Increase of maternal plasma leptin concentrations during pregnancy: comparison with nonpregnant women

To investigate the physiological changes of leptin levels and whether placenta is linked to its production during pregnancy, plasma of 65 pregnant women at various gestational weeks were compared with those of 34 age- and body mass index (BMI)-matched nonpregnant women in the study. The leptin levels showed a gradual increase from 7-13 gestational week, then continuously elevated during weeks 14-20, 21-27, 28-34, virtually reaching a peak at 35-41 weeks' gestation. When they were compared to those of age- and BMI-matched nonpregnant women, a significant (P < 0.0001) increase was found with every gestational week. There were positive correlations between maternal leptin and BMI of first (7-13th week), second (14-27th week) and third (28-41st week) trimesters, with the correlation coefficients of 0.40 (P < 0.05), 0.54 (P < 0.001), and 0.49 (P < 0.001), respectively. No correlation (r = -0.17, P > 0.05, n = 31) was found between maternal leptin level and the neonatal birth weight. These data suggest that placental production of leptin is one major source of higher levels in maternal circulating leptin other than maternal gain of fat mass and that maternal leptin level is not related to fetal birth weight during pregnancy.

Changes of circulating leptin levels during normal menstrual cycle: relationship to estradiol and progesterone

A possible role of ovarian steroids on the modulation of leptin production has recently been suggested. To investigate the relationship between leptin and ovarian steroids during the normal menstrual cycle, twenty-three healthy, normal-weight women were enrolled in the study. Blood was collected into chilled EDTA tubes on cycle days (D) 3, 7, 10, preovulatory (D13-15), midluteal (D 21-23) and late luteal (D 25-27) phases. Plasma leptin, estradiol (E2), progesterone (P), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured by RIA. Leptin levels showed no significant changes throughout the follicular (D7 and D10), preovulatory (8.6 +/- 0.5 ng/mL), midluteal (8.9 +/- 0.6 ng/mL) and late luteal (7.7 +/- 0.4 ng/mL) phases, as compared with those of D3 (7.4 +/- 0.5 ng/mL) level. There was no positive correlation between leptin and E2 levels in D 3 and D 7 (r = 0.14, P > 0.05) or in D 10 and preovulatory day (r = 0.25, P > 0.05). Also, no positive correlation between leptin and E2 (r = 0.12, P > 0.05) or leptin and P (r = 0.17, P > 0.05) levels were observed in the mid- and late luteal phases. These data clearly indicate that physiological alterations of circulating E2 and P concentrations have no significant influence on the leptin changes during normal menstrual cycle.

Lipoleiomyoma of the uterus

Uterine lipoleiomyoma may associate with certain concomitant metabolic disorders. The possible clinical correlates and the potential implications on the pathogenesis are elaborated.

Laser-enhanced ionization detection of Pb in seawater by flow injection analysis with on-line preconcentration and separation

The flame laser-enhanced ionization (LEI) technique is coupled with the flow injection analysis system to measure the trace lead amounts in aqueous solution and in seawater. The flow injection (FI) manifold is incorporated with a microcolumn packed with a C18 bonded silica. The chelating agent DDPA is used to form the Pb-DDPA complex, which may be sorbed in the microcolumn and then eluted with methanol. The preconcentrated Pb is then detected by the LEI technique with either single-step or two-step excitation. At 5- and 15-mL volume-fixed sample loading, the detection limits of 0.011 and 0.0033 ng/mL (11 and 3.3 ppt) and enrichment factors of 16 and 48 are achieved, respectively, using a two-step FI-LEI. The sensitivity of the current system proves to be better by at least 1 order of magnitude than that of conventional LEI method. The FI-LEI also increases the tolerance of matrix interference. The LEI signal is slightly reduced to 80% intensity as 10,000 micrograms/mL (ppm) Na and K matrixes are mixed in the lead solution. The resistance to the alkali matrixes is enhanced approximately 4 times that reported previously using a similar water-immersed probe as a LEI collector. Finally, the FI-LEI is for the first time applied to detect the Pb content in seawater, achieving a result of 0.0112 +/- 0.0006 ng/mL (ppb) consistent with the certified value of 0.013 +/- 0.005 ng/mL (ppb).

