Infertile women with and without endometriosis: a case control study of luteal phase and other infertility conditions

The furcation involvement of 100 molars in 25 patients suffering from moderate to advanced periodontitis was investigated. The horizontal probing attachment level (PAL-H) within the furcations was assessed 2x within 2 weeks using the pressure-calibrated (0.25 N) flexible plastic universal explorer version of the TPS probe (TPS). To determine the measurement error of PAL-H assessments, the standard deviation of single measurements was calculated. The measurements were repeated using a colour-coded Nabers probe and compared to the TPS assessments. 253 furcations were evaluated (100 buccal, 47 lingual, 53 mesiolingual and 53 distolingual, respectively). For buccal, lingual, mesiolingual and distolingual furcations, the standard deviations were 0.486 mm, 0.598 mm, 0.846 mm, 1.039 mm, respectively. Measurement error was less in buccal and lingual furcations than in mesiolingual and distolingual sites (p < 0.005). The agreement of replicate measurements of furcation degrees was excellent for buccal and lingual furcations (weighted kappa [standard error] 0.824 [0.076] and 0.779 [0.107], respectively), but only moderate for mesiolingual and distolingual furcations (weighted kappa 0.688 [0.096] and 0.544 [0.101], respectively). Only in distolingual sites there was a significant (p < 0.025; paired t-test) underestimation of PAL-H by the TPS as compared to the Nabers probe. At all locations the TPS underestimated furcation degrees significantly (p < 0.1; Stuart-Maxwell's chi 2) as compared to Nabers probe. Measurement error of mesiolingual and distolingual furcations was significantly higher than of buccal or lingual sites. The reproducibility of PAL-H measurements in furcations using TPS is comparable to data published for scorings with colour-coded Nabers probes. Through and through furcations are likely to be underestimated by using the flexible plastic version of the TPS probe. Hence, it seems to be unsuitable for a proper assessment of the degree of furcation involvement.     

Idiopathic hemochromatosis: case report of a patient presenting with neurologic symptoms

Idiopathic hemochromatosis is an iron-storage disease more common in men than in women. It is characterized clinically by diabetes mellitus, cirrhosis of the liver, pigmentation of the skin and cardiac failure. The diagnosis may be overlooked when the presenting symptoms do not follow the pattern. A case is reported which was diagnosed after an onset that featured neurologic symptoms.     

Ramipril and felodipine: a comparison of the efficacy and safety of monotherapy versus combination therapy

A multinational, double-blind, randomised study was conducted to investigate the efficacy and safety of a low-dose combination of the angiotensin converting enzyme inhibitor, ramipril, and the calcium antagonist, felodipine ER, in 642 patients with mild to moderate hypertension [supine diastolic blood pressure (DBP) = 95-115 mm Hg]. After a 4-week single-blind placebo run-in, patients were randomly allocated to once-daily felodipine extended release (ER; 2.5 mg), ramipril (2.5 mg) or felodipine ER/ramipril (2.5/2.5 mg) for 12 weeks. In the intention-to-treat analysis, mean DBP decreased significantly (p < 0.0001) after felodipine ER, ramipril and the combination (-9.1, -9.8 and -11.4 mm Hg, respectively). The decrease was significantly greater with the combination than with felodipine ER monotherapy (p = 0.02). The number of responding patients (final DBP < or = 90 mm Hg or a decrease of > or = 10 mm Hg) was also higher with the combination than with felodipine ER or ramipril monotherapy (65.1%, 53.1%, 55.7%, respectively). There were no differences between the three groups with respect to the incidence of adverse events overall or those considered treatment-related. There were fewer cases of peripheral oedema with combination therapy than with felodipine ER monotherapy. Thirty-three patients (5.1%) withdrew from the study because of adverse events, but there was no clear pattern with regard to the specific events leading to withdrawal. There were no clinically relevant changes in laboratory or clinical safety variables. Ramipril/felodipine ER 2.5/2.5 mg is an appropriate starting dosage when initiating combination antihypertensive therapy.     

Differential social comparison processes in women with and without eating disorder symptoms.

