Knowledge of Emergency Contraceptive Pills among Hungarian Women Presenting for Induced Abortion or Seeking Emergency Contraception

Aim: To compare the differences in contraceptive characteristics and the knowledge of emergency contraception (ECP) among women who used ECP after unprotected intercourse and those who sought an abortion. Methods: A questionnaire survey was conducted in a Hungarian university hospital among women for whom ECP was prescribed after unprotected intercourse (n = 940) as well as women who presented for the termination of pregnancy (n = 1592) between January 1, 2005 and November 20, 2006. Their knowledge of ECP and their experience with and attitudes toward ECP use were targeted. Results: The availability of ECP was well known (87.9 %), but it was still greatly underutilized: applied by only 13 of the 1592 women who resorted to abortion. Primarily, the ECP group consisted of those who experienced a condom failure significantly more often (odds ratio [OR] = 4.1), followed by those cases where ECP applications was a consequence of not using any kind of contraception (OR = 3.8). Fewer than one third (32 %) of the abortion seekers had previously used ECP, and only one fifth knew how to obtain it. Appropriate awareness of ECP was influenced by information obtained from health-care providers (adjusted odds ratio [AOR] = 3.93) or school education (AOR = 1.82). Conclusions: More thorough education is needed to provide a deeper knowledge of ECP use during contraceptive counseling for women seeking abortion, including those contraceptive mishaps where unintended pregnancy can be prevented by ECP.

A silicon-based microelectrode array with a microdrive for monitoring brainstem regions of freely moving rats

OBJECTIVE

Exploring neural activity behind synchronization and time locking in brain circuits is one of the most important tasks in neuroscience. Our goal was to design and characterize a microelectrode array (MEA) system specifically for obtaining in vivo extracellular recordings from three deep-brain areas of freely moving rats, simultaneously. The target areas, the deep mesencephalic reticular-, pedunculopontine tegmental-and pontine reticular nuclei are related to the regulation of sleep-wake cycles.

APPROACH

The three targeted nuclei are collinear, therefore a single-shank MEA was designed in order to contact them. The silicon-based device was equipped with 3 × 4 recording sites, located according to the geometry of the brain regions. Furthermore, a microdrive was developed to allow fine actuation and post-implantation relocation of the probe. The probe was attached to a rigid printed circuit board, which was fastened to the microdrive. A flexible cable was designed in order to provide not only electronic connection between the probe and the amplifier system, but sufficient freedom for the movements of the probe as well.

MAIN RESULTS

The microdrive was stable enough to allow precise electrode targeting into the tissue via a single track. The microelectrodes on the probe were suitable for recording neural activity from the three targeted brainstem areas.

SIGNIFICANCE

The system offers a robust solution to provide long-term interface between an array of precisely defined microelectrodes and deep-brain areas of a behaving rodent. The microdrive allowed us to fine-tune the probe location and easily scan through the regions of interest.

Hepcidin and its potential clinical utility

A number of pathophysiological conditions are related to iron metabolism disturbances. Some of them are well known, others are newly discovered or special. Hepcidin is a newly identified iron metabolism regulating hormone, which could be a promising biomarker for many disorders. In this review, we provide background information about mammalian iron metabolism, cellular iron trafficking, and the regulation of expression of hepcidin. Beside these molecular biological processes, we summarize the methods that have been used to determine blood and urine hepcidin levels and present those pathological conditions (cancer, inflammation, neurological disorders) when hepcidin measurement may have clinical relevance.

Experimental study on the mechanical interaction between silicon neural microprobes and rat dura mater during insertion

In vivo insertion experiments are essential to optimize novel neural implants. Our work focuses on the interaction between intact dura mater of rats and as-fabricated single-shaft silicon microprobes realized by deep reactive ion etching. Implantation parameters like penetration force and dimpling through intact dura mater were studied as a function of insertion speed, microprobe cross-section, tip angle and animal age. To reduce tissue resistance, we proposed a unique tip sharpening technique, which was also evaluated in in vivo insertion tests. By doubling the insertion speed (between 1.2 and 10.5 mm/min), an increase of 10-35% in penetration forces was measured. When decreasing the cross-section of the microprobes, penetration forces and dimpling was reduced by as much as 30-50% at constant insertion speeds. Force was noticed to gradually decrease by decreasing tip angles. Measured penetration forces through dura mater were reduced even down to 11±3 mN compared to unsharpened (49±13 mN) probes by utilizing our unique tip sharpening technique, which is very close to exerted penetration force in the case of retracted dura (5±1.5 mN). Our findings imply that age remarkably alters the elasticity of intact dura mater. The decreasing stiffness of dura mater results in a significant rise in penetration force and decrease in dimpling. Our work is the first in vivo comparative study on microelectrode penetration through intact and retracted dura mater.