Bilateral periopticointrascleral hemorrhages associated with traumatic child abuse

PURPOSE

To report a case of bilateral periopticoscleral hemorrhages associated with traumatic child abuse.

METHODS

Postmortem gross examination and histopathologic studies of both eyes and the optic nerves of a 6-month-old infant who died from subdural hematoma.

RESULTS

Gross examination and histopathologic step sections disclosed bilateral intrascleral hemorrhages around both optic nerves. In addition, bilateral diffuse multilayered retinal, vitreous, and sublaminar (beneath the internal limiting membrane) hemorrhages were present.

CONCLUSION

Periopticointrascleral hemorrhages are characteristic of blunt head trauma and may constitute important forensic evidence in cases of suspected child abuse.

Increased heat shock protein-70 in unilateral ureteral obstruction in rats

Our previous studies noted the oxidative stress of unilateral ureteral obstruction (UUO). Now, we seek to explore whether UUO affects the intrinsic cellular antioxidants and triggers heat shock protein (HSP-70) and whether these are still highly expressed after reversal of the UUO (R-UUO). In addition, we designed the experiment to determine whether this expression of HSP-70 is a localized or a generalized response. Male Sprague-Dawley rats (125-150 g) were randomly assigned to sham operation, left UUO, or R-UUO procedures at six rats per group. The sham, UUO, and R-UUO animals were studied 10 days after UUO or 7 days after R-UUO. A clear increase in the left (obstructed) kidney's malondialdehyde (MDA), a marker of lipid peroxidation, was observed: a significant 2.6-fold of sham during UUO and a 1.7-fold of sham in R-UUO. The contralateral (unobstructed) right kidney showed a significant rise in MDA during UUO, but during R-UUO the MDA had fallen back to sham values. It is possibly the result of a systemic effect from the free radicals produced by the oxidative stress of the UUO. The antioxidant enzyme, manganese superoxide dismutase (MnSOD) of the left, obstructed kidney showed a significant reduction in UUO compared to that of the sham. Upon reversal of UUO (R-UUO), MnSOD was lower than that of the sham. The left kidney's HSP-70 increased during UUO and was 3.7-fold that of sham (P < 0.05) but, during R-UUO, was not different from sham (P, ns). The contralateral (intact) right kidneys' HSP-70 showed no change between sham, UUO, and R-UUO states. We conclude that UUO gives rise to oxidative stress which is generalized in both the obstructed and the contralateral unobstructed kidney, as indicated by the elevation in kidney MDA content in both kidneys. The intrinsic cellular antioxidant enzyme, manganese superoxide dismutase, showed a significant and generalized reduction in both UUO and R-UUO. In contrast, the HSP-70 was markedly elevated only in the obstructed kidney and not in the R-UUO or in the contralateral kidney, suggesting that the elevation of HSP-70 is a specific and localized response to oxidative injury of UUO.

Acute fulminant sarcocystosis in a captive-born rhesus macaque

A captive-born juvenile female rhesus macaque (Macaca mulatta) was acquired from a commercial breeder and placed in quarantine. Within 8 days of arrival, the animal became anorexic, inactive, and dehydrated. Subsequently, generalized edema and facial ecchymoses developed, and despite supportive therapy, the animal became moribund and was euthanatized. Macroscopic examination showed diffuse stippling and streaking of the myocardium. Histopathologic examination revealed multifocal to coalescing myocardial edema, necrosis, lymphohistiocytic inflammation, and generalized endothelial infection with Sarcocystis sp. Immature and mature schizonts within endothelial cells were most prevalent in the heart. Fewer schizonts were present in the vasculature of other tissues, including skeletal muscle, smooth muscle, adipose tissue, brain, and retina. Mature tissue cysts within muscle fibers were not found in the myocardium but were occasionally seen in skeletal muscle. Analysis of polymerase-chain-reaction-amplified 18s ribosomal RNA gene sequences revealed 96% identity to published sequences of S. hirsuta, S. hominis, and S. fusiformis and 95% identity to S. cruzi and S. tenella. However, sequences did not show complete identity with any organism in the GenBank database. Sequence homology suggests that this is a newly described Sarcocystis sp. Results of antibody tests for simian retrovirus, simian T-lymphotropic virus 1, and simian immunodeficiency virus were negative, suggesting that viral immunosuppression was unlikely to have augmented the pathogenicity of sarcosporidial infection. Clinical and histopathologic findings in this case of fulminant sarcosporidiosis are similar to those described in Dalmeny disease in cattle, which is associated with ingestion of massive numbers of infective Sarcocystis oocysts.

