[Clinical and psychological disorders of pregnant women induced by abuse]

This study is performed on a population of pregnant women during the second trimester of their pregnancy. The aim of this study is to demonstrate that clinical symptoms noticeable by the obstétricians during their consultations. Eight hundred and fifty-three patients have been involved in this study by responding to an anonymous questionnary. Hundred and seventy-five patients(groupI) have been abuse either physically or psychologically or sexually. The study shows that there is a strong difference between the groupI and the group without abuse in their medical past history (678 patients) about the occurracy of several disorders. The most frequently observed troubles are sexuals disorders, school failures, deficients relationship with others persons, anxiety and troubles of humor. We can concluded, about those clinical manifestations, that they do exist during pregnancy and probably thoses symptoms are linked to traumatism occured during their past history. Obstetricians must look after thoses symptoms very seriously to propose a good management of the pregnancy either about their psychological problems or about the social environnement in which they live.

Measurement of gene amplification in FFPE tumor tissues by quantitative real-time PCR in comparison with FISH

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Background: Amplified oncogenes such as HER2 and EGFR have proven to be good targets for molecular therapy. Recent retrospective analyses suggest that EGFR amplification predicate better responses to EGFR kinase inhibitors. However, different methods were used to measure EGFR gene amplification and polysomy in these studies, including FISH and various real-time quantitative PCR platforms, which may have led to the different conclusions reported by these groups. In this study, we compared Taqman- QPCR with FISH in scoring EGFR and HER2 amplification and EGFR polysomy on 42 FFPE tumor samples. Methods: DNA was prepared from 42 FFPE tumor tissues of breast, colon, lung, and stomach origin. Taqman QPCR was carried out according to manufacturer’s protocol on an ABI-7900HT instrument. FISH analysis for EGFR and HER2 amplification was carried out according to Vysis standard protocols. Results: QPCR reference probes for measuring EGFR and HER2 amplification were designed against DNA fragments near the centromeric regions of chromosome 7 and chromosome 17, respectively. A QPCR probe for RNase P on chromosome 6 was designed and used as a reference for measuring EGFR polysomy. HER2 amplification was detected in ∼25% FFPE breast tumor samples by both FISH and QPCR methods, although amplification scores were consistently higher by QPCR than by FISH. EGFR amplification was rare in all samples screened but high polysomy (6 copy and above) was detected in 40% FFPE gastric tumor samples. Again there was high concordance between FISH and Taqman QPCR results. Conclusions: Our data showed high concordance between Taqman QPCR and FISH in scoring EGFR and HER2 amplification. Taqman QPCR is a highly sensitive, accurate, convenient, and economical technology for measuring EGFR and HER2 amplification and EGFR polysomy in FFPE tissues. With well validated target and reference primers/probes, Taqman QPCR provides an attractive alternative to FISH for measuring oncogene amplification for retrospective studies on archived FFPE samples and for screening patients for clinical trials.

No significant financial relationships to disclose.

Detection of testosterone propionate administration in horse hair samples

A sensitive and specific method has been developed to detect semi-quantitatively testosterone in horse hair samples. The method involved a washing step with sodium dodecylsulfate aqueous solution. The mane and tail hair samples (100mg) were dissolved in 1 mL of sodium hydroxide for 15 min at 95 degrees C in the presence of d3-boldenone used as internal standard. The next three steps involved diethyl ether extraction and a solid phase extraction on Isolute C18 (EC) cartridges eluted with methanol. The residue was derivatized by adding 100 microL of acetonitrile and 30 microL of PFPA then incubating for 15 min at 60 degrees C. After evaporation, 30 microL of hexane was added and 2.5 microL was injected into the column (a bonded phase fused silica capillary column DB5MS, 30 m x 0.25 mm i.d. x 0.25 microm film thickness) of a Trace GC chromatograph. In order to improve the sensitivity of the method, damping gas flow has been optimized. Testosterone was identified in MS(2) full scan mode on the Polaris Q instrument. The assay was capable of detecting less than 1 pg mg(-1). The recovery was close to 90%. The analysis of tail and mane samples collected from a gelding horse having received a single dose of testosterone propionate (1 mg kg(-1)) showed the presence of testosterone in the range of 1-6 pg mg(-1) in hair collected during 5 months after administration.

