Effects of expiratory muscle activation via high-frequency spinal cord stimulation

In persons with spinal cord injury, lower thoracic low-frequency spinal cord stimulation (LF-SCS; 50 Hz, 15 mA) is a useful method to restore an effective cough. Unfortunately, the high-stimulus-amplitude requirements and potential activation of pain fibers significantly limit this application in persons with intact sensation. In this study, the mechanism of the expiratory muscle activation, via high-frequency SCS (HF-SCS; 500 Hz, 1 mA) was evaluated in dogs. In group 1, the effects of electrode placement on airway pressure generation (P) was evaluated. Maximal P occurred at the T9-T10 level with progressive decrements in P at more rostral and caudal levels for both LF-SCS and HF-SCS. In group 2, electromyographic (EMG) latencies of internal intercostal muscle (II) activation were evaluated before and after spinal root section and during direct motor root stimulation. Onset time of II EMG activity during HF-SCS was significantly longer (3.84 ± 1.16 ms) than obtained during direct motor root activation (1.61 ± 0.10 ms). In group 3, P and external oblique (EO) EMG activity, before and after sequential spinal section at the T11-T12 level, were evaluated. Bilateral dorsal column section significantly reduced EO EMG activity below the section and resulted in a substantial fall in P. Subsequent lateral funiculi section completely abolished those activities and resulted in further reductions in P. We conclude that 1) activation of the expiratory muscles via HF-SCS is dependent entirely on synaptic spinal cord pathways, and 2) HF-SCS at the T9 level produces a comparable level of muscle activation with that achieved with LF-SCS but with much lower stimulus amplitudes. NEW & NOTEWORTHY The findings in the present study suggest that lower thoracic high-frequency spinal cord stimulation with low stimulus currents results in sufficient activation of the expiratory muscles via spinal circuitry to produce large positive airway pressures sufficient to generate an effective cough mechanism. This method, therefore, may be applied in patient populations with intact sensation such as stroke and amyotrophic lateral sclerosis to restore an effective cough.

High frequency spinal cord stimulation-New method to restore cough

Spinal cord stimulation (SCS, 50Hz) is a useful method to restore an effective cough in persons with spinal cord injury (SCI). However, high stimulus amplitudes and potential activation of pain fibers, significantly limits this application. It is our hypothesis that high frequency SCS (HF-SCS), with low stimulus amplitudes may provide the same level of expiratory muscle activation. In 6 dogs, the effects of SCS, with varying stimulus parameters on positive pressure (P) generation was evaluated. At any given level of stimulus current, mean P was largest at 500Hz, compared to all other stimulus frequencies. For example, with stimulation at 1mA and frequencies of 200, 500 and 600Hz, P were 25±3, 58±4, 51±6cmH2O, respectively. By comparison, P achieved with conventional SCS parameters was 61±5cmH2O. HF-SCS results in a comparable P compared to that achieved with conventional stimulus parameters but with much lower stimulus amplitudes. This method may be useful to restore cough even in subjects with intact sensation.

A large multicenter study analysis of adverse events associated with single operator cholangiopancreatoscopy

AIM

Cholangiopancreatoscopy (CP) is an endoscopic technique that allows for direct visualization of the biliary and pancreatic ducts using a narrow caliber endoscope that passes through the working channel of a duodenoscope directly into the bile and/or pancreatic ducts. Little data is available on the safety of CP. We performed a multicenter retrospective study to evaluate the frequency and severity of adverse events with single operator CP.

METHODS

A multicenter retrospective study was conducted.

RESULTS

A total of 282 single operator peroral CP procedures were performed in 224 patients (128 M, 96 F). Most procedures involved the performance of therapeutic maneuvers, with most cases including multiple therapeutic maneuvers. Cholangioscopic or pancreatoscopic-assisted tissue sampling was performed in 222 procedures. Thirty-seven patients underwent electrohydraulic lithotripsy (EHL) for the treatment of common bile duct stones. Adverse events in patients undergoing single cholangioscopy and pancreatoscopy included post-ERCP pancreatitis (N.=11, 3.9%, all mild), post-ERCP cholangitis (N.=4, 1.4%), bleeding (N.=3, 1%), and perforation (N.=2, 0.7%).

