Outcome in single and twin pregnancies at 20 to 24 weeks gestation: ten years experience in one perinatal center

OBJECTIVE

The aim of this investigation was to evaluate the outcome at 20 to 24 weeks gestation of twin and singleton extremely low birth weight infants.

STUDY DESIGN

The authors conducted a retrospective cohort study of live newborns at 20 to 24 weeks gestation admitted to one neonatal intensive care unit (NICU) from 2000 to 2009. Outcome mortality and predictors of outcome were evaluated. Results were compared for twin and singleton infants.

RESULTS

The cohort of infants consisted of 60 singleton infants and 17 twins. The results suggest an increased risk of death for twins when compared with singletons. A correlation between neonatal C-reactive protein (CRP) and bacterial culture positive results on admission to NICU might be a predictor of neonatal outcome.

CONCLUSION

In extremely low birth weight infants, twin delivery is associated with an independent increased risk of death. Both first- and second-born twins are at increased risk.

Prevalence, Spectrum and Antibiotic Susceptibility of Bacterial and Candida Colonization between the 21st and 33rd Week of Gestation in Women with PPROM - 5 Years' Experience in 1 Perinatal Center

Objective: The aim of this study was to evaluate the prevalence, spectrum and antibiotic susceptibility of bacterial and Candida colonization of the vagina between the 21st and the 33rd week of gestation in women who had preterm premature rupture of membranes (PPROM). Study design: High vaginal swabs from 245 subjects with PPROM were analyzed in a retrospective cohort study using cultivation-dependent methods. Patients were additionally divided into two groups: women with PPROM between the 21st and 27th week of gestation (group A) and women with PPROM between the 28th and 33rd week of gestation (group B). A subgroup analysis comparing the two groups was done. Results: The prevalence of pathological bacterial colonization was similar in both study groups (40.8 vs. 41.4 %; p > 0.05), however, a difference in antibiotic susceptibility was noted, which did not reach statistical significance (resistance to ampicillin 71.4 vs. 52.5 %; cefuroxime 9.5 vs. 11.7 %; gentamicin 28.6 vs. 16.4 %; ciprofloxacin 5.0 vs. 5.4 %). In group A there was a statistically significant lower rate of Candida colonization (11.1 vs. 24.3 %; p = 0.04). Conclusion: In patients with early PPROM, the rate of Candida colonization (group A) is lower and there are indications of a difference in antibiotic susceptibility of the colonizing bacteria depending on gestational age. Larger study groups are required to confirm these preliminary results.

Electromagnetic vortex fields, spin, and spin-orbit interactions in electron vortices

Electron vortices are shown to possess electric and magnetic fields by virtue of their quantized orbital angular momentum and their charge and current density sources. The spatial distributions of these fields are determined for a Bessel electron vortex. It is shown how these fields lead naturally to interactions involving coupling to the spin magnetic moment and spin-orbit interactions which are absent for ordinary electron beams. The orders of magnitude of the effects are estimated here for ȧngström scale electron vortices generated within a typical electron microscope.

Identification of Serum MicroRNA-21 as a Biomarker for Chemosensitivity and Prognosis in Human Osteosarcoma

Objective:

The aim of this study was to investigate the serum level of microRNA (miR)-21 in patients with osteosarcoma and its correlation with chemosensitivity and prognosis.

Methods:

miR-21 levels in sera from 65 patients with osteosarcoma and 30 healthy controls were measured by real-time reverse transcription-polymerase chain reaction. Correlations between serum miR-21 and clinicopathological features in patients with osteosarcoma were determined. The prognostic significance of serum miR-21 was assessed using a Cox proportional hazards model.

Results:

The serum level of miR-21 was significantly higher in patients with osteosarcoma than in control subjects. High serum miR-21 was significantly correlated with advanced Enneking stage and chemotherapeutic resistance. Univariate and multivariate analyses for overall survival showed that upregulation of serum miR-21 was an independent, unfavourable prognostic factor for patients with osteosarcoma (hazard ratio, 2.325).