Non-thromboembolic risk in systemic lupus erythematosus associated with antiphospholipid syndrome

Objectives

We investigated the impact of secondary antiphospholipid syndrome (APS) and antiphospholipid antibody (aPL) positivity on the non-thromboembolic clinical manifestations of systemic lupus erythematosus (SLE).

Methods

In total, 224 patients with SLE were studied, of whom 105 were aPL-positive; 52 fulfilled the criteria for APS. SLE- and APS-related clinical and laboratory features were assesed: SLE patients with aPL or APS were compared with those without these features.

Results

Not only thromboembolic events, but also Coombs-positive haemolytic anaemia, thrombocytopenia and endocarditis occurred significantly more frequently in the aPL-positive than in the aPL-negative patients. In the APS + SLE subgroup, several non-thromboembolic symptoms occurred more often than in the absence of APS: pleuritis, interstitial lung disease, myocarditis, nephritis and organic brain syndrome. The mean number of major organ manifestations (1.2 vs. 0.5) and the overall number of organ manifestations (8.1 vs. 6.9) were higher in the APS + SLE patients than in those without APS ( p < 0.05). The APS + SLE subgroup more frequently required intensive immunosuppressive treatment than did the APS-negative patients ( p < 0.05).

Conclusions

SLE patients with aPL positivity or secondary APS also have a higher risk to develop non-thromboembolic disease manifestations in addition to the aPL-related symptoms, and are predisposed to more severe SLE manifestations.

What is the significance of a microscopically positive resection margin in the curative-intent treatment of rectal adenocarcinoma? A retrospective study

PURPOSE

The aim of this study was to analyze the characteristics of patients with rectal cancer operated with a microscopic positive margin (R1) and thus avoid these situations or adapt treatment in these particular cases.

METHODS

We reviewed all the pathology data of resected specimens from patients with rectal or recto-sigmoid cancer operated with curative intent at the Institute of Oncology "Prof. Dr. Ion Chiricuta" between 2000-2011 (763 patients in 12 years) and the pathology files of patients from other institutions referred for adjuvant treatment to our hospital (318 patients). We included patients with anterior resection, Hartmann's procedure and abdomino-perineal resection, but we excluded patients with local excision and patients with R2/R1 at first, but R0 after re-resection (56 patients). We have identified 31 patients with R1, but had to exclude one case from analysis because this patient was lost to follow-up.

RESULTS

With surgery alone the local relapse (LR) was unavoidable. In the neoadjuvant chemoradiation (CRT) group 85.7% of the patients did not develop LR despite of R1. In the adjuvant CRT cohort 50% of the patients were LR-free at 2 years after conventional radiotherapy (p<0.01).

CONCLUSION

Based on these results it is concluded that a clear resection margin is extremely important for the local control of rectal cancer, because it cannot be always compensated by adjuvant CRT. In R1 cases neoadjuvant CRT seems to offer better prognosis than adjuvant CRT. To avoid R1 and its consequences a good quality control of total mesorectal excision (TME) is needed and CRT should be done before and not after surgery. R1 after primary surgery needs to be compensated by re-resection if possible, otherwise probably high dose radiotherapy with chemotherapy is needed.