CONCLUSION

Overall, our data shows that ERCP performed with single operator cholangioscopy or pancreatoscopy is safe with adverse events similar to that seen in large studies of ERCP performed without these additional techniques. Of note, vigorous irrigation of the bile ducts was not associated with increased rates of post-procedure cholangitis in our study.

Fungi occurring in forests injured by air pollutants in the Upper Silesia and Cracov industrial Regions. V. Fungi inhabiting the overground portions of trees used in the regeneration of stands converted in 1971-1975

Results of investigations on fungi infecting both the leaves, needles or shoots, and the branches or trunks of 6-15-year-old tree species in forest stands rebuilt within two industrial regions in Poland are given in this paper.

MSX1 gene and nonsyndromic oral clefts in a Southern Brazilian population

Nonsyndromic oral clefts (NSOC) are the most common craniofacial birth defects in humans. The etiology of NSOC is complex, involving both genetic and environmental factors. Several genes that play a role in cellular proliferation, differentiation, and apoptosis have been associated with clefting. For example, variations in the homeobox gene family member MSX1, including a CA repeat located within its single intron, may play a role in clefting. The aim of this study was to investigate the association between MSX1 CA repeat polymorphism and NSOC in a Southern Brazilian population using a case-parent triad design. We studied 182 nuclear families with NSOC recruited from the Hospital de Clínicas de Porto Alegre in Southern Brazil. The polymorphic region was amplified by the polymerase chain reaction and analyzed by using an automated sequencer. Among the 182 families studied, four different alleles were observed, at frequencies of 0.057 (175 bp), 0.169 (173 bp), 0.096 (171 bp) and 0.67 (169 bp). A transmission disequilibrium test with a family-based association test (FBAT) software program was used for analysis. FBAT analysis showed overtransmission of the 169 bp allele in NSOC (P=0.0005). These results suggest that the CA repeat polymorphism of the MSX1 gene may play a role in risk of NSOC in populations from Southern Brazil.

Interdependence of Genotype and Growing Site on Seed Mineral Compositions in Common Bean

Essential minerals are considered as key determinants of optimum health and nutritive quality of common bean seed. This study aimed to identify genetically stable essential minerals in common bean. Eleven diverse common bean genotypes were grown in three distinct growing environments and 17 essential minerals were analyzed by Inductively Coupled Plasma-Optical Emission Spectroscopy. Genetic control of mineral composition in common bean seed was demonstrated by large (p<0.01) genotypic differences in Ca and Sr contents and moderate genotypic difference was observed in Fe content. Significant influence of genotype and environments (G×E) interaction was observed in the content of all minerals. The ratios between genetic and environmental variances and between genetic and G×E variances indicated the greater influence and stability of genetic factor on the concentration of Ca and Sr in common bean seed. Significant positive correlations among important minerals such as Zn with S, P, Fe and Na and Cu with K, Mg, Ni, P were identified. The stability of genetic effects on Ca and Sr concentration in common bean has been identified in this study. Calcium is one of the most important minerals which regulates many cellular processes and has important structural roles in living organisms. Further studies to characterize Ca physiology in common bean may identify genetic or biochemical markers to expedite breeding common bean with enhanced Ca concentration.

Self-expanding plastic esophageal stents versus jejunostomy tubes for the maintenance of nutrition during neoadjuvant chemoradiation therapy in patients with esophageal cancer: a retrospective study