[Heterotopic pregnancy: a case report with a rare symptomatology]

Heterotopic pregnancy was a rare pathology many years ago, but its survey is more frequently observed during last years with Assisted Reproduction Technics. We report a case of a heterotopic pregnancy with a rare symptomatology, with in the front plan a miscarriage. It's diagnostic is difficult and occurred very late. The main treatment consists to perform a salpingotomy under laparoscopy. However laparotomy treatment is frequently performed in relation to the late time of diagnosis.

Impact of human activity on the distribution of native and non-native cockroach species (Dictyoptera) in La Réunion and Mayotte

Establishment of non-native species and human-driven alteration of habitats are major causes of the decline of native faunas. Interference between native and non-native cockroach species was evaluated here by comparing their distribution areas in two oceanic islands: Mayotte and La Réunion. A factorial correspondence analysis showed that their presence is related to environmental parameters among which human activity, humidity and altitude are the three most important. Human activity and humidity favour establishment and development of non-native species, whereas altitude limits their presence. Non-native species form guilds (up to seven species). Their distribution areas overlap and illustrate their colonizing capacities. On the contrary, distribution areas of native species never overlap, although some co-occur with non-native species. Native species are more endangered when they are established in cultivated areas than when they are in protected natural areas.

Involvement of cytochrome P450 monooxygenases in the response of mosquito larvae to dietary plant xenobiotics

The response of mosquito larvae to plant toxins found in their breeding sites was investigated by using Aedes aegypti larvae and toxic arborescent leaf litter as experimental models. The relation between larval tolerance to toxic leaf litter and cytochrome P450 monooxygenases (P450s) was examined at the toxicological, biochemical and molecular levels. Larvae pre-exposed to toxic leaf litter show a higher tolerance to those xenobiotics together with a strong increase in P450 activity levels. This enzymatic response is both time- and dose-dependent. The use of degenerate primers from various P450 genes (CYPs) allowed us to isolate 16 new CYP genes belonging to CYP4, CYP6 and CYP9 families. Expression studies revealed a 2.3-fold over-expression of 1 CYP gene (CYP6AL1) after larval pre-exposure to toxic leaf litter, this gene being expressed at a high level in late larval and pupal stages and in fat bodies and midgut. The CYP6AL1 protein has a high level of identity with other insect's CYPs involved in xenobiotic detoxification. The role of CYP genes in tolerance to natural xenobiotics and the importance of such adaptive responses in the capacity of mosquitoes to colonize new habitats and to develop insecticide resistance mechanisms are discussed.

A new reversed-phase liquid chromatographic/tandem mass spectrometric method for analysis of underivatised amino acids: evaluation for the diagnosis and the management of inherited disorders of amino acid metabolism

Seventy-six compounds of biological interest for the diagnosis of inherited disorders of amino acids (AA) metabolism have previously been demonstrated to be detectable in positive mode electrospray ionisation tandem mass spectrometry (ESI-MS/MS), after separation by ion-pairing reversed-phase liquid chromatography (RPLC). The separation method used tridecafluoroheptanoic acid as ion-pairing agent, and a gradient of acetonitrile for the elution of the most retained compounds. This method had previously been demonstrated to be suitable for the qualitative diagnosis of many AA disorders, and for the quantitative measurement of 16 AA in biological fluids, using their stable isotope labelled (SIL) AA as internal standard. For quantification of the other AA, an internal standard was chosen among the available SIL-AA, as close as possible to the analyte to be measured, in terms of structural analogy, and of retention time in the chromatographic system. The performances of the quantitative analysis of the other AA to be measured are reported here. They show validated results for several AA, allowing their accurate quantification, with another SIL-AA as internal standard. For some other AA, quantitative results were not accurate, allowing only semi-quantitative or qualitative determination for these parameters.

Two differing presentations of optic nerve head drusen

BACKGROUND

Optic nerve head drusen was recognized histologically in 1858 by Heinrich Muller The majority of optic nerve head drusen cases have been benign in nature. However, optic nerve head drusen can be visually devastating.

CASE REPORTS

Two patients were diagnosed with optic nerve head drusen. They were similar in age and each had a best-corrected visual acuity of 20/20 OU. Although the diagnosis was the same, the disease affected each person very differently. One is currently asymptomatic; the other is legally blind secondary to severely constricted visual fields. These cases demonstrate the diversity of visual effects produced by optic nerve head drusen. Appropriate ocular workup, including visual fields, B-scan ultrasonography, computed tomography, and other tests, are presented.