Der Einfluss des Kuhgewichts auf die Betriebsrentabilität und auf die ökonomischen Gewichte der Fleischrindmerkmale

Abstract. Title of paper: Impact of mature cow weight on farm profitability and economic weights of beef cattle traits The impact of mature cow weight on the profitability of beef cattle farming and on the economic importance of 10 performance and functional traits was analyzed. The examined traits were: calving performance, stillbirth and calf losses till weaning, weight of calves at birth, at 120 and at 205 days of age, mature weight of cows, conception rates of heifers and cows and productive lifetime of cows. The cow weight was varied from 500 to 700 kg in 50 kg intervals. The economic efficiency of all farming systems was expressed as profit per cow and year. The economic importance of a trait (marginal economic value) was defined as partial derivative of the profit function with respect to trait mean. The program package ECOWEIGHT was used for all calculations. The results showed that beef cattle farming with all cow weight classes could be profitable when including subsidies in the incomes of a farm. Without subsidies, a positive profitability can be reached only when keeping small-framed cows (500 to 550 kg). In all modelled production systems, the most important trait was conception rate of cows followed by weaning weight of calves (at 205 days of age) for light cows or productive lifetime of cows in systems with heavy cows.

Adjuvant partial breast radiotherapy for early breast cancer--ready for a change?

Partial breast radiotherapy (PBRT) has recently gained an optional place as local adjuvant treatment after breast-conserving surgery (BCS) for selected early-stage breast cancer. With high-dose-rate (HDR) interstitial multicatheter brachytherapy (BT) performed under strict quality assurance criteria, there is level B evidence derived from one single randomized study with follow-up longer than 5 years and level C from several mature prospective non-randomized studies. For intra-lumpectomy cavity Mammosite HDR-BT and for external beam RT, as well as 3-dimensional (3D)-conformal or intra-operative therapy by electrons or photons, there is only level D evidence with no mature enough prospective data. Large phase III trials are ongoing for each PBRT technique, but their results might offer a level A evidence no earlier than 5 years.

Pet127 governs a 5' -> 3'-exonuclease important in maturation of apocytochrome b mRNA in Saccharomyces cerevisiae

The details of mRNA maturation in Saccharomyces mitochondria are not well understood. All seven mRNAs are transcribed as part of multigenic units. The mRNAs are processed at a common 3'-dodecamer sequence, but the 5'-ends have seven different sequences. To investigate whether apocytochrome b (COB) mRNA is processed at the 5'-end from a longer precursor by an endonuclease or an exonuclease, a 64-nucleotide sequence, which is required for the protection of COB mRNA by the Cbp1 protein and is found at the 5'-end of the processed COB mRNA, was duplicated in tandem. The wild-type 64-nucleotide element functioned in either the upstream or downstream position when paired with a mutant element. In the tandem wild-type strain, the 5'-end of the mRNA was at the 5'-end of the upstream unit, demonstrating that the mRNA is processed by an exonuclease. Accumulation of precursor COB RNA in single and double element strains with a deletion of PET127 demonstrated that the encoded protein governs the 5'-exonuclease responsible for processing the precursor to the mature form.

Molecular detection of adenovirus type 8 epidemic keratoconjunctivitis in Hungary

Bevezetés: A heveny kötőhártya-gyulladás (conjunctivitis) fertőzéses és nem fertőzéses eredetű lehet. A fertőzéses eredetű járványos conjunctivitisek (conjunctivitis epidemica) kórokozói vírusok, ezen belül elsősorban az adenovírusok különböző típusai. Célkitűzés: A szerzők célja egy keratoconjunctivitis járvány epidemiológiai leírása volt a virális kórokozó molekuláris kimutatásával. Módszer: A járvány – részben retrospektív – felderítésében klasszikus járványügyi módszereket alkalmaztak. A laboratóriumi etiológiai vizsgálat az adenovírus hexon régiójának kimutatásával polimeráz láncreakcióval (PCR), majd szekvenálással történt frissen gyűjtött conjunctiva-váladékból. Eredmények: A keratoconjunctivitis járványban összesen 60-an betegedtek meg 2006. október 9. és december 18-a között hét baranyai településen. A betegek átlagéletkora 51,2 év volt. A vezető tünetek a conjunctiva belövelltsége (100%), a könnyezés (94%), az idegentest-érzés (83%) és a homályos látás (76%) voltak. Az esetek felében mindkét szem érintett volt. A fertőzés közvetlen kontaktussal terjedt részben nosocomiálisan, a szemészeti szakellátás során. Nyolc conjunctivaváladékból 5-ben (62,5%) genetikailag azonos, 8-as típusú adenovírust lehetett kimutatni (HAdV8/Baranya/2006/HUN; EF210714), mely 100%-ban azonos volt egy Ausztriában 2004-ben kimutatott adenovírussal (DQ149614). Következtetések: A részben a szemészeti ellátáshoz kapcsolódó nosocomiális keratoconjunctivitis-járványt az adenovírus 8-as típusa okozta. A megbetegedés klinikai felismerése, laboratóriumi diagnosztikája és a járványügyi intézkedések együttesen szükségesek a keratoconjunctivitis-fertőzések és a következményes járvány megelőzéséhez.