In patients undergoing chemoradiotherapy for esophageal cancer, the inability to eat may severely impair nutritional status. We conducted a retrospective study to compare the efficacy of the Polyflex self-expanding silicone stent (PS) versus a jejunostomy tube (JT) for maintaining nutrition during neoadjuvant chemoradiation therapy in patients with esophageal cancer who were scheduled for resectional surgery. Thirty-six patients were treated either with PS placement (12 patients) or JT placement (24 patients) prior to receiving an 8-week course of chemoradiation therapy. Patients were interviewed weekly until cessation of therapy. Patient data were collected on procedural success and complication rates, nutritional status, and dysphagia scores. PS placement was successful in 11 of 12 patients (92%), and those 11 patients were able to resume oral nutrition. Dysphagia scores improved from a mean of 3 to 1 in the PS group (P < 0.005) but did not change significantly in the JT group. PS were removed endoscopically without complications prior to the esophagectomies. Albumin levels and weight increased significantly in both the PS and JT groups. There were no significant differences between groups in the procedural success rates (PS 92% vs. JT 100%, P = 0.33), complication rates (PS 22% vs. JT 4%, P = 0.11), mean increase in weight (PS 4.4 kg vs. JT 4.2 kg, P = 0.59), and mean increase in serum albumin (PS 0.62 g/dL vs. JT 0.44 g/dL, P = 0.05). PS is a safe and effective alternative to a surgical JT for maintaining nutrition in this subset of patients.

The effect of combined therapy on activity of cathepsin D and alpha-1-antitrypsin in the blood serum of women with cervical cancer

PURPOSE OF INVESTIGATION

The aim of the study was to determine the activity of cathepsin D (CTSD) and alpha-1-antitrypsin (AAT) in the blood serum of women with cervical carcinoma treated with different modes of therapy.

METHODS

The study was conducted on 68 women suffering from carcinoma of the uterine cervix, that were irradiated intracavitarily by a Selectron LDR brachytherapy unit. Additionally, all patients were treated with different therapy methods according to clinical stage.

RESULTS

In women with cervical cancer, CTSD activity was higher while AAT activity was lower both before and after brachytherapy sessions as compared to controls. Six months after the end of therapy, the activity of CTSD and AAT reverted back to the values characteristic for healthy women.

CONCLUSION

The estimation of cathepsin D and alpha-1-antitrypsin activity during the course of cervical cancer management may be useful in early detection of potential recurrence and/or widespread metastasis formation.

Schmerzhaftes Hyperexzitabilitätssyndrom unter Oxaliplatin-haltiger Chemotherapie

The platinum derivative oxaliplatin is widely used in colorectal cancer. Its side effects differ from those of the other platinum compounds cisplatin and carboplatin. An acute, painful hyperexcitability syndrome (HES) accompanied by cold induced paresthesia, dysesthesia and myotonia is unique to oxaliplatin, whereas a chronic, peripheral sensory neuropathy (PSN) can be caused by all platinum compounds. It is believed that HES is the result of peripheral nerve hyperexcitability as a consequence of voltage-gated sodium channel dysfunction, which may be caused by calcium level imbalance. Therapeutic options for HES are the administration of calcium and magnesium, the serotonin and noradrenaline reuptake inhibitor (SNRI) venlafaxine and the thiophosphate amifostine.

Influence of preoperative MRI on the surgical management of patients with operable breast cancer

613

Background: To evaluate the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). Methods: Retrospective analysis of 160 patients with operable breast cancer (stages Tis, through T4), who were treated from 2002 through 2004. All patients underwent a full mammographic assessment, high frequency breast ultrasound, and breast MRI. The impact of preoperative MRI was evaluated for each patient with regard to changes in the therapeutic procedure. Patient and tumor characteristics were analysed to identify possible patient subgroups that predominantly benefit from preoperative MRI. Results: Preoperative MRI affected the clinical management in 44 of 160 patients (27.5%). In 30 cases (18.75%) additional in-situ or invasive cancers or a more widespread tumor extent were diagnosed correctly which went undetected by clinical palpation, mammography, and breast ultrasound. In 14 cases (8.75%) additional, surgical procedures were performed based on suspicious MRI findings with benign pathology. Age, menopausal status, breast density, tumor characteristics (type, tumor size, grading), ER-, PR- and HER2- receptor features did not significantly differ between patients in which breast MRI affected the clinical management and patients that experienced no additional information from MRI. Conclusions: Preoperative breast MRI changes surgical management in a considerable amount of patients with operable breast cancer. MRI detects additional invasive carcinoma and proves to be a meaningful supplement to the conventional work-up in the clinical management of breast cancer. This benefit is independent from patients and tumor characteristics.

No significant financial relationships to disclose.