Assessment of hypothalamic-pituitary function by hormonal pulsatility, gonadotropin-releasing hormone and thyrotropin-releasing hormone testing in women with euprolactinemic secondary amenorrhea

To evaluate the integrated hypothalamic-pituitary function of euprolactinemic secondary amenorrhea, blood samples of 23 patients were taken every 15 min for 4 hours in examination of pulsatile LH, FSH, PRL secretions and then 2 hours GnRH, TRH tests were performed. Nine normal cycling women (group I) served as the controls. Thirteen amenorrheic women (group II) revealed responsive bleeding to progestin injection and the other 10 women (group III) were nonresponsive. The LH frequency, amplitude, and LH response to GnRH of groups II and I were comparable, whereas delta PRL after TRH in group II (60.8 +/- 18.9 ng/ml) exhibited a significantly (P < 0.05) exaggerated response, as compared with that of group I (43.6 +/- 11.4 ng/ml). The LH frequency (1.3 +/- 0.4/4h) and amplitude (1.7 +/- 0.4 mIU/mL) of group III were significantly lower (P < 0.01) than those in group I (2.4 +/- 0.5 and 2.5 +/- 0.5, respectively), but their delta LH and delta FSH responses to GnRH showed no differences from those of controls. The frequency, amplitude of PRL and delta PRL response to TRH in group III were no significant difference with those of group I. These results suggest that masked PRL hypersecretion and loss of the regulatory pulsatility of gonadotropin release may be responsible in part for the causes resulting to euprolactinemic secondary amenorrhea. The analysis of these hormonal environments is useful for the understanding of clinical perspectives, pathophysiology and management.

Very late antigen 4 (VLA4) antagonists as anti-inflammatory agents

In recent years antagonists of very late antigen-4 (VLA4, also known as integrin alpha(4) beta(1)) have shown great promise in treating inflammatory disorders in a number of animal models. The most advanced in this endeavor is a humanized anti-alpha(4) antibody, Antegren, which is in phase II clinical trials for multiple sclerosis. The first reported small-molecule VLA4 antagonist to advance into clinical trials is currently in phase I as an aerosol for treating asthma. A number of peptides, cyclic peptides and peptidomimetics have been disclosed and are in preliminary stages of development.

Localization of persistent Enterocytozoon bieneusi infection in normal rhesus macaques (Macaca mulatta) to the hepatobiliary tree

Enterocytozoon bieneusi is the most common microsporidian parasite recognized in human patients with AIDS. Recently, we identified a virtually identical organism causing a spontaneous infection associated with hepatobiliary and intestinal disease in simian immunodeficiency virus (SIV)-infected macaques. To examine the natural history of the infection, we examined captive rhesus macaques for E. bieneusi by PCR, in situ hybridization, and cytochemical techniques. PCR performed on fecal DNA detected enterocytozoon infection in 22 (16.7%) of 131 normal rhesus macaques (Macaca mulatta), compared to 18 (33.8%) of 53 rhesus macaques experimentally inoculated with SIV. In normal rhesus macaques, persistence of infection was demonstrated for up to 262 days and was usually not associated with clinical signs. In six of seven normal rhesus animals, E. bieneusi was detected by PCR in bile obtained through percutaneous cholecystocentesis but not by in situ hybridization performed on endoscopic biopsies of duodenum and proximal jejunum.

