Gamete retrieval in terminal conditions: is it practical? What are the consequences?

There is an increasing interest in, and request for, gamete retrieval from recently deceased or near-dead subjects for the purpose of posthumous procreation. This usually arises in an emergency situation with little time for physicians to consider ethical ramifications. Advance planning is needed to help these physicians make thoughtful decisions.

Confounding factors in diagnosing brain death: a case report.

Background: Brain death is strictly defined medically and legally. This diagnosis depends on three cardinal neurological features: coma, absent brainstem reflexes, and apnea. The diagnosis can only be made, however, in the absence of intoxication, hypothermia, or certain medical illnesses.

Cerebrovascular disease and cognitive dysfunction.

As the general population ages, the progressive cognitive decline that occurs with aging and dementia is having a significant socioeconomic impact on society. Vascular dementia associated with cerebral vascular disease is now the third most common cause of dementia. Recent evidence has revealed a new and significant etiopathogenetic role of cerebrovascular pathology, as well as newly determined risk factors for the development of neurocognitive deficits and other forms of dementia including Alzheimer's disease.

A1 adenosine receptor overexpression decreases stunning from anoxia-reoxygenation: role of the mitochondrial K(ATP) channel.

Myocardial A1 adenosine receptor (A1AR) overexpression protects hearts from ischemia-reperfusion injury; however, the effects during anoxia are unknown. We evaluated responses to anoxia-reoxygenation in wild-type (WT) and transgenic (Trans) hearts with approximately 200-fold overexpression of A1ARs. Langendorff perfused hearts underwent 20 min anoxia followed by 30 min reoxygenation.

Controlled perfusion decreases reperfusion injury after high-flow reperfusion.

Introduction: Some investigators have suggested that high pulmonary artery flow rates increase the risk of severe reperfusion injury after lung transplantation. We hypothesized that controlling the initial flow rate and pulmonary artery pressure would decrease the severity of lung dysfunction in the setting of high-flow reperfusion.

Methods: Using our isolated, ventilated, blood-perfused rabbit lung model, all groups underwent lung harvest, 4-hour storage (4 degrees C), and blood reperfusion.

The bacterial protein SipA polymerizes G-actin and mimics muscle nebulin.

SipA is a Salmonella protein delivered into host cells to promote efficient bacterial entry, which is essential for pathogenicity. SipA exerts its function by binding F-actin, resulting in the stabilization of F-actin and the stimulation of the bundling activity of fimbrin. Here we show that under low salt conditions where spontaneous nucleation and polymerization of actin do not occur, SipA induces extensive polymerization.

Pubertal alterations in growth and body composition. VI. Pubertal insulin resistance: relation to adiposity, body fat distribution and hormone release.

Objective: To investigate the independent influence of alterations in fat mass, body fat distribution and hormone release on pubertal increases in fasting serum insulin concentrations and on insulin resistance assessed by the homeostasis model (HOMA).

Design And Subjects: Cross-sectional investigation of pre- (n=11, n=8), mid- (n=10, n=11), and late-pubertal (n=10, n=11) boys and girls with normal body weight and growth velocity.

Measurements: Body composition (by a four-compartment model), abdominal fat distribution and mid-thigh interfascicular plus intermuscle (extramyocellular) fat (by magnetic resonance imaging), total body subcutaneous fat (by skinfolds), mean nocturnal growth hormone (GH) release and 06:00 h samples of serum insulin, sex steroids, leptin and insulin-like growth factor-I (IGF-I).

Synthetic peptides of Goodpasture's antigen in antiglomerular basement membrane nephritis in rats.

Goodpasture's syndrome (GPS) is an autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and anti-glomerular basement membrane (GBM) antibodies. The alpha(3) noncollagenous domain (NC1) of type IV collagen [alpha(3)(IV)] is the pathogen. The disease is T-cell-dependent; thus linear peptides initiate the autoimmune process.

Pitfalls in the endoscopic drainage of subperiosteal orbital abscesses secondary to sinusitis.

Objective: To review the safety and efficacy of endoscopic drainage of subperiosteal orbital abscesses (SPOAs) secondary to sinusitis and to evaluate risk factors that may be associated with failure.

Study Design: Retrospective chart review.

Methods: All patients admitted to the University of the Virginia Health System with a diagnosis of SPOA between 1992 and 1999 were reviewed.

The endoscopic modified Lothrop: long-term follow-up on 44 patients.

Background: The gold standard for surgical treatment of chronic frontal sinusitis has been the osteoplastic flap with obliteration. In an attempt to preserve the frontal sinus, we have been performing the endoscopic modified Lothrop orfrontal drill-out.

Methods: Retrospective chart review.

Characterization of the p90 ribosomal S6 kinase 2 carboxyl-terminal domain as a protein kinase.

The carboxyl-terminal domain (CTD) of the p90 ribosomal S6 kinases (RSKs) is an important regulatory domain in RSK and a model for kinase regulation of FXXFXF(Y) motifs in AGC kinases. Its properties had not been studied. We reconstituted activation of the CTD in Escherichia coli by co-expression with active ERK2 mitogen-activated protein kinase (MAPK).

Androgen receptor phosphorylation. Regulation and identification of the phosphorylation sites.