Endoscopic sphincterotomy with or without cholecystectomy for choledocholithiasis in high-risk surgical patients: a decision analysis

BACKGROUND

Laparoscopic cholecystectomy (LC) is recommended for patients with choledocholithiasis after ERCP with sphincterotomy (ES) and stone extraction.

AIM

We designed a decision model to address whether ES alone versus ES followed by LC (ES + LC) is the optimal treatment in high-risk patients with choledocholithiasis.

METHODS

Our cohort were patients with obstructive jaundice who have undergone an ES with biliary clearance. Recurrent biliary complications over a 2-year period stratified by gallbladder status (in/out) and age-stratified surgical complication rates were obtained from the literature. Failure of therapy was defined as either recurrent symptoms or death attributed to biliary complications.

RESULTS

For age 70-79 years, ES failed in 15% whereas ES + LC failed in 17% of cases. Mortality in the EC + LC group was 3.4 times that of the ES alone cohort. For age 80+ years, ES was dominant with an incremental success rate of 8%. Mortality in the ES + LC was 7.6 times that of ES. For age <70, ES + LC was the dominant strategy with an incremental success rate 5%. Sensitivity analysis in the groups confirmed our conclusions.

CONCLUSIONS

Management of choledocholithiasis by ES and stone clearance, but without cholecystectomy, should be considered for patients aged 70+. For low-risk patients, ES + LC should be performed to prevent recurrent biliary complications.

A survey of oesophageal cancer: pathology, stage and clinical presentation

BACKGROUND

Oesophageal adenocarcinoma is the sixth leading cause of cancer-related mortality worldwide. Previously, oesophageal cancer was mainly squamous cell, presenting late with dysphagia and weight loss.

AIMS

To examine the distribution of oesophageal cancer histopathology at a large, urban hospital; to determine the tumour stage and symptoms at presentation; and to evaluate the impact of endoscopic surveillance in Barrett's oesophagus.

METHODS

From 1999 to 2004, all patients diagnosed with oesophageal cancer were evaluated retrospectively for demographics and tumour stage at presentation using endoscopic ultrasonography and computerized tomography.

RESULTS

A total of 131 patients were included. 81% of tumours were adenocarcinomas; most localized to the distal oesophagus (97%). Patients presented with dysphagia (56%), pain (30%) and/or weight loss (16%). Irrespective of histology, locally advanced lesions accounted for most cases. Thirteen patients had lesions detected in Barrett's surveillance; these were early or intermediate stage in nine patients, but late stage in four patients.

CONCLUSIONS

Adenocarcinoma has become the dominant histologic subtype, comprising 81% of proven malignancies. Despite a change in histopathology, most cancers are diagnosed at an advanced stage, presenting with dysphagia, pain and/or weight loss. Endoscopic surveillance of Barrett's oesophagus allows earlier diagnosis of cancer in most, but not all, patients.

Quantitative architectural analysis: a new approach to cortical mapping

Recent progress in anatomical and functional MRI has revived the demand for a reliable, topographic map of the human cerebral cortex. Till date, interpretations of specific activations found in functional imaging studies and their topographical analysis in a spatial reference system are, often, still based on classical architectonic maps. The most commonly used reference atlas is that of Brodmann and his successors, despite its severe inherent drawbacks. One obvious weakness in traditional, architectural mapping is the subjective nature of localising borders between cortical areas, by means of a purely visual, microscopical examination of histological specimens. To overcome this limitation, more objective, quantitative mapping procedures have been established in the past years. The quantification of the neocortical, laminar pattern by defining intensity line profiles across the cortical layers, has a long tradition. During the last years, this method has been extended to enable a reliable, reproducible mapping of the cortex based on image analysis and multivariate statistics. Methodological approaches to such algorithm-based, cortical mapping were published for various architectural modalities. In our contribution, principles of algorithm-based mapping are described for cyto- and receptorarchitecture. In a cytoarchitectural parcellation of the human auditory cortex, using a sliding window procedure, the classical areal pattern of the human superior temporal gyrus was modified by a replacing of Brodmann's areas 41, 42, 22 and parts of area 21, with a novel, more detailed map. An extension and optimisation of the sliding window procedure to the specific requirements of receptorarchitectonic mapping, is also described using the macaque central sulcus and adjacent superior parietal lobule as a second, biologically independent example. Algorithm-based mapping procedures, however, are not limited to these two architectural modalities, but can be applied to all images in which a laminar cortical pattern can be detected and quantified, e.g. myeloarchitectonic and in vivo high resolution MR imaging. Defining cortical borders, based on changes in cortical lamination in high resolution, in vivo structural MR images will result in a rapid increase of our knowledge on the structural parcellation of the human cerebral cortex.