Ultrastructural morphology of Enterocytozoon bieneusi in biliary epithelium of rhesus macaques (Macaca mulatta)

Enterocytozoon bieneusi is the most common microsporidian parasite found in humans with acquired immunodeficiency syndrome. A nearly identical organism was recently recognized in rhesus macaques (Macaca mulatta). Ultrastructural examination of this microsporidian parasite in biliary epithelium of rhesus macaques reveals characteristics unique to E. bieneusi, including 1) a lack of sporophorus vesicles or pansporoblastic membranes, 2) direct contact of all stages with the host-cell cytoplasm, 3) elongated nuclei present within proliferative and sporogonial stages, 4) late thickening of the sporogonial plasmodium plasmalemma, 5) electron-lucent inclusions present throughout the life cycle, 6) precocious development of electron dense discs before plasmodial division to sporoblasts, and 7) the presence of polar tube doublets within spores and sporoblasts visualized as 5-7 coils in section.

Starvation depresses acylglycerol biosynthesis in bovine subcutaneous but not intramuscular adipose tissue homogenates

The primary objective of this study was to document the effects of starvation on acylglycerol biosynthesis in homogenates of intramuscular and subcutaneous adipose tissues. Adipose tissue samples were obtained from 8th-13th thoracic rib sections from 12 Angus cattle (six steers plus six heifers). Three steers and three heifers were starved for 72 h prior to slaughter while the remainder were slaughtered 4 h after food was withheld. Fat-free 700 x g centrifugal fractions were used to measure the esterification of radiolabeled sn-glycerol 3-phosphate (G-3-P) into acylglycerols at 1.0 mM palmitic or stearic acid, or 0.2 mM oleic, linoleic, or alpha-linolenic acid. There were significant tissue x fatty acid interactions for rates of incorporation into diacylglycerols and triacylglycerols; in subcutaneous, but not intramuscular homogenates, palmitic > stearic = oleic = linoleic = alpha-linolenic acid. Subcutaneous homogenates incorporated a greater percentage of G-3-P into triacylglycerols, and a lesser percentage into phospholipid, than intramuscular homogenates (P < 0.05). In intramuscular homogenates, the primary product of G-3-P esterification to saturated fatty acids was phospholipids. When unsaturated fatty acid served as substrates, triacylglycerols and phospholipids were produced in equal proportions in intramuscular homogenates, and triacylglycerols were the predominant product in subcutaneous homogenates. Intramuscular adipose tissue homogenates exhibited no response to starvation, whereas triacylglycerol and diacylglycerol synthesis was depressed by approximately 50% in subcutaneous adipose tissue homogenates. Similarly, phosphatidic phosphohydrolase activity, initially greater in subcutaneous than in intramuscular adipose tissue, was decreased by approximately 50% by starvation in subcutaneous adipose tissue, but not in intramuscular adipose tissue. We conclude that differences in rates of diacylglycerol and triacylglycerol biosynthesis, and response to starvation, between intramuscular and subcutaneous adipose tissues were due to dissimilarities in the activity of phosphatidic phosphohydrolase.

Effects of task goal on movement kinematics and line bisection performance in adults without disabilities

OBJECTIVE

This study investigated (a) whether the kinematic profile of a reaching-for-an-object movement would differ depending on the goal of the reaching task and (b) the effect of task goal on attentional carryover.

METHOD

Twenty-four adults without disabilities performed a horizontal line bisection task under three conditions: (a) a natural condition (pressing the ringing lever of a desk bell), (b) an impoverished condition (touching the ringing lever of a desk bell), and (c) a control condition (bisecting a line only). Only the natural and impoverished conditions used the reaching task (i.e., pressing or touching the ringing lever of the desk bell). The kinematic profile of reaching for the bell was established with the OPTO-TRAK system, a quantitative kinematic analysis measure. The line bisection task was performed immediately after the reaching task, which was located adjacent to the left of the line to be bisected.

RESULTS

The natural condition elicited better quality of reaching movement than did the impoverished condition. It produced significantly shorter movement time and higher peak velocity. A less impressive effect was found for percentage of reach where peak velocity occurs. Bisection performance under the two experimental conditions was leftward biased relative to the control condition, and the magnitude of leftward bias in the natural condition was greater than that for the impoverished condition.

CONCLUSION

Results supported one core assumption of occupational therapy: goal-directed and functional tasks can be used to enhance human performance. If the results hold for clinical populations, manipulations of functional goals may enhance movement performance of persons with disabilities and remediate left neglect often seen in clients who have had a stroke.