[Hepatitis A outbreak in Transdanubia (Hungary): molecular connections and epidemiological conclusions - 2006]

INTRODUCTION

Hepatitis A virus (HAV) is one of the most important cause of fecally transmitted acute infectious hepatitis worldwide. In Hungary, beside the sporadic HAV infections, outbreaks also occur, particularly in Northeast part of the country where the subgenotype IA is endemic. The reported number of HAV cases was less than 10 per year in Southwest Hungary.

AIMS

A part of the European HAV surveillance, the author's aims were to follow and to analyze the outbreak of hepatitis A in Transdanubia (Southwest Hungary) in 2006 by molecular epidemiological methods.

MATERIALS AND METHODS

Sera samples from symptomatic patients were tested prospectively by enzyme-immunoassay (EIA) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequence- and phylogenetic analysis.

RESULTS

Between June and December 2006, a total of 115 serum samples were positive for HAV IgM antibody in Southwest Hungary. Thirty (76.9%) of the 39 samples were RT-PCR-positive and contain genetically identical subgenotype IB hepatitis A virus (HAV/Transdanubia/2006/HUN) which has 100% nucleotide identity to strain IT-MAR-02 from Italy in 2002. Until now, approximately 1200-1300 persons have been infected with the probably imported strain. The average age of patients was 18 years (years 1 to 80). In this study, detailed clinical and epidemiological data of the outbreak are presented.

CONCLUSIONS

Only a prospective molecular epidemiological study could verify the connection between the first sporadic HAV cases in June, the outbreak in August and the endemic spread of the virus since September in Southwest Hungary. This epidemic calls attention to how a hepatitis A outbreak can develop anywhere and at any time in Hungary and to the importance of active HAV immunization in the primary prevention.

Co-circulation of genotype IA and new variant IB hepatitis A virus in outbreaks of acute hepatitis in Hungary—2003/2004

Hepatitis A virus (HAV) is one of the most important causes of acute infectious hepatitis worldwide. In Hungary, the reported number of HAV infections has been decreasing in the last four decades, nevertheless, still, each year 500-800 new cases and multiple outbreaks occur, particularly in the northeast region of Hungary. In Hungary, serology is used routinely to establish the diagnosis of HAV infection without genetic analysis of HAV strains for molecular epidemiology. In this study, serum samples collected from symptomatic patients were tested by enzyme-immunoassay (anti-HAV-IgM ELISA) to establish the cause of three acute hepatitis A outbreaks (outbreak 1--from low prevalence region in Southwest Hungary in 2003 and outbreaks 2 and 3 from the endemic region in Northeast Hungary in 2004). Outbreak strains were characterized by reverse transcription-polymerase chain reaction (RT-PCR) amplification of a 360 bp viral VP1/2A region, amplicon sequencing and phylogenetic analysis. Four, seven, and three sera from outbreaks 1, 2, and 3, respectively, were investigated by RT-PCR for HAV genome and HAV RNA was detected in 4 (100%), 4 (57%), and 2 (67%) samples. All strains belonged to genotype I HAV. Outbreak 1 was caused by the new variant subtype IB and outbreaks 2 and 3 caused by genetically identical subtype IA strains. The Hungarian IA and IB hepatitis A viruses had the highest nucleotide identity, 98.4% and 99.0%, to IT-SCH-00 and IT-MAR-02 strains, respectively, detected in year 2000 and 2002 in Italy. Endemic subtype IA and probably imported new variant subtype IB HAV viruses was detected in outbreaks of hepatitis in Hungary that are closely related genetically to HAV strains in Italy.