Mapping auditory cortex in the La Plata dolphin (Pontoporia blainvillei)

This study deals with the mapping of the primary and secondary auditory cortex. Due to their important role in echolocation they were the first areas to be examined [P.J. Morgane, M.S. Jacobs, in: R.J. Harrison (Ed.), Functional Anatomy of Marine Mammals, Comparative Anatomy of the Cetacean Nervous System, vol. 1, Academic Press, London, 1972, pp. 117-144]. We analysed the brain of a La Plata dolphin (Pontoporia blainvillei), which had been fixed in formaldehyde, embedded in paraffin, cut in sections of 20mum thickness and stained with cresyl violet. The experimental approach being impossible, we used cytoarchitectonic variations in the neocortex. Former electrophysiological data [T.F. Ladygina, A.Y. Supin, Localization of the projectional sensory areas in the cortex of the porpoise Tursiops truncates, Zh. Evol. Biokhim. Fiziol. 13 (1978) 712-718] [Sokolov, T.F. Ladygina, A.Y. Supin, Location of sensory zones in cerebral cortex of dolphin, Dokl. Biol. Sci., Russian Original 202 (1-6) (1972)] provided the framework for the exact determination of borders between functional cortical areas. We used a stereological observer-independent procedure based on changes in volume density of cell bodies throughout the neocortex [A. Schleicher, et al., Stereological approach to human cortical architecture: Identification and delineation of cortical areas, J. Chem. Neuroanat. 20 (2000) 31-47]. Due to the computer program's high sensitivity to changes in volume density it was possible to analyse the poorly laminated dolphin cortex. The 3D-reconstruction of the auditory cortex was processed using the AMIRA 3.0 Graphics software package comparing the main primary gyri in the histological sections with those in coronal magnetic resonance imaging scans of another intact Pontoporia brain.

Current density threshold for the stimulation of neurons in the motor cortex area

The aim of this study was to determine a current density threshold for exciting the motor cortex area of the brain. The current density threshold for excitation of nerve fibres (20 microm in diameter) found in the literature is approximately 1 A/m(2) at frequencies lower than 1 kHz. In consideration of a safety factor of 100, the International Commission on Non-Ionizing Radiation Protection (ICNIRP) recommends to restrict the exposure to 0.01 A/m(2). The electromagnetic stimulation of neurons in the motor cortex is used in the clinical diagnosis of nerve lesions and neuropathy by means of magnetic or electrical transcranial stimulation. Combining medical data from clinical studies and technical specifications of the Magstim Model 200 stimulator, we were able to compute the current density threshold for the excitation of the human motor cortex by means of the finite element method (FEM). A 3D-CAD head model was built on the basis of magnetic resonance imaging (MRI) slices and segmented into four anatomical structures (scalp, skull, brain, and ventricular system) with different conductivities. A current density threshold for the stimulation of the motor cortex area of the upper limbs of 6 and 2.5 A/m(2) at 2.44 kHz and 50 Hz, respectively, was calculated. As these values lie above the recommended ICNIRP values by two orders of magnitude there is no need for lower safety standards with regard to stimulation of the brain.

[The influence of demographic and behavioral factors on the risk of human papillomavirus infection]

OBJECTIVES

The aim of this work was the assessment of correlation between different types of HPV and chosen factors: the number of pregnancies, childbirths and smoking habits.

MATERIALS AND METHODS

Patients were examined in the Gynaecology Clinic, Silesian Medical Academy in Zabrze from 1998 until 2000. They were either hospital patients or women subjected to routine cytological examination. The smears were simultaneously collected for both cytooncologic examination and PCR identification of HPV viruses. Cytological smears were classified according to the Bethesda system.