Characterization of pulsatile secretion of gonadotropin and prolactin in women with normal menstrual cycle, secondary amenorrhea and polycystic ovary syndrome (PCOS)

To characterize the episodic fluctuations of serum LH, FSH and PRL in women with normally cycling, secondary amenorrhea and polycystic ovary syndrome (PCOS), four groups of women were studied: group I (N = 8) consisted of normal women in the follicular phase of the cycle; group II (N = 10) of women with secondary amenorrhea and positive progesterone withdrawal bleeding; group III (N = 8) of women with secondary amenorrhea and negative progesterone withdrawal bleeding; group IV (N = 9), women with polycystic ovary syndrome (PCOS). Blood samples were obtained at 15 minute intervals for 4 hours during one admission day. Ovarian steroids were measured to evaluate the baseline endocrine environment in each group. Distinct pulsatile fluctuations of serum LH, FSH and PRL were observed in all subjects. These pulses showed a high degree of coincidence in LH with FSH and LH with PRL in each group. However, the mean (+/- SD) frequencies of LH in group III and group IV were significantly lower (P < 0.01) and higher (P < 0.01) than in group I, respectively. The mean frequencies of FSH in groups III and IV were lower (P < 0.05), as compared with those of group I. The mean amplitude of LH in group IV was significantly higher (P < 0.001) than in group I. These results suggest that loss of the regulatory pulsatility of gonadotropin releases may be a contributory cause to anovulation and secondary amenorrhea. The concomitant pulsatile releases of gonadotropin and PRL are essential to reproductive function and their regulatory controls in the follicular phase may be mediated through a common neuroendocrine mechanism in normal and hypogonadal women.

Random mutagenesis of the cAMP chemoattractant receptor, cAR1, of Dictyostelium. Mutant classes that cause discrete shifts in agonist affinity and lock the receptor in a novel activational intermediate

The cAMP chemoattractant receptor, cAR1, of Dictyostelium transduces extracellular cAMP signals via G protein-dependent and G protein-independent mechanisms. While site-directed mutagenesis studies of G protein-coupled receptors have provided a host of information regarding the domains essential for various functions, many mechanistic and structural questions remain to be resolved. We therefore carried out polymerase chain reaction-mediated random mutagenesis over a large part of the cAR1 sequence (from TMIII through the proximal part of the cytoplasmic tail). We devised a rapid screen for loss-of-function mutations based on the essential role of cAR1 in the developmental program of Dictyostelium. Although there were an average of two amino acid substitutions per receptor, approximately 90% of the mutants were able to substitute for wild-type cAR1 when expressed in receptor null cells. About 2% were loss-of-function mutants that expressed wild-type levels of receptor protein. We used biochemical screens to select about 100 of these mutants and chose eight representative mutants for extensive characterization. These fell into distinct classes. One class had a conditional defect in cAMP binding that was reversed by high salt. Another large class had decreased affinity under all conditions. Curiously, the decreases were clustered into three discrete intervals. One of the most interesting class of mutants lost all capacity for signal transduction but was phosphorylated in response to agonist binding. This latter finding suggests that there are at least two activated states of cAR1 that can be recognized by different downstream effectors.

[Operation directions by comparing financial ratio of 22 provincial hospitals]

Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a hospital with more confidence, flexibility and readiness for internal improvement always demonstrates greater business efficiency.

Effects of left-sided movements on line bisection in unilateral neglect

Thirteen patients with left neglect performed line bisection under four conditions: no cue, visual cueing involving the report of a digit placed at the left end of the line, circling the left-end digit, and digit circling plus tracing of the line with the right index finger from its left end to its midpoint before bisection. Digit circling plus finger tracing was unequivocally more effective in reducing left neglect than digit circling alone, which was in turn more effective than visual cueing; indeed, digit circling with tracing completely abolished the rightward bisection bias. Thus continuously directing visuomotor control to the left side of the line (even with the right hand) until bisection is performed reduces neglect more than only requiring patients to attend to left-sided visual cues. The facilitatory effects of the cueing procedures may reflect their differential efficacy in constraining as well as attracting attention and action to the left part of the target line. These findings have implications for neglect rehabilitation.