Conclusions:

miR-21 might be a good candidate for a therapeutic target, and a potential biomarker for the prediction of chemotherapeutic sensitivity and prognosis in patients with osteosarcoma.

Prevalence of buried Barrett's metaplasia in patients before and after radiofrequency ablation

BACKGROUND AND STUDY AIM

Radiofrequency ablation (RFA) to treat Barrett's esophagus is increasingly accepted. Description of the etiology, natural history, and prevalence of buried Barrett's metaplasia (BBM) following RFA is limited, although BBM continues to pose a clinical dilemma. We aimed to assess the prevalence, characteristics, and eradication rate of BBM in patients with both dysplastic and nondysplastic Barrett's esophagus, treated with RFA and followed over time.

PATIENTS AND METHODS

The presence of Barrett's esophagus, dysplasia, and BBM, before and after RFA, was assessed by two gastrointestinal pathologists in a retrospective chart review of patients who had undergone RFA at our center and had completed appropriate follow-up.

RESULTS

We identified 112 patients with completed treatment and no further planned RFA. In 108, no residual Barrett's esophagus was seen after RFA; 4 patients with persistent Barrett's tissue underwent surgery. Regarding BBM, 17/112 patients (15.2%) had evidence of BBM during evaluation. In 12/17 (70.5%) BBM was found during the RFA treatment, with 8 having previously undergone non-RFA therapy and RFA for Barrett's esophagus and 4 having no previous intervention. In 5/17 (29.4%), BBM was seen only after RFA monotherapy. All 17 showed no evidence of BBM at final evaluation and were classified in the complete remission group (108/112).

CONCLUSION

Both Barrett's esophagus and BBM were completely eradicated in all patients with long-term follow-up after RFA. Almost half of the patients with BBM had a prior history of non-RFA therapy for Barrett's esophagus compared with 26% the non-BBM cohort. All patients with previously identified Barrett's esophagus and BBM were completely cleared of disease at final follow-up.

Liver T1ρ MRI measurement in healthy human subjects at 3 T: a preliminary study with a two-dimensional fast-field echo sequence

OBJECTIVES

The aim of this study was to explore the technical feasibility of T(1)ρ MRI for the liver, and to determine the normal range of liver T(1)ρ in healthy subjects at clinical 3 T.

METHODS

There were 15 healthy volunteers. Three representative axial slices were selected to cut through the upper, middle and lower liver. A rotary echo spin-lock pulse was implemented in a two-dimensional fast-field echo sequence. Spin-lock frequency was 500 Hz, and the spin-lock times of 1, 10, 20, 30, 40 and 50 ms were used for T(1)ρ mapping. The images were acquired slice by slice during breath-holding. Regions of interest (ROIs; n=5) were manually placed on each slice of the liver parenchyma region, excluding artefacts and vessels. The mean value of these ROIs (n=15) was regarded as the liver T(1)ρ value for the subject. Six subjects were scanned once at fasting status; six subjects were scanned once 2 h post meal; three subjects were scanned twice at fasting status; and seven subjects were scanned twice 2 h post meal.

RESULTS

When two readers measured the same 10 data sets, the interreader reproducibility (ICC: intraclass correlation coefficient) was 0.955. With the 10 subjects scanned twice, the ICC for scan-rescan reproducibility was 0.764. There was no significant difference for the liver T(1)ρ value at the fasting status (43.08±1.41 ms) and post-meal status (42.97±2.38 ms, p=0.867). Pooling together all the 32 scans in this study, the normal liver T(1)ρ value ranged from 38.6 to 48.3 ms (mean 43.0 ms, median 42.6 ms).

CONCLUSION

It is feasible to obtain consistent liver T(1)ρ measurement for human subjects at 3 T.

Object position and image magnification in dental panoramic radiography: a theoretical analysis

OBJECTIVES

The purpose of our study was to investigate how image magnification and distortion in dental panoramic radiography are influenced by object size and position for a small round object such as a ball bearing used for calibration.