RESULTS

A relationship between the presence of HPV and number of pregnancies or childbirths was confirmed as well as the relationship between smoking and the presence of HPV genome. The higher number of pregnancies or childbirths the higher frequency of HPV presence is. HPV presence was more frequent in the group of smoking women.

CONCLUSIONS

A relationship between the presence of HPV and the number of past childbirth or pregnancies was found. The statistically significant correlation between smoking and the risk of HPV infection was also confirmed.

Nitric oxide synthase-I containing cortical interneurons co-express antioxidative enzymes and anti-apoptotic Bcl-2 following focal ischemia: evidence for direct and indirect mechanisms towards their resistance to neuropathology

Neuronal nitric oxide-I is constitutively expressed in approximately 2% of cortical interneurons and is co-localized with gamma-amino butric acid, somatostatin or neuropeptide Y. These interneurons additionally express high amounts of glutamate receptors which mediate the glutamate-induced hyperexcitation following cerebral injury, under these conditions nitric oxide production increases contributing to a potentiation of oxidative stress. However, perilesional nitric oxide synthase-I containing neurons are known to be resistant to ischemic and excitotoxic injury. In vitro studies show that nitrosonium and nitroxyl ions inactivate N-methyl-D-aspartate receptors, resulting in neuroprotection. The question remains of how these cells are protected against their own high intracellular nitric oxide production after activation. In this study, we investigated immunocytochemically nitric oxide synthase-I containing cortical neurons in rats after unilateral, cortical photothrombosis. In this model of focal ischemia, perilesional, constitutively nitric oxide synthase-I containing neurons survived and co-expressed antioxidative enzymes, such as manganese- and copper-zinc-dependent superoxide dismutases, heme oxygenase-2 and cytosolic glutathione peroxidase. This enhanced antioxidant expression was accompanied by a strong perinuclear presence of the antiapoptotic Bcl-2 protein. No colocalization was detectable with upregulated heme oxygenase-1 in glia and the superoxide and prostaglandin G(2)-producing cyclooxygenase-2 in neurons. These results suggest that nitric oxide synthase-I containing interneurons are protected against intracellular oxidative damage and apoptosis by Bcl-2 and several potent antioxidative enzymes. Since nitric oxide synthase-I positive neurons do not express superoxide-producing enzymes such as cyclooxygenase-1, xanthine oxidase and cyclooxygenase-2 in response to injury, this may additionally contribute to their resistance by reducing their internal peroxynitrite, H(2)O(2)-formation and caspase activation.

Bioinformatics -- a patenting view

The use of bioinformatics in the biological sciences has brought about a change in the way that biological inventions can be protected by patent laws. Using approaches developed in the fields of computer science and business, patent applicants now seek to protect certain aspects of their inventions, which include software, methods of doing business and uses of information as well as more traditional biotechnological products and processes. These approaches are useful in resolving some of the difficulties now faced in prosecuting patent applications directed to biological inventions that are claimed in more conventional terms.

Changes in insulin-like growth factor I, 17-b-estradiol, and progesterone in postmenopausal women with benign and malignant ovarian tumours

BACKGROUND

The aim of this research was to observe changes in IGF-I and steroid hormones in postmenopausal women with benign and malignant ovarian tumors.

MATERIAL AND METHODS

The concentrations of insulin-like growth factor I (IGF-I), 17-b-estradiol and progesterone were examined by radioimmunological assay in three groups of postmenopausal women: patients with malignant ovarian tumors, patients with benign ovarian tumors, and healthy women. In all three groups the age and body mass index (BMI) were comparable.

RESULTS

The concentrations of IGF-I in the serum of the patients with malignant cancer were significantly lower. The concentrations of estradiol were significantly higher in the patients with both benign and malignant ovarian tumors as compared to the controls.

CONCLUSIONS

Decreased IGF-I concentration in the serum of postmenopausal women with ovarian tumors may suggest that the tumor is malignant.