Isolation and expression of a host response gene family encoding thaumatin-like proteins in incompatible oat-stem rust fungus interactions

Four cDNA clones (corresponding to tlp-1, -2, -3, and -4 genes) encoding thaumatin-like (TL), pathogenesis-related proteins were isolated from oat (Avena sativa) infected by an incompatible isolate Pga-1H of the oat stem rust fungus (Puccinia graminis f. sp. avenae). All four cDNA clones contained an open reading frame predicted to encode a 169-amino acid polypeptide with a signal peptide of 21 amino acids at the N-terminus, suggesting that these proteins are transported through a secretory pathway. The amino acid sequences revealed high homology among the four cDNA clones, 80 to 99% identity and 86 to 100% similarity. The tlp genes and several TL protein genes of certain cereals are clustered into a small group that is phylogenetically separate from the major group of TL protein genes of several plant species. In plants infected with the incompatible isolate Pga-1H, or an inappropriate isolate Pgt-8D of P. graminis f. sp. tritici, high levels of tlp gene transcripts accumulated at 42 to 48 h AI and thereafter when hypersensitive host cell death occurred and hyphal growth was inhibited, whereas in plants infected with a compatible isolate Pga-6A, relatively lower amounts of transcripts were detected. Overall, transcript levels were higher with tlp-1 than with the three other genes. Spray with a light mineral oil used as a spore carrier induced transient expression of tlp-1, -2, and -3 genes at 16 to 30 h AI which obscured the initial induction of the tlp genes in response to infection by the pathogens. In contrast, tlp-4 was induced very little by oil spray, so that induction was clearly observed in response to either compatible, incompatible, or inappropriate isolates at 24 to 30 h AI. Wounding leaves by either slicing or puncturing them strongly induced tlp-1 and tlp-3, moderately induced tlp-2, but had no effect on tlp-4. Taken together, the results showed that tlp genes displayed differential responses to oil spray, mechanical wounding, and pathogen infection and that the expression of tlp genes, especially tlp-1, in oat is associated with resistance reactions in response to infection by incompatible and inappropriate isolates of the stem rust fungi.

Ultrasound-guided percutaneous transhepatic fine needle aspiration cytology study of gallbladder polypoid lesions

OBJECTIVE

To determine the accuracy and safety of ultrasound (US)-guided percutaneous transhepatic fine needle aspiration cytology (PT FNAC) in the diagnosis of large gallbladder (GB) polyps, especially cholesterol polyps.

METHODS

Between January 1993 and April 1995, 17 patients with GB polyps of a size over 1 cm were examined preoperatively with US-guided PT FNAC, with needle aspiration from the center of the polyps. A cytological-histopathological correlation study was performed postoperatively to assess the accuracy of the PT FNAC results.

RESULTS

1) All eight cholesterol polyps were accurately diagnosed with the PT FNAC alone, showing foamy histiocytes. 2) In five patients, a diagnosis of epithelial tumor was made with PT FNAC study, showing the presence of columnar epithelium, but the PT FNAC failed to detect focal malignant change in adenomas of three of these patients. Only one case of adenocarcinoma was correctly diagnosed preoperatively by the PT FNAC. 3) The PT FNAC failed to detect an inflammatory polyp in one patient. 4) Failed cytology study was encountered in three patients-only bile was aspirated out. One patient had a GB stone, misdiagnosed as a GB polyp, another had an adenomyoma, and the last patient had chronic cholecystitis with Rokitansky-Aschoff sinuses. 5) One complication occurred-mild bile peritonitis.

CONCLUSIONS

US-guided PT FNAC directly targeting the GB lesions seems accurate in the diagnosis of cholesterol polyps, and is a safe procedure.