CONCLUSION

There is no existing treatment for optic nerve head drusen. Proper diagnosis and patient education is the best-available modality of care. Patients need to be aware of potential complications which, while rare, can affect vision. Visual-field testing can aid in monitoring for subtle changes in vision.

Reduction of bladder outlet resistance by selective stimulation of the ventral sacral root using high frequency blockade: a chronic study in spinal cord transected dogs

PURPOSE

The use of electrical neural stimulation as treatment for neurogenic bladder is complicated by simultaneous contraction of the striated sphincter. This result is due to the composition of the ventral sacral roots, which contain somatic fibers innervating the external urethral sphincter and preganglionic parasympathetic fibers innervating the detrusor, among others. The somatic fibers have a larger caliber than the parasympathetic fibers and, as large diameter fibers, need a lower stimulus amplitude for activation than smaller fibers. Activation of the smaller fibers is always accompanied by activation of the larger fibers. We studied the effect of chronic application of selective combined low and high frequency current stimulation of the ventral sacral root on bladder evacuation and urethral resistance in chronically spinalized (spinal cord transected above the spinal micturition center) male dogs for daily bladder evacuation.

MATERIALS AND METHODS

A total of 14 male mongrel dogs weighing 20 to 25 kg. underwent transection of the spinal cord at the T10 vertebra. The S2 ventral sacral root was wrapped with a bipolar electrode connected to a subcutaneous microstimulator. Daily bladder evacuation by neural stimulation with determination of the voided and residual urine volumes was done for 8 months. The animals were stimulated only with low frequency current during the 1-month spinal shock phase. Selective parameters of combined low frequency stimulation and high frequency blockade currents were subsequently applied for 6 months. For the last study month the animals were again stimulated by low frequency current alone. Bladder and urethral pressure as well as electromyography of the external urethral sphincter and pelvic floor muscles were evaluated monthly. Histopathological testing of the chronically stimulated nerve and external sphincter was performed.

RESULTS

Of the 14 dogs 12 completed the followup study. During the shock phase with the application of low frequency only stimulation the animals voided 26% of mean functional bladder capacity with the early return of detrusor activity. Mean detrusor pressure plus or minus standard error of mean was 76.4 +/- 21.6 cm. water, while mean urethral pressure was 83.6 +/- 16.8 cm. water. During the application of selective combined low and high frequency stimulation 7 animals (58%) evacuated the bladder completely with post-void residual urine less than 10% of mean individual functional bladder capacity and 5 (42%) had mean post-void residual urine less than 20% of mean individual bladder capacity. Mean detrusor pressure was 73.5 +/- 20 cm. water and mean urethral pressure was 44 +/- 7.3 cm. water. There was a 45.19% reduction in the mean electromyography activity of the external sphincter. Stimulation of the dogs for the last month by low frequency current resulted in the voiding of 33% of mean bladder capacity with an increase in mean urethral pressure and electromyography activity.

CONCLUSIONS

These results of reducing external sphincter activity by the simultaneous application of high frequency current blockade of the somatic fibers and activation of the autonomic fibers of the bladder by low frequency stimulation are promising.

Implantable selective stimulator to improve bladder voiding: design and chronic experiments in dogs

Among the treatments to enhance the bladder voiding, the sacral roots neurostimulation is one of the most promising techniques. The electrostimulation of sacral nerves provokes a simultaneous contraction of the detrusor muscle as well as the external urethral sphincter (EUS). A new simplified-architecture implantable stimulator with its wireless controller have been designed to investigate high-frequency inhibition stimulation strategies. This innovative technique based on high-frequency inhibition reduces sphincter activity during stimulation. Low-frequency current pulses also applied to the sacral roots induces contraction of the detrusor muscle resulting in low pressure voiding. Chronic experiments were carried out on ten male mongrel paraplegic dogs. One cuff electrode was implanted along with each stimulator for eight months. The animals were stimulated twice a day using the prototypes of our implantable selective stimulator while voided and residual urine volume were measured during the procedure. These experiments revealed that the proposed stimulation strategy enhances bladder voiding by more than 50% in comparison with low-frequency only stimulation. The residual urine volume was reduced to an average of 9% and low pressure micturition was achieved as shown by weekly cystourethrogram.