On the basis of predictions from social comparison theory (L. Festinger, 1954) and informed by findings from the social comparison and eating disorder literatures, hypotheses were tested regarding the social comparison behaviors of women with eating disorder symptoms and their asymptomatic peers. Results indicated differentiating social-cognitive processes for these groups. First, a greater tendency to engage in everyday social comparison predicted the presence of eating disorder symptoms. Second, social comparisons of one's own body to images of other women's bodies using a range of shapes and sizes also differentiated these 2 groups, with more self-defeating self-appraisals predicting the presence of eating disorder symptoms. Finally, self-esteem partially mediated the relationship between body-related social comparisons and eating disorder symptom status. Results are discussed in terms of their implications for research and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CaBPs and other immunohistochemical markers of the human vomeronasal system: a comparison with other mammals

After more than two centuries of almost sporadic inquiry as to the existence and function of the human vomeronasal system (VNS), the last decade has seen a resurgent interest in it. The principal question vexing many laboratories is whether adult humans retain the VNS that clearly develops during fetal growth. Additional questions are whether the structurally defined fetal VNS has any function role, and if this structure and function extend into postnatal life. One research tool that has been successfully used to identify key components of the mammalian VNS has been immunohistochemistry (IHC). This technique has clearly defined the vomeronasal receptor neurons in the vomeronasal organ, the vomeronasal nerve that projects into the central nervous system, and the target of this nerve, the accessory olfactory bulb. This review will discuss immunohistochemical studies that have identified these features in the mammalian VNS, and relate them to structural and IHC studies of the fetal and adult human VNS. Suggestions as to future studies to clarify the status of the human VNO also are offered.     

The contribution of subtle oocyte or sperm dysfunction affecting fertilization in endometriosis-associated or unexplained infertility: a controlled comparison with tubal infertility and use of donor spermatozoa

This study aims to determine the relative contribution of oocyte and/or sperm dysfunction to the reduction of fertilization rates in vitro in cases of minor endometriosis and prolonged unexplained infertility. The results of in-vitro fertilization (IVF) treatment with ovarian stimulation have been compared between couples with the above conditions and women with tubal infertility (as control for oocyte function) and the use of donor spermatozoa (as control for sperm function). Fertilization and cleavage rates using husband's spermatozoa were significantly reduced in endometriosis couples (56%, n = 194, P < 0.001) and further significantly reduced in couples with unexplained infertility (52%, n = 327, P < 0.001) compared with tubal infertility (60%, n = 509). Using donor spermatozoa the rates were the same as using husband's spermatozoa in tubal infertility (61%, n = 27) or endometriosis (55%, n = 21) but significantly though only partly improved with unexplained infertility (57%, n = 60, P < 0.02). In unexplained infertility, a significantly increased proportion of couples experienced complete failure of fertilization and cleavage in a cycle (5-6% versus 2-3%). However, complete failure was not usually repetitive, and the affected couples did not account for the overall reduction in fertilization and cleavage rates, which remained significantly lower in the rest of the unexplained and endometriosis groups. Implantation and pregnancy rates appeared similar in all groups. The benefit of IVF treatment in cases of minor endometriosis and prolonged unexplained infertility is due to superabundance of oocytes obtained by stimulation. The reduction in natural fertility associated with endometriosis appears to be at least partly due to a reduced fertilizing ability of the oocyte. In unexplained infertility, there is distinct impairment due to otherwise unsuspected sperm dysfunction but probably also oocyte dysfunction.     

Posttraumatic stress disorder among incarcerated battered women: a comparison of battered women who killed their abusers and those incarcerated for other offenses

During development, telencephalic neural progenitors acquire positional specification and give rise to distinct structures such as the striatum and cortex. Here, we examine, in vivo, the influence of developmental stage, cell-surface molecules and regional differences along the dorso-ventral and antero-posterior axes on the selective incorporation of neural progenitors derived from different regions of the developing brain, utilizing a cross-species in utero transplantation paradigm. Striatal progenitors derived from the embryonic day (E) 12-14 mouse lateral ganglionic eminence (LGE) were observed consistently to incorporate into the developing striatum as early as 24-48 h following intraventricular injection into the E15-17 rat host. By removing cell-surface molecules from the LGE progenitors, the pattern of incorporation was remarkably different with no preferential striatal incorporation. Cortical progenitors with intact cell-surface molecules, by contrast, displayed little telencephalic (including striatal) incorporation as compared with precursors from the LGE. However, both progenitors from cortex and LGE incorporated widely into diencephalic and mesencephalic structures. The capacity for integration of precursors derived from the LGE and cortex gradually decreased during development of the host and was minimal in the postnatal day (P) 1 host. Unlike the telencephalic precursors, the vast majority of progenitors derived from the midbrain and cerebellar primordium (with cell-surface molecules intact) incorporated into diencephalic and midbrain nuclei with only a few cells observed in the telencephalon. These results demonstrate that incorporation of neural progenitors across the ventricular wall in the embryonic host is strictly developmentally regulated, dependent on their position along the antero-posterior axes and in the case of progenitors from the LGE is mediated by cell-surface molecules expressed on the transplanted cells.     