A stereological approach to human cortical architecture: identification and delineation of cortical areas

Stereology offers a variety of procedures to analyze quantitatively the regional and laminar organization in cytoarchitectonically defined areas of the human cerebral cortex. Conventional anatomical atlases are of little help in localizing specific cortical areas, since most of them are based on a single brain and use highly observer-dependent criteria for the delineation of cortical areas. In consequence, numerous cortical maps exist which greatly differ with respect to number, position, size and extent of cortical areas. We describe a novel algorithm-based procedure for the delineation of cortical areas, which exploits the automated estimation of volume densities of cortical cell bodies. Spatial sampling of the laminar pattern is performed with density profiles, followed by multivariate analysis of the profiles' shape, which locates the cytoarchitectonic borders between neighboring cortical areas at sites where the laminar pattern changes significantly. The borders are then mapped to a human brain atlas system comprising tools for three dimensional reconstruction, visualization and morphometric analysis. A sample of brains with labeled cortical areas is warped into the reference brain of the atlas system in order to generate a population map of the cortical areas, which describes the intersubject variability in spatial conformation of cortical areas. These population maps provide a novel tool for the interpretation of images obtained with functional imaging techniques.

[Laparotomy performed in pregnant women due to non-obstetrical causes]

OBJECTIVE

The clinical characteristics of laparotomy during pregnancy were investigated.

MATERIALS AND METHODS

A series of 24 cases of laparotomy during pregnancy was investigated with respect to clinicopathologic features and outcome.

RESULTS

Among 23 cases there were 20 ovarian tumors, 2 acute appendicitis and 2 uterine fibroid. Gestational ages at the time of surgery ranged from 16 to 24 weeks of patients with ovarian tumors and from 30 to 32 weeks in others. No intraoperative or postoperative maternal or fetal complications occurred. One patient had a stage III ovarian carcinoma and went to total hysterectomy, and other patient had a stage IA ovarian carcinoma.

CONCLUSIONS

Appendectomy can be performed without additional risk to the fetus for those who require surgical intervention during pregnancy. Ovarian surgery in pregnancy for persistent masses is important to obtain a final histologic diagnosis.

[Comparison of conservative and laparoscopic treatment of PCOS]

OBJECTIVE

Aim of study contained clinical analysis of results conservative (Clostilbegyt) and laparoscopic (electro-catheterisation of ovaries) methods of treatment PCOS. Authors analysed count of pregnancy, deliveries and serum concentrations of LH, FSH, LH/FSH ratio, 17 beta E2 before and after treatment.

MATERIAL AND METHODS

Stady included 50 obese patients (group A, BMI > 28) treated by Clostilbegyt and 50 lean patients (group B, BMI < 28) treated by laparoscopic ovarian electrocautery.

RESULTS

We found higher percentage of pregnancies (84%) and deliveries in group B (72%) versus A. We obtained statistically significant higher serum concentrations of LH, 17 beta E2 and LH/FSH ratio of group B versus A.

CONCLUSIONS

1. Recommendation method for treatment PCOS is a laparoscopic electro-catheterisation of ovaries. 2. This method stabilize hormonal secretion of hypothalamic-pituitary-ovarian axis in the PCOS.

Treatment of alcohol withdrawal syndrome with gabapentin

Four in-patients with moderate alcohol-withdrawal syndromes benefited from treatment with gabapentin administered in an add-on fashion to clomethiazole. In comparison with the amount of clomethiazole required as estimated using a specially developed score during previous detoxifications of these patients at our hospital, gabapentin (400 mg q.i.d.) clearly reduced the amount of clomethiazole needed now Gabapentin, an anticonvulsant with favorable pharmacokinetic properties and tolerability, and with no known risk of dependence, may therefore be a useful new drug in the treatment of alcohol withdrawal. We believe that the potential value of gabapentin in alcohol withdrawal deserves further controlled studies.

[The evaluation of susceptibility to oxidation of selected lipoproteins of pregnant women with type B diabetes mellitus in 2nd and 3rd trimester of pregnancy]

OBJECTIVES AND DESIGN

The aim of study was estimation of susceptibility on the process of oxidation of selected lipoproteins of pregnant women with IDDM in II, III trimester of pregnancy.