Activation of signal transduction kinase cascades has been shown to alter androgen receptor (AR) activity. Although it has been suggested that changes in AR phosphorylation might be directly responsible, the basal and regulated phosphorylations of the AR have not been fully determined. We have identified the major sites of AR phosphorylation on ARs expressed in COS-1 cells using a combination of peptide mapping, Edman degradation, and mass spectrometry.

The endoplasmic reticulum is the main site for caspase-3 activation following aluminum-induced neurotoxicity in rabbit hippocampus.

We have assessed the distribution of caspase-3 in subcellular fractions from rabbit brain hippocampus and find that in controls the pro-caspase-3 form is distributed mainly in the cytoplasm. In animals treated intracisternally with the neurotoxin aluminum-maltolate, although pro-caspase-3 levels are higher in the cytosolic fractions, p17, the active caspase-3, is localized mainly in the endoplasmic reticulum. This distribution is confirmed by immunohistochemistry which demonstrates the co-localization of p17 with calnexin, a specific marker of the endoplasmic reticulum.

Adrenal tumor with caval extension--case report and review of the literature.

Extension of adrenal cortical carcinomas into the IVC is rare. We describe one such tumor that extended to the level of the right atrium. In an effort to aid recognition and guide work-up of an upper pole lesion, we review the literature comprised of 77 similar cases and analyze the data in terms of patient demographics, anatomic distribution, clinical and laboratory evidence of endocrine function.

Gleason scores of prostate biopsy and radical prostatectomy specimens over the past 10 years: is there evidence for systematic upgrading?

Background: With the advent of the prostate specific antigen (PSA) assay, an increased detection rate of prostate carcinoma has ensued. This has been associated with a downward stage migration. In contrast, grade has shifted heavily toward moderate differentiation.

Percutaneous vertebroplasty in the treatment of malignant spine disease.

Percutaneous vertebroplasty is a minimally invasive, radiologically-guided interventional procedure originally developed in France for the treatment of painful vertebral hemangiomas. The technique consists of the percutaneous puncture of the affected vertebral body, followed by injection of an acrylic polymer to provide bone augmentation and prevent further collapse. The internal "casting" of the trabecular microfractures results in pain relief and vertebral consolidation.

Ischemia-reperfusion injury after lung transplantation increases risk of late bronchiolitis obliterans syndrome.

Background: Bronchiolitis obliterans syndrome (BOS) is the most common cause of long-term morbidity and mortality after lung transplantation. Our hypothesis was that early ischemia-reperfusion injury after lung transplantation increases the risk of BOS.

Methods: Data on 134 patients who had lung transplantation between January 1, 1990 and January 1, 2000, was used for univariate and multivariate logistic regression analysis.

The effects of reverse atrial electrical remodeling on atrial defibrillation thresholds.

The implantable atrial defibrillator is a developing therapeutic option for paroxysmal atrial fibrillation, but shock related discomfort continues to be a limiting factor. To further characterize successful defibrillation, the relationship between reverse atrial electrical remodeling and internal atrial defibrillation thresholds in canines with chronic atrial fibrillation was examined. Testing was performed in 21 dogs.

Complications of coarctation repair.

Surgery's role in the treatment of coarctation has been established, and the benefit to life expectancy and quality of life is undeniable. Three postaortic coarctation repair complications are discussed, with review of existing literature: recurrent or residual aortic coarctation, postrepair aneurysm formation, and spinal cord ischemia. Incidence, potential causative factors, and outcome of surgical or transcatheter treatment for recurrent and residual aortic coarctation are reviewed.

Sensitive detection and quantitation of mouse eosinophils in tissues using an enzymatic eosinophil peroxidase assay: its use to rapidly measure pulmonary eosinophilia during experimental respiratory syncytial virus infection of mice.

Eosinophils are granular proinflammatory leukocytes implicated in the pathogenesis of several inflammatory processes including allergy, asthma, and in the development of enhanced disease during respiratory syncytial virus (RSV) infection. Here, we adapted a colorimetric assay to measure eosinophil peroxidase (EPO) activity in inflamed mouse lung tissue in order to quantitate pulmonary eosinophilia during experimental RSV infection. Using the substrate o-phenylenediamine dihydrochloride (OPD) in the presence of bromide ions, we show that this assay is able to quantitate limiting numbers of eosinophils in lung tissue homogenates even in the presence of large numbers of infiltrating neutrophils and macrophages.

Treatment of urogenital atrophy with low-dose estradiol: preliminary results.

Objective: To determine the lowest dosage of vaginally administered estradiol (E2) that reverses signs and symptoms of urogenital atrophy but does not substantially increase plasma E2 levels.

Design: Single-blind, single-arm study to determine the effects of de-escalating doses of vaginal estrogen on symptoms of urogenital atrophy, vaginal pH, and vaginal and urethral cytology. A questionnaire was used to assess subjective vaginal and urethral symptoms.

The utrophin actin-binding domain binds F-actin in two different modes: implications for the spectrin superfamily of proteins.

Utrophin, like its homologue dystrophin, forms a link between the actin cytoskeleton and the extracellular matrix. We have used a new method of image analysis to reconstruct actin filaments decorated with the actin-binding domain of utrophin, which contains two calponin homology domains. We find two different modes of binding, with either one or two calponin-homology (CH) domains bound per actin subunit, and these modes are also distinguishable by their very different effects on F-actin rigidity.