METHODS

Two ball bearings (2.5 mm and 6 mm in diameter) were placed at approximately the same position between the teeth of a plastic skull and radiographed 21 times. The skull was replaced each time. Their images were measured by software using edge detection and ellipse-fitting algorithms. Using a standard definition of magnification, equations were derived to enable an object's magnification to be determined from its position and vice versa knowing the diameter and machine parameters.

RESULTS

The average magnification of the 2.5 mm ball bearing was 1.292 (0.0445) horizontally and 1.257 (0.0067) vertically with a mean ratio of 1.028 (0.0322); standard deviations are in parentheses. The figures for the 6 mm ball bearing were 1.286 (0.0068), 1.255 (0.0018) and 1.025 (0.0061), respectively. Derived positions of each ball bearing from magnification were more consistent horizontally than vertically. There was less variation in either direction for the 6 mm ball bearing than the 2.5 mm one.

CONCLUSIONS

Automatic measurement of image size resulted in less variation in vertical magnification values than horizontal. There are only certain positions in the focal trough that achieve zero distortion. Object location can be determined from its diameter, measured magnification and machine parameters. The 6 mm diameter ball bearing is preferable to the 2.5 mm one for more reliable magnification measurement and position determination.

Prenatal Foetal Non-invasive ECG instead of Doppler CTG - A Better Alternative?

Introduction: This study aimed to evaluate foetal signal quality obtained using an antenatal foetal ECG system (Monica 24™) and compare it with Doppler ultrasound CTG monitoring (Corometrics® 250 series). Material and Methods: Seventy pregnant women (gestational age: between 20 + 0 weeks and 40 + 0 weeks) were examined using the Monica AN24™ system and also underwent Doppler CTG. The signal quality of both methods was compared and correlated with gestational age and pre-pregnancy body mass index (BMI). Results: Overall, ECG had a signal quality of 77.4 % and CTG had a signal quality of 73.1 % (p > 0.05). In gestational weeks (GW) 20-26, the signal quality of ECG was significantly better compared to that obtained with CTG (75.5 vs. 45.3 %; p = 0.003), while in GW 27-36, the signal quality was better with CTG (72.3 vs. 83.0 %, p = 0.001). No difference in signal quality was found between the two methods after the 37th GW (87.7 vs. 86.1 %; p > 0.05). CTG showed a statistically significant correlation with BMI (rho 0.25, p < 0.05) while ECG showed no such correlation. Conclusion: The use of non-invasive ECG is particularly indicated in the early weeks of pregnancy, while CTG offers superior results during the vernix period. There was no difference in signal quality after the vernix period. The signal quality with ECG was found to be independent of BMI, while the signal quality of CTG deteriorated with increasing BMI.

Associations between testosterone, bone mineral density, vitamin D and semen quality in fertile and infertile Chinese men

Testosterone (T) and vitamin D (VD) interact in androgen deficient men, however, this interaction and subsequent semen quality and bone mineral density (BMD) status is not clear in infertile men. Our objective was to investigate T, VD, semen quality, BMD and their relationships in Chinese infertile men. We conducted a cross-sectional study of 559 men aged 20-40 years, including 195 fertile men, 9 infertile men with known risk factors for osteoporosis (WR) and 355 infertile men without known risk factors for osteoporosis (WOR). WOR infertile men constituted 314 oligo-, astheno-, teratospermic or normospermic infertile men (OATN men) and 41 non-obstructive azoospermic men (NOA men). Differences of parameters were assessed, and the relationships were adjusted by multiple linear regression. WOR infertile men had significantly lower T, lumbar spine and total hip BMD than fertile men (all p < 0.05). Bioavailable T (Bio-T) and 25-hydroxyvitamin D [25(OH)D] were independent determinants of BMD in WOR infertile men (all p < 0.01) but not in fertile men. After stratifying Bio-T, WOR infertile men had lower BMD than fertile men (all p < 0.05) in low Bio-T subgroups (Bio-T ≤ 11.6 nmol/L), but not high Bio-T subgroups (Bio-T > 11.6 nmol/L). 25(OH)D was an independent determinant of sperm motility and morphology in WOR OATN men (all p < 0.05), with only borderline significance in fertile men(motility: p = 0.047; morphology: p = 0.056). T determined sperm concentration (square root) and morphology in WOR OATN men (all p < 0.001). No correlations between T and 25(OH)D were found in all groups. We suggest that infertile men have lower T and BMD than fertile men. 25(OH)D and T were associated with low BMD and poor semen quality in infertile men.