BLOOD-BRAIN BARRIER CHANGES DURING COMPENSATED AND DECOMPENSATED HEMORRHAGIC SHOCK

Dysfunction of the blood-brain barrier (BBB) can be associated with a large number of central nervous system and systemic disorders. The aim of the present study was to determine BBB changes during different phases of hemorrhagic shock. The experiments were carried out on male Wistar rats anaesthetized with urethane. To produce compensated or decompensated hemorrhagic shock, mean arterial pressure was decreased from the normotensive control values to 40 mmHg by a standardized method of blood withdrawal from the femoral artery. Cerebral blood flow changes were followed by laser-Doppler flowmetry, and arterial blood gas values were monitored over the whole procedure. Cortical blood flow was significantly reduced in compensated and in decompensated hemorrhagic shock compared with the normotensive rats. As the shock shifted to the decompensated phase, the blood flow reduction was more pronounced. BBB permeability studies using sodium fluorescein (molecular weight of 376) and Evan's Blue albumin (molecular weight of 67,000) have revealed a significant increase of the BBB permeability for sodium fluorescein in the decompensated stage of hemorrhagic shock. Western blot analysis of brain capillaries showed that the expression of the transmembrane tight junction protein occludin was reduced in response to hemorrhagic shock, and the decrease of occludin was more pronounced in the decompensated phase. A similar expression pattern was shown by the transmembrane adherens junction protein cadherin as well. Our results suggest that the decompensated phase of hemorrhagic shock is associated with disturbances of the BBB, which may be explained by the dysfunction of interendothelial junctions caused by decreased occludin and cadherin levels.

Biogenesis of cytosolic ribosomes requires the essential iron-sulphur protein Rli1p and mitochondria

Mitochondria perform a central function in the biogenesis of cellular iron-sulphur (Fe/S) proteins. It is unknown to date why this biosynthetic pathway is indispensable for life, the more so as no essential mitochondrial Fe/S proteins are known. Here, we show that the soluble ATP-binding cassette (ABC) protein Rli1p carries N-terminal Fe/S clusters that require the mitochondrial and cytosolic Fe/S protein biogenesis machineries for assembly. Mutations in critical cysteine residues of Rli1p abolish association with Fe/S clusters and lead to loss of cell viability. Hence, the essential character of Fe/S clusters in Rli1p explains the indispensable character of mitochondria in eukaryotes. We further report that Rli1p is associated with ribosomes and with Hcr1p, a protein involved in rRNA processing and translation initiation. Depletion of Rli1p causes a nuclear export defect of the small and large ribosomal subunits and subsequently a translational arrest. Thus, ribosome biogenesis and function are intimately linked to the crucial role of mitochondria in the maturation of the essential Fe/S protein Rli1p.

Maturation of cytosolic iron-sulfur proteins requires glutathione

Glutathione is the major protective agent against oxidative stress in Saccharomyces cerevisiae. Deletion of the GSH1 gene (strain Deltagsh1) encoding the enzyme that catalyzes the first step of glutathione biosynthesis leads to growth arrest, which can be relieved by either glutathione or reducing agents such as dithiothreitol. Because defects in the biosynthesis of cellular iron-sulfur (Fe/S) proteins are associated with increases in glutathione levels, we examined the consequences of glutathione depletion on this essential process. No significant defects were detected in the amounts, activities, and maturation of mitochondrial Fe/S proteins in glutathione-depleted Deltagsh1 cells. On the contrary, the maturation of extra-mitochondrial Fe/S proteins was decreased substantially. The defect was rectified neither by addition of dithiothreitol nor under anaerobic conditions excluding oxidative damage of Fe/S clusters. A double mutant in GSH1 and ATM1 encoding a mitochondrial ATP binding cassette (ABC) transporter involved in cytosolic Fe/S protein maturation is nonviable even in the presence of dithiothreitol. Similar to atm1 and other mutants defective in cytosolic Fe/S protein maturation, mitochondria from glutathione-depleted Deltagsh1 cells accumulated high amounts of iron. Together, our data demonstrate that glutathione, in addition to its protective role against oxidative damage, performs a novel and specific function in the maturation of cytosolic Fe/S proteins.