Right-hemispheric activation approaches to neglect rehabilitation poststroke

Unilateral neglect is a common neurological syndrome resulting from right-hemisphere strokes and has important prognostic value for functional outcome. This article identifies three approaches to neglect rehabilitation that are based on right-hemispheric activation mechanisms: (a) the lateralized task approach, (b) the controlled sensory stimulation approach, and (c) the limb activation approach. Their theoretical bases, experimental findings, and practical implications for neglect remediations are discussed. Meta-analytic procedures were used to critically review and statistically combine the results from potentially relevant studies, including 9 group design studies and 22 single-subject studies. An overall mean effect size r of .77 was found for the group design studies. For the studies with individual subjects as units of analysis, an overall mean r of .89 was obtained. This review provided empirical support for intervention in cases of unilateral neglect on the basis of brain activation mechanisms. Some appropriate areas for further research include evaluating treatment efficacy against functional criteria, refining intervention procedures in keeping with the advances in brain activation research, and identifying the optimal conditions for promoting generalized training.

Collagenolytic enzymes and progestin in induced ovulation in rabbits with hyperprolactinemia

To clarify the possible role of collagenolytic enzymes and progestin in induced ovulation and to investigate whether progesterone interacts with these enzymes in leading to ovulation during the hyperprolactinemic state, the alterations of 2,4-dinitrophenyl-Pro-Gln-Gly-Ile- Ala Gly-Gln-D-Arg-OH peptidase (DNP-peptidase) and alpha-n-benzoyldl-Arg-beta-naphthylamide hydrolase (BANA-hydrolase) activities were measured in rabbit ovaries. The ovaries were primed with four daily sulpiride (SLP) injections followed by human chorionic gonadotropin (hCG) administration. The peripheral and ovarian progesterone, 20 alpha-hydroxypregn-4-en-3-one (20 alpha OHP) levels and ovulation rate at 14 hours after hCG administration in SLP-treated rabbits were significantly suppressed as compared with the control animals. The usual changes in DNP-peptidase and BANA-hydrolase activities in the follicular tissue at 8 and 10 hours after hCG were also altered by this abnormal hypersecretion of circulating prolactin. When progesterone was administered concomitantly with hCG to the hyperprolactinemic rabbits during ovulation induction, the ovulation rate was restored to a physiologic level comparable to that of the controls. These results suggest that both progesterone and collagenolytic enzymes are mandatory for follicular rupture induced by hCG and that progesterone may interact with these enzymes to facilitate the completion of the ovulatory process during the hyperprolactinemic state.

A simple method for DNaseI footprinting analysis

DNaseI footprinting technique has been a very useful method in gaining direct and immediate information about the location of a protein binding site in the DNA sequence. In this report, we present a method that overcomes many of the inconveniences of previous methods. This method was based on the combination of PCR technique and the dideoxy DNA sequencing reaction. It avoids the need of the secondary restriction sites that any candidate DNA sequence for DNaseI footprinting analysis can be prepared efficiently as long as its flanking sequences are known. Replacing the difficult Maxam-Gilbert DNA sequencing with the dideoxy-mediated DNA sequencing method makes the footprinting experiments even safer and easier.

A comparison of enzyme-linked immunosorbent assay (ELISA) with sperm immobilization test (SIT) in detection of antisperm antibodies in sera of infertile women

In the present study, an enzyme-linked immunosorbent assay (ELISA) for antisperm antibodies was compared with a traditional standard sperm immobilization test (SIT) in sera from 158 infertile women in order to evaluate their clinical usefulness for various causes of infertility. Ten pregnant and unmarried women were used as the control group. There was a higher incidence rate by ELISA (13.9%) compared with that by SIT (10.1%) after examination of overall samples, although the difference was not statistically significant. The unexplained infertility group exhibited the highest incidence among the various causes of infertility in both of these two methods. Fifteen (93.8%) of 16 patients with positive SIT showed positive reaction in ELISA method, indicating that a close correlation exists between the two methods. The positive predictive value (54.5%) of ELISA was significantly (p < 0.05) lower than that (87.5%) of SIT, as evaluated with the results of postcoital test (PCT) performed at periovulatory phase. This suggests that the ELISA method for antisperm antibodies is less specific than SIT in view of the PCT results. Nevertheless, no fresh sperms are not required for the ELISA examination. Thus, it seems that the ELISA method may provide a convenient and practical means for mass screening in detecting antisperm antibodies in clinical practice.