Binge drinking among college students: a comparison of California with other states

The aim of the present study was to describe the expression and distribution of bone morphogenetic protein (BMP) in odontogenic tumors by immunohistochemistry using monoclonal antibody against bovine BMP (BMPMcAb). Eight types of odontogenic tumors (44 cases), including ameloblastoma (20 cases), cementifying fibroma (8 cases), benign cementoblastoma (5 cases), dentinoma (3 cases), compound odontoma (2 cases), adenomatoid odontogenic tumor (2 cases), calcifying epithelial odontogenic tumor (2 cases) and odontogenic fibroma (2 cases), were studied. The results showed that, according to the immunostaining pattern of BMPMcAb, tumors could be classified into two types: all cementifying fibromas, benign cementoblastomas, dentinomas, odontogenic fibromas, and compound odontomas demonstrated a positive reaction, whereas all ameloblastomas, adenomatoid odontogenic tumors, and calcifying epithelial odontogenic tumors were negative. BMPMcAb-positive odontogenic tumors were those tumors with formation of enamel, dentin, cementum or bone. Therefore, BMP might play an important role in the formation of calcified dental tissues and the development of odontogenic tumors contaning such tissues.     

Local humoral immunity in women with combined forms of infertility

An evaluation was done of the immunity status in 100 women presenting with infertility of associated genesis. An immunologic investigation into blood serum, follicular fluid (FF) and peritoneal fluid (PF) was carried out at day 14-16 and 18-23 of the menstrual cycle. The functional status of spermatozoa was characterized with the aid of the index of their survival in FF and PF. Local humoral immunity of FF and PF differs from the indices in blood serum, which fact was manifested by a striking reduction of Igs G, A, M. Sperm-immobilizing antibodies (SIAB) have been identified in blood serum, FF, and PF in 14, 4%, 22.4%, and 25% of women. SIAB production is associated with inadequacy of local immunity, such as low levels of SIgA, IgA, and lysozyme. Occurrence of SIAB in PF and FF worsens general motility of spermatozoa by agglutination of the latter, which fact undoubtedly affects conception.     

Primary palmar hyperhidrosis presenting with unilateral symptoms: a report of two cases and review of the literature

To further investigate the association between Parkinson's disease (PD) and genetic polymorphism of the CYP2D6 gene, a mutant allele (CVP2D6J) frequently observed in the Japanese population and related to EM/PM polymorphism (phenotypically, individuals are either extensive metabolizers [EM] or poor metabolizers [PM] of debrisoquine) was investigated. The CYP2D6J gene with a nucleotide substitution from C to T at position 188 (the HphI site in exon 1), which reduces CYP2D6 enzyme activity, was analyzed by polymerase chain reaction (PCR) and by digestion with HphI. No significant relationship was observed between PD patients and controls for this mutation. This suggests that the EM/PM polymorphism of CYP2D6 contributes little to the pathogenesis of PD. To further study the molecular basis for the relationship between PD and CYP2D6, the heterogeneity of CYP2D6 was investigated by combined genotype analysis of the two mutant CYP2D6 genes (ie, CYP2D6J, the HphI site mutation in exon 1, and CYP2D6L, the HhaI site mutation in exon 6). Although some characteristic patterns of the combined genotypes were observed in both PD patients and controls, a strong association between the heterogeneity of the CYP2D6 gene and PD was not shown by combined genotype analysis.     

Outcome in general medical patients presenting with common symptoms: a prospective study with a 2-week and a 3-month follow-up

Human T-cell-mediated autoimmune diseases are often genetically linked to particular alleles of HLA class II genes. Vogt-Koyanagi-Harada's (VKH) disease, which is regarded as an autoimmune disorder in multiple organs containing melanocytes, has been found to be associated with HLA-DR4 (DRB1(*)0405) and HLA-DR53 (DRB4(*)0101). Tyrosinase is a melanoma antigen (Ag) expressed by normal melanocytes as well as melanoma cells against which responses by autologous T cells have been detected. We established a T-cell line from the peripheral blood of a patient with VKH disease which responded to synthetic peptides corresponding to tyrosinase. The T-cell line was generated which recognized the tyrosinase p188 - 208 peptide when presented by the HLA-DR4 (DRB1(*)0405) molecule on the surface of HLA class II-expressing L-cell transfectants. The minimal antigenic peptide which induced T-cell responses was an 11-amino-acid sequence and located at tyrosinase p193 - 203 (E-I-W-R-D-I-D-F-A-H-E). This peptide contained the DRB1(*)0405-binding peptide motif (hydrophobic residues (Y, F, W) at position 1 as an anchor residue, and negatively charged residues (D, E) at position 9), which corresponded to the W at p195 and the D at p203. These observations demonstrate that tyrosinase peptides are immunogenic, and may be a candidate for an autoantigen in VKH disease, suggesting that probing the T-cell responses against synthetic peptides is a productive approach for identifying the autoantigenic peptides associated with autoimmune diseases including VKH disease.     

Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding

Successful treatment of a severe haemoptysis with microcoil embolization in an en block double-lung transplanted patient is described. A 53 year old woman with advanced bronchiolitis obliterans syndrome experienced severe haemoptysis 26 months after an en bloc double-lung transplantation with direct bronchial artery revascularization using the left internal mammary artery. Bronchoscopy showed that the haemoptysis originated from the lingula. Only two months after the transplant, left internal mammary arteriograms revealed proliferation and enlargement of the bronchial arteries in the lingula. The early occurrence of the vascular malformation indicated a pre-existing bronchiectasis in the donor lung, possibly due to tobacco smoking. After uncomplicated microcoil embolization of the left internal mammary artery, the patient experienced no further episodes of haemoptysis. Microcoil embolization can be used successfully to treat massive haemoptysis related to proliferated and enlarged bronchial arteries in transplanted lungs with bronchial artery revascularization.     

Outcome of IVF in patients with endometriosis in comparison with tubal-factor infertility

PURPOSE: The aim of this retrospective study was to compare the outcome of in vitro fertilization and embryo transfer in women with endometriosis and a control group with tubal-factor infertility. METHODS: Forty-eight patients with endometriosis underwent 65 cycles of in vitro fertilization and embryo transfer at Huddinge University Hospital. The matched control group with tubal-factor infertility consisted of 98 cycles in 98 patients. These groups were retrospectively analyzed regarding stimulation, fertilization, embryo development, implantation, and pregnancy outcome. RESULTS: The fertilization rate was significantly lower in women with endometriosis, but the cleavage, implantation, and pregnancy rates did not differ. CONCLUSIONS: Our results show that women with endometriosis have a lower fertilization rate compared with women with tubal-factor infertility. However, once the oocyte is fertilized, it seems that the preembryo has a normal chance of implantation, leading to similar pregnancy rates.     

Clinical features in panic disorder with agoraphobia: a comparison of men and women

This study compared 96 women and 58 men suffering from panic disorder with agoraphobia. Participants completed questionnaires assessing various clinical features associated with panic disorder with agoraphobia (PDA), general adjustment, and drug/alcohol use. Results showed that PDA is a more severe condition in women. Women reported more severe agoraphobic avoidance when facing situations or places alone, more catastrophic thoughts, more body sensations, and higher scores on the Fear Survey Schedule. Also, women more often had a comorbid social phobia or posttraumatic stress disorder. The lower agoraphobic avoidance of men was associated with their alcohol use. However, there were no differences between genders in other dimensions, including depression, situational and trait anxiety, stressful life events, social self-esteem, marital adjustment, and drug use.     

Occurrence of antinuclear antibodies in women with endometriosis and unexplained infertility

The relationship between female infertility, endometriosis and antinuclear antibodies (ANA) in the blood of women without clinical symptoms of autoimmune disease is described. ANA in the titre of 1:40 and more, was detected in 63% women with endometriosis, 70.4% women with idiopathic infertility, 3.3% women with hypothalamic-pituitary dysfunction and 5.6% healthy nonpregnant women. The occurrance of ANA in endometriosis and idiopathic infertility was more frequently connected with negative postkoital test and the number of spontaneous abortions. We suggest, that (auto)immunological mechanisms play an important role in endometriosis and unexplained infertility.     

The complete genomic sequence of the modified vaccinia Ankara strain: comparison with other orthopoxviruses

The complete genomic DNA sequence of the highly attenuated vaccinia strain modified vaccinia Ankara (MVA) was determined. The genome of MVA is 178 kb in length, significantly smaller than that of the vaccinia Copenhagen genome, which is 192 kb. The 193 open reading frames (ORFs) mapped in the MVA genome probably correspond to 177 genes, 25 of which are split and/or have suffered mutations resulting in truncated proteins. The left terminal genomic region of MVA contains four large deletions and one large insertion relative to the Copenhagen strain. In addition, many ORFs in this region are fragmented, leaving only eight genes structurally intact and therefore presumably functional. The inserted DNA codes for a cluster of genes that is also found in the vaccinia WR strain and in cowpox virus and includes a highly fragmented gene homologous to the cowpox virus host range gene, providing further evidence that a cowpox-like virus was the ancestor of vaccinia. Surprisingly, the central conserved region of the genome also contains some fragmented genes, including ORF F5L, encoding a major membrane protein, and ORFs F11L and O1L, encoding proteins of 39.7 and 77.6 kDa, respectively. The right terminal genomic region carries three large deletions all classical poxviral immune evasion genes and all ankyrin-like genes located in this region are fragmented except for those encoding the interleukin-1 beta receptor and the 68-kDa ankyrin-like protein B18R. Thus, the attenuated phenotype of MVA is the result of numerous mutations, particularly affecting the host interactive proteins, including the ankyrin-like genes, but also involving some structural proteins.