MATERIALS AND METHODS

Study included 80 women. Patients were divided into four groups: pregnant with IDDM, pregnant healthy, nonpregnant with and without IDDM. We used spectrophotometric method for estimation of susceptibility on oxidation of HDL, LDL in the four groups of patients.

RESULTS

In the group of diabetic pregnant we found increased serum concentrations of LDL. The comparison of examined groups showed statistically significant higher susceptibility on the oxidation of chosen lipoproteins in pregnant with IDDM. This group of patients characterized lower antioxidation activity than other groups.

CONCLUSIONS

Diabetic pregnant characterized higher serum concentrations of LDL, and increase of peroxidation of lipids than other groups. This group showed lower total antioxidation activity. In the groups of diabetic women we obtained increased suspectibility of oxidation LDL and HDL.

Endophytic fungi in branches of Norway spruce with particular reference to Tryblidiopsis pinastri

A variety of endophytic fungi were isolated from the branches of Norway spruce (Picea abies). We found that as internodes age, the composition of endophytic species gradually changes, both qualitatively and quantitatively. One of the dominating species, Tryblidiopsis pinastri, was most common in young internodes. In contrast, three other common species, Phialocephala scopiformis, Geniculosporium serpens, and Tapesia livido-fusca, were most frequently isolated from old internodes. Mollisia spp. were also common components of the endophytic flora of the Norway spruce in Sweden. Keywords: Picea abies, Tryblidiopsis pinastri, Phialocephala scopiformis, Geniculosporium spp., Tapesia spp., Mollisia spp.

Transcriptional control of rat hepatic glutaminase expression by dietary protein level and starvation

Mammalian liver possesses a unique isozyme of phosphate-activated glutaminase that is subject to long-term regulation. In rats during starvation or after consumption of diets containing high amounts of protein (60%), hepatic glutaminase activity was 100% higher than in rats fed a 20% protein diet. Conversely, rats fed low protein diets (0 and 5%) had lower hepatic glutaminase activity when compared with rats fed the 20% protein diet. Differences in activity with different dietary protein levels were not due to differences in the amount of food consumed. The relative abundance of mRNA encoding hepatic glutaminase was lower in rats fed 0% protein and higher in those starved or fed 60% protein diet when compared with rats fed the 20% protein diet. The mRNA elongation assay in hepatic nuclei isolated from these animals demonstrated that the rate of transcription of the glutaminase gene was also different in rats starved or fed different levels of dietary protein. Overall, the results indicate that differences in hepatic glutaminase activity in rats starved or fed different levels of protein are mainly due to differences in the rate of transcription of the gene. In this way the regulation of hepatic glutaminase expression is similar to that seen for other enzymes involved in hepatic amino acid catabolism but differs markedly from that of renal glutaminase, in which changes in transcription rate are not observed and alterations of mRNA turnover are the principle mechanism of long-term regulation.

CGS 22745: a selective orally active inhibitor of 5-lipoxygenase

CGS 22745, and aralkyl hydroxamic acid, inhibited 5-hydroxyeicosatetraenoic acid (5-HETE) and leukotriene B4 (LTB4) synthesis in guinea pig leukocytes (IC50 = 0.6 microM). The compound did not appreciably affect cyclooxygenase (ram seminal vesicles), 12-lipoxygenase and thromboxane synthase (human platelets) or 15-lipoxygenase (human neutrophils). CGS 22745 inhibited A23187-induced formation of LTB4 in blood (IC50's of 4.3, 0.56 and 3.2 microM for human, dog and rat, respectively). At 1 mg/kg i.v. in dogs, it caused 96% inhibition of A23187-stimulated LTB4 formation ex vivo after 5 min. Its effective biological half-life was greater than 160 min. In dogs at 3 and 10 mg/kg p.o., CGS 22745 inhibited ex vivo A23187-stimulated LTB4 formation at 3 hr by 48% and 97%, respectively. The inhibition persisted up to 6 hr (26% at 3 mg/kg; 49% at 10 mg/kg). CGS 22745 (3, 10 and 30 mg/kg p.o.) inhibited exudate formation, mononuclear cells and PMN accumulation in a dose-dependent manner during the late phase (48 and 72 hr) of carrageenan-induced pleurisy in the rat.