Cardiac malformation in neonatal mice lacking connexin43

Gap junctions are made up of connexin proteins, which comprise a multigene family in mammals. Targeted mutagenesis of connexin43 (Cx43), one of the most prevalent connexin proteins, showed that its absence was compatible with survival of mouse embryos to term, even though mutant cell lines showed reduced dye coupling in vitro. However, mutant embryos died at birth, as a result of a failure in pulmonary gas exchange caused by a swelling and blockage of the right ventricular outflow tract from the heart. This finding suggests that Cx43 plays an essential role in heart development but that there is functional compensation among connexins in other parts of the developing fetus.

Detection of psychiatric morbidity in gynecology patients by two brief screening methods

Psychiatric morbidity was studied in 100 women attending gynecological outpatient and inpatient set-ups using two brief screening instruments: the General Health Questionnaire, 12 items, and the Present State Examination, ten short questions. Psychiatric morbidity was detected in 36% and was found to be higher in women with uterine prolapse and infections but not in those with menstrual irregularities (p < 0.001). The commonest psychiatric symptoms detected in this population were worrying (50%), aches and pains (51%), depression (50%) and disturbances of biological function (51%). The commonest diagnoses were neurotic depression (70%) and adjustment disorders (23%). The screening instruments used were found to be simple, sensitive, specific, with high identification indices and easy to administer.

Estrogen receptor mutations in tamoxifen-resistant breast cancer

Clinical resistance to antiestrogens like tamoxifen is a major problem in the treatment of hormone-dependent breast cancers. Since the estrogen receptor plays a central role in mediating the effects of estrogens and antiestrogens, we hypothesized that mutations in the estrogen receptor could be one mechanism by which breast tumors evolve from a hormone-dependent to a hormone-independent phenotype. The eight exons of the estrogen receptor complementary DNA from 20 tamoxifen-resistant and 20 tamoxifen-sensitive tumors were screened by Single Strand Conformation Polymorphism (SSCP), and the variant conformers were sequenced to identify the nucleotide changes. A 42-base pair replacement was found in exon 6 of a tamoxifen-resistant tumor. A single base pair deletion in exon 6 of a tamoxifen-resistant metastatic tumor but not in the primary tumor was detected in another case. If translated, both these mutations could generate truncated receptors with an intact DNA-binding domain and a defective hormone-binding domain that could constitutively activate transcription of previously estrogen-responsive genes. The remaining 18 of 20 tamoxifen-resistant tumors did not contain mutations in any of the 8 exons of the estrogen receptor complementary DNA. These results suggest that mutations in the estrogen receptor occur at a low frequency and do not account for most estrogen-independent, tamoxifen-resistant breast tumors.

Invasive bladder cancer and uremia: dilemma in management

Invasive bladder cancer presenting with uremia is a rare phenomenon. The management of these sick patients becomes problematic since one does not know how aggressive the treatment should be and what possible outcome to expect. In this retrospective review of 117 patients with invasive bladder cancer we describe 8 patients with uremia, and discuss our management strategy and prognosis.

Disposition of salmeterol xinafoate in laboratory animals and humans

The disposition of [14C]salmeterol xinafoate, a new inhaled beta 2-adrenoceptor agonist with both bronchodilator and antiinflammatory activity, has been studied in laboratory animals and humans following intravenous and oral administration. [14C]Salmeterol was rapidly absorbed in animal species and humans with Cmax observed within 2 hr. Cmax was similar for normalized oral dose level in mice, rats, and rabbits. In dogs, Cmax was higher and reflected the greater oral bioavailability in this species. The plasma t1/2, after intravenous administration, was 5 hr in rats and 2 hr in dogs. The volume of distribution of salmeterol was significantly greater than total body water in both rats (40 liters/kg) and dogs (6 liters/kg) and indicated high tissue uptake of the compound. Plasma clearance was high in rats (95 ml/min/kg) and dogs (30 ml/min/kg). Radioactive drug-related material was widely distributed throughout body tissues in rats. The highest concentrations were present in kidney, liver, gastrointestinal tract, pituitary, lung, heart, and bone marrow. Transfer of radioactive drug-related material across the placental barrier or into milk, studied in rats, was low. In all species the majority of an oral or intravenous dose (55-75%) was excreted in feces. Biliary excretion in rats and dogs accounted for 53% (0-27 hr) and 40% (0-8 hr) of an oral dose, respectively, indicating good absorption across the gastrointestinal tract. Enterohepatic circulation was significant in rats. Salmeterol was cleared predominantly by metabolism in animals and humans.(ABSTRACT TRUNCATED AT 250 WORDS)

Hysteroscopic assessment of abnormal uterine bleeding in users of the intrauterine contraceptive device

Sixty users of the IUD who complained of abnormal menstrual blood loss were evaluated by hysteroscopy, and the findings were compared with a matched group who had this investigation for "missing strings". Submucous fibroids and endometritis were more frequent in the study group whereas malposition of the IUD was commoner in the controls (p < 0.05).

Surgery for post-hysterectomy vaginal prolapse

Nine cases treated by surgery for post-hysterectomy vaginal prolapse are reviewed. The mean time between presentation and the antecedent hysterectomy was 12.8 years. Two patients who had abdominal sacral colpopexy alone developed recurrence of prolapse. Additional culdoplasty and colposuspension improved the cure rate but prolonged the mean operating time. Restoration of vaginal anatomy and function is best achieved with the combined operation.

Diagnostic hysteroscopy

Diagnostic hysteroscopy was performed on 100 patients. The most frequent indication was abnormal uterine bleeding. In premenopausal women, submucous fibroids were the main findings and in post-menopausal women, 59 per cent had an atrophic endometrium. Precise localization of the missing intrauterine contraceptive devices was achieved in all cases. Hysteroscopy improved diagnostic accuracy and reduced the need for blind curettage.