Expression of human papilloma virus E7 protein causes apoptosis and inhibits DNA synthesis in primary hepatocytes via increased expression of p21(Cip-1/WAF1/MDA6)

The impact of human papilloma virus (HPV16) E7 proteins and retinoblastoma (RB) antisense oligonucleotides upon mitogen-activated protein kinase (MAPK)-mediated inhibition of DNA synthesis via p21(Cip-1/WAF1/MDA6) (p21) was determined in primary hepatocytes. Prolonged activation of the MAPK pathway in p21(+/+) or p21(-/-) hepatocytes caused a large decrease and increase, respectively, in DNA synthesis. Either transfection with RB antisense oligonucleotides, expression of wild type E7, or RB binding mutant E7 (C24S) proteins increased p21 levels and reduced DNA synthesis in p21(+/+) hepatocytes. RB antisense oligonucleotides and E7 proteins increased apoptosis in p21(+/+), but not p21(-/-), hepatocytes. Expression of wild type E7 increased DNA synthesis above control levels in p21(-/-) cells, which was additive with prolonged MAPK activation. In contrast, expression of mutant E7 did not alter DNA synthesis above control levels in p21(-/-) cells and was supra-additive with prolonged MAPK activation. Antisense ablation of RB in p21(-/-) hepatocytes had a weak stimulatory effect upon DNA synthesis itself but enhanced the capacity of mutant E7 protein to stimulate DNA synthesis to the same level observed using wild type E7. The ability of prolonged MAPK activation to stimulate DNA synthesis in the presence of mutant E7 and antisense RB was additive. Collectively, the present data demonstrate that loss of RB function together with loss of p21 function plays an important role in the E7- and MAPK-dependent modulation of apoptosis and DNA synthesis in primary hepatocytes.

An update on HL7's XML-based document representation standards

Many people know of HL7 as an organization that creates healthcare messaging standards. But HL7 is also developing standards for the representation of clinical documents (such as discharge summaries and consultation notes). These document standards comprise the HL7 Clinical Document Architecture (CDA). Last year we presented a high-level conceptual overview of the CDA. Since that time, CDA has entered HL7's formal ballot process (which when successful will make the CDA an ANSI-approved HL7 standard). This article delves into the technical details of the current CDA proposal. Note that due to space limitations, only a subset of CDA details can be described. Also, because the ballot process elicits considerable feedback, it is likely that the material presented here will undergo evolution prior to becoming a final standard. The most up-to-date information is available on HL7's web site (www.hl7.org).

Interaction of calicheamicin gamma1(I) and its related carbohydrates with DNA-protein complexes

We report studies of the contribution of DNA structure, holding the sequence constant, to the affinity of calicheamicin gamma(1)(I) and its aryltetrasaccharide moiety for DNA. We used polynucleotide chains as models of known protein-binding sequences [the catabolite activator protein (CAP) consensus sequence, AP-1 and cAMP response element (CRE) sites] in their free and protein-bound forms. The proteins were selected to provide examples in which the minor-groove binding site for the carbohydrate is (CAP) or is not (GCN4) covered by the protein. Additionally, peptides related to the GCN4 and CREB families, which have different bending effects on their DNA-binding sites, were used. We observe that proteins of the CREB class, which induce a tendency to bend toward the minor groove at the center of the site, inhibit drug-cleavage sites located at the center of the free AP-1 or CRE DNA sites. In the case of GCN4, which does not induce DNA bending, there is no effect on calicheamicin cleavage of the CRE site, but we observe a GCN4-induced rearrangement of the cutting pattern in the AP-1 site. This effect may arise from either a subtle local conformational rearrangement not accompanied by bending or a localized reduction in DNA flexibility. Whereas GCN4 binding is not inhibited by the calicheamicin aryltetrasaccharide, binding of CAP to its DNA target is significantly inhibited, and calicheamicin cutting of DNA at the center of the CAP-DNA complex site is strongly reduced by protein binding. This result probably reflects steric inhibition of drug binding by the protein.

HL7 document patient record architecture: an XML document architecture based on a shared information model

The HL7 SGML/XML Special Interest Group is developing the HL7 Document Patient Record Architecture. This draft proposal strives to create a common data architecture for the interoperability of healthcare documents. Key components are that it is under the umbrella of HL7 standards, it is specified in Extensible Markup Language, the semantics are drawn from the HL7 Reference Information Model, and the document specifications form an architecture that, in aggregate, define the semantics and structural constraints necessary for the exchange of clinical documents. The proposal is a work in progress and has not yet been submitted to HL7's formal balloting process.