A novel role for RIP1 kinase in mediating TNFα production

Receptor-interacting protein 1 (RIP1) is a Ser/Thr kinase with both kinase-dependent and kinase-independent roles in death receptor signaling. The kinase activity of RIP1 is required for necroptosis, a caspase-independent pathway of programmed cell death. In some cell types, the inhibition of caspases leads to autocrine production of TNFα, which then activates necroptosis. Here, we describe a novel role for RIP1 kinase in regulating TNFα production after caspase inhibition. Caspase inhibitors activate RIP1 kinase and another protein, EDD, to mediate JNK signaling, which stimulates Sp1-dependent transcription of TNFα. This pathway is independent of nuclear factor κB and also occurs after Smac mimetic/IAP antagonist treatment or the loss of TNF receptor-associated factor 2 (Traf2). These findings implicate cIAP1/2 and Traf2 as negative regulators of this RIP1 kinase-dependent TNFα production pathway and suggest a novel role for RIP1 kinase in mediating TNFα production under certain conditions.

The association of bovine T1R family of receptors polymorphisms with cattle growth traits

The three members of the T1R class of taste-specific G protein-coupled receptors have been proven to function in combination with heterodimeric sweet and umami taste receptors in many mammals that affect food intake. This may in turn affect growth traits of livestock. We performed a comprehensive evaluation of single-nucleotide polymorphisms (SNPs) in the bovine TAS1R gene family, which encodes receptors for umami and sweet tastes. Complete DNA sequences of TAS1R1-, TAS1R2-, and TAS1R3-coding regions, obtained from 436 unrelated female cattle, representing three breeds (Qinchuan, Jiaxian Red, Luxi), revealed substantial coding and noncoding diversity. A total of nine SNPs in the TAS1R1 gene were identified, among which seven SNPs were in the coding region, and two SNPs were in the introns. All five SNPs in the TAS1R2 gene and all three SNPs in the TAS1R3 gene were identified in the coding region. Four SNPs (TAS1R1 g.5081C>T, TAS1R1 g.5110C>A, TAS1R2 g.288A>G, TAS1R2 g.2552T>C) were significantly associated with body height of Qinchuan cattle (P<0.05). The heterozygous genotypes of the four SNPs showed a molecular heterosis on cattle heights at hip cross and sacra. The individuals with different genotypic combinations of the four SNPs had significant association with heights at hip cross and sacra (P<0.05).

Molecular definitions of cell death subroutines: recommendations of the Nomenclature Committee on Cell Death 2012

In 2009, the Nomenclature Committee on Cell Death (NCCD) proposed a set of recommendations for the definition of distinct cell death morphologies and for the appropriate use of cell death-related terminology, including 'apoptosis', 'necrosis' and 'mitotic catastrophe'. In view of the substantial progress in the biochemical and genetic exploration of cell death, time has come to switch from morphological to molecular definitions of cell death modalities. Here we propose a functional classification of cell death subroutines that applies to both in vitro and in vivo settings and includes extrinsic apoptosis, caspase-dependent or -independent intrinsic apoptosis, regulated necrosis, autophagic cell death and mitotic catastrophe. Moreover, we discuss the utility of expressions indicating additional cell death modalities. On the basis of the new, revised NCCD classification, cell death subroutines are defined by a series of precise, measurable biochemical features.