RESUMEN
Endometriosis is a major cause of infertility and pelvic pain, affecting more than 10% of reproductive-aged women. Progesterone resistance has been observed in the endometrium of women with this disease, as evidenced by alterations in progesterone-responsive gene and protein expression. cAMPResponse Element-Binding 3-like protein 1 (Creb3l1) has previously been identified as a progesterone receptor (PR) target gene in mouse uterus via high density DNA microarray analysis. However, CREB3L1 function has not been studied in the context of endometriosis and uterine biology. In this study, we validated progesterone (P4) regulation of Creb3l1 in the uteri of wild-type and progesterone receptor knockout (PRKO) mice. Furthermore, we observed that CREB3L1 expression was significantly higher in secretory phase human endometrium compared to proliferative phase and that CREB3L1 expression was significantly decreased in the endometrium of women with endometriosis. Lastly, by transfecting CREB3L1 siRNA into cultured human endometrial stromal cells (hESCs) prior to hormonal induction of in vitro decidualization, we showed that CREB3L1 is required for the decidualization process. Interestingly, phosphorylation of ERK1/2, critical factor for decidualization, was also significantly reduced in CREB3L1-silenced hESCs. It is known that hESCs from patients with endometriosis show impaired decidualization and that dysregulation of the P4-PR signaling axis is linked to a variety of endometrial diseases including infertility and endometriosis. Therefore, these results suggest that CREB3L1 is required for decidualization in mice and humans and may be linked to the pathogenesis of endometriosis in a P4-dependent manner.
Asunto(s)
Proteína de Unión a Elemento de Respuesta al AMP Cíclico/genética , Endometriosis/genética , Endometrio/metabolismo , Proteínas del Tejido Nervioso/genética , Progesterona/farmacología , Receptores de Progesterona/genética , Adulto , Animales , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/antagonistas & inhibidores , Proteína de Unión a Elemento de Respuesta al AMP Cíclico/metabolismo , Endometriosis/metabolismo , Endometriosis/patología , Endometriosis/cirugía , Endometrio/patología , Femenino , Regulación de la Expresión Génica , Humanos , Histerectomía , Ciclo Menstrual/efectos de los fármacos , Ciclo Menstrual/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Persona de Mediana Edad , Proteína Quinasa 1 Activada por Mitógenos/genética , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteína Quinasa 3 Activada por Mitógenos/genética , Proteína Quinasa 3 Activada por Mitógenos/metabolismo , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Proteínas del Tejido Nervioso/metabolismo , Cultivo Primario de Células , ARN Interferente Pequeño/genética , ARN Interferente Pequeño/metabolismo , Receptores de Progesterona/deficiencia , Transducción de Señal , Células del Estroma/efectos de los fármacos , Células del Estroma/metabolismo , Células del Estroma/patologíaRESUMEN
Conditionally replicating adenoviruses (CRAd) are a promising class of gene therapy agents that can overcome already known glioblastoma (GBM) resistance mechanisms but have limited distribution upon direct intratumoral (i.t.) injection. Collagen bundles in the extracellular matrix (ECM) have an important role in inhibiting virus distribution. In fact, ECM pre-treatment with collagenases improves virus distributions to tumor cells. Matrix metalloproteinases (MMPs) are an endogenous class of collagenases secreted by tumor cells whose function can be altered by different drugs including anti-angiogenic agents, such as bevacizumab. In this study we hypothesized that upregulation of MMP activity during anti-angiogenic therapy can improve CRAd-S-pk7 distribution in GBM. We find that MMP-2 activity in human U251 GBM xenografts increases (*P=0.03) and collagen IV content decreases (*P=0.01) during vascular endothelial growth factor (VEGF-A) antibody neutralization. After proving that collagen IV inhibits CRAd-S-pk7 distribution in U251 xenografts (Spearman rho=-0.38; **P=0.003), we show that VEGF-blocking antibody treatment followed by CRAd-S-pk7 i.t. injection reduces U251 tumor growth more than each individual agent alone (***P<0.0001). Our data propose a novel approach to improve virus distribution in tumors by relying on the early effects of anti-angiogenic therapy.
Asunto(s)
Adenoviridae/fisiología , Inhibidores de la Angiogénesis/farmacología , Colágeno/metabolismo , Glioma/terapia , Ensayos Antitumor por Modelo de Xenoinjerto , Adenoviridae/genética , Adenoviridae/metabolismo , Animales , Anticuerpos Bloqueadores/inmunología , Anticuerpos Bloqueadores/farmacología , Línea Celular Tumoral , Terapia Combinada , Terapia Genética/métodos , Vectores Genéticos/administración & dosificación , Vectores Genéticos/genética , Glioma/genética , Glioma/patología , Humanos , Proteínas Inhibidoras de la Apoptosis/genética , Inyecciones Intralesiones , Estimación de Kaplan-Meier , Masculino , Metaloproteinasa 2 de la Matriz/genética , Metaloproteinasa 2 de la Matriz/metabolismo , Ratones , Ratones Desnudos , Viroterapia Oncolítica/métodos , Polilisina/genética , Polilisina/metabolismo , Regiones Promotoras Genéticas/genética , Proteolisis , Survivin , Factor A de Crecimiento Endotelial Vascular/inmunología , Replicación Viral/efectos de los fármacosRESUMEN
UNLABELLED: The aim of this study was to determine whether serial urinary conductance measurements can be used to estimate reliably the end of the transition period of negative sodium balance in preterm infants. The relationship between urine conductance, measured by a conductance meter, and urine sodium concentration was determined in 109 pooled samples of urine obtained from 14 preterm infants during the transitional period of fluid balance. It was shown by linear regression analysis that urine sodium concentration (mmol l(-1)) = 0.78 x urine conductance - 1.25. Urine sodium concentrations derived from the above formula were concordant with urine sodium measured directly when used to calculate daily sodium balance in all 14 infants. CONCLUSION: Urine conductance can be accurately measured at the cotside by neonatal nurses and used to identify the timing of the postnatal transition from negative to positive sodium balance in preterm infants. These findings can help in making decisions on the introduction of postnatal sodium administration to preterm infants.
Asunto(s)
Recien Nacido Prematuro , Sodio/orina , Desequilibrio Hidroelectrolítico/fisiopatología , Desequilibrio Hidroