variability. CONCLUSIONS: OCs and, therefore, hormones can alter day-to-day affect variability. Four variables are associated with this effect: duration of use, OC type, personal psychiatric history, and family psychiatric history.     

On the role of Staphylococcus aureus sortase and sortase-catalyzed surface protein anchoring in murine septic arthritis

Anchoring of Staphylococcus aureus surface protein to the cell wall is catalyzed by sortase, a transpeptidase. The contribution of staphylococcal surface proteins to establishment of infection was examined using a murine septic arthritis model. Intravenous inoculation of mice with the sortase-deficient mutant S. aureus strain SMK3 did not result in weight loss or severe septic arthritis, in contrast to the parent strain, S. aureus Newman. Direct inoculation of the sortase mutant into joint cavities also failed to cause severe synovitis or erosive arthritis. Furthermore, intravenous inoculation with staphylococci resulted in the rapid clearing of the sortase mutant from the bloodstream. This phenomenon demonstrates the involvement of host neutrophils; when these cells were depleted, sortase mutant staphylococci caused severe systemic infection, although not septic arthritis. These results suggest that sortase mutant staphylococci are significantly less virulent than the parent strain, Newman: the sortase mutant has decreased ability to reach target organs and, once there, to induce an inflammatory response.