HIV-2 antibodies in serum samples from Maharashtra state

Two hundred serum samples were tested to detect the presence of HIV-2 infection in Maharashtra state. The serum samples were derived from various groups including those with high risk behaviour for HIV infection. All samples were tested by three combined HIV-1 and HIV-2 ELISA kits. The reactivity was confirmed by LiaTek HIV 1+2 immunoblot. The study confirmed that HIV-2 infection exists in Maharashtra, as 14 samples showed antibodies to HIV-2 and 14 showed antibodies to both HIV-1 and HIV-2. Antibodies to HIV-2 or HIV-1 and HIV-2 were detected mainly in persons with high risk behaviour.

Differential cell behaviour on polylysine and gelatin in primary culture of mouse mammary adenocarcinoma

Cells dissociated from spontaneous and transplanted tumours of C3HJax mammary gland have been cultured on polylysine and gelatin substrates. The isolated cells proliferated to form monolayers with high degree of organoid structure as indicated by formation of alveolar cavities. Differences were observed in the cell attachment, growth pattern, number and size of alveolar cavities, cells which lined the cavity and cell morphology on polylysine and gelatin substrates as compared to conventional cell culture plastic surface. On polylysine more than 90% cells attached rapidly, within 15-45 min after plating, with or without serum and formed confluent monolayers marked by presence of large and small alveolar cavities. Multiple interacting cell types took part in organization of the cavity. Cells lining the cavity constantly proliferated and rearranged to expand it. On gelatin, 60-70% cells attached over a period of 6-24 hr in presence of serum and formed confluent monolayers dominated by small alveolar cavities. Cells forming the cavities were epithelial in nature and cavities once formed did not increase in size. Upon subculture, the cell morphology on these substrates was strikingly different. On polylysine, the predominant cell type had numerous irregular microvilli whereas on gelatin, cells had smoother boundaries with a few stunted cytoplasmic extensions. The cell attachment on conventional surface was low, 40-50%. When seeded at high cell density, formation of alveolar cavities was suppressed and at low cell density, cultures were marked by contact inhibition of cells and failure to attain confluence. These results suggest differential behaviour and interaction of mammary tumour epithelium with the substrates used.

Pregnancy outcome in paraplegic women

Six cases of paraplegia in pregnancy are reviewed. The major medical complications were urinary tract infection and anaemia. The obstetrical problems were pre-term labour and one perinatal loss due to unattended birth.

Isolation & characterization of angiogenic factors from cultured cells & conditioned media

Angiogenic factors were isolated by ion exchange chromatography from three established cell lines viz., HEp 2, HeLa and CHO, a primary culture of mouse mammary adenocarcinoma and from conditioned media of HEp2 and cultured mammary adenocarcinoma cells. The angiogenic activity was assayed by chicken chorioallantoic membrane assay. The angiogenic factor eluted at 0.5 M, exhibited lambda max at 258 +/- 1 nm, contained protein and nucleic acid. The cellular angiogenic factor showed a ratio of 1:1 for protein and nucleic acid whereas the secreted angiogenic factor had 3-5 parts of protein to 1 part of nucleic acid. The angiogenic factor from HEp2 and CHO cells did not bind to heparin-agarose. Microheterogeneity of the angiogenic factors was established by SDS-PAGE. Antiserum raised against the cellular angiogenic factor from HEp2 cells, showed a titre of 1:1600 by ELISA. The angiogenic factor was directly localized on whole cells by ELISA. Cellular as well as secreted angiogenic factors crossreacted with the antibody. Neutralizing effect of the antiserum on induction of angiogenesis was detected on chicken chorioallantoic membrane.

Ehlers-Danlos syndrome in pregnancy

We herein report the case of a black pregnant teenager with Type 1 Ehlers-Danlos syndrome. A successful abdominal delivery was achieved at 38 weeks' gestation.

A longitudinal follow up of development of preterm infants

A prospective study was undertaken to determine the development of preterm (PT) babies (gestation less than 37 weeks). One hundred and seventy two preterm babies and 36 control babies were followed up for a period of 18-24 months. Psychomotor development was assessed using the Bayley Scales of Infant Development at 3, 6, 9, 12, 18, 24 months, using the corrected or post conceptional age. Preterm babies, as a group, caught up with normal babies between 18-24 months, both on the motor and mental scale. Higher the birth weight, better was the mean motor development quotient at 18 months. Uncomplicated preterm babies showed higher mean development quotients at 18 months than preterm babies with additional complications and they also caught up earlier (12-18 months) than the latter group who caught up between 18-24 months. Similarly, PT appropriate for gestational age (AGA) babies showed, earlier 'catch up' than PT small for gestational age (SGA) babies. The incidence of cerebral palsy was low (4%).

A study of Baroda Development Screening Test for infants

Baroda Development Screening Test for Infants based on Baroda Norms on BSID-Research Form 1961 were studied at the Child Development Unit of the Department of Pediatrics in the K.E.M. Hospital, Pune. Screening validity, sensitivity, specificity, over-referrals and under-referrals were calculated in three samples--(i) 730 records of 130 babies evaluated on BSID-Baroda Norms during 1979 and December 1984; (ii) 101 records of babies tested at six months out of the first sample; and (iii) 50 babies screened by interviewing the mothers and tested on the full scales by the experts. Screening validity, sensitivity and specificity were more than 76, 66 and 77%, respectively. Over-referrals were highest (35%) in the sample screened by interview. Suggestions are made to improve the screening by interview. Baroda Development Screening Test for Infants is recommended for use in the field for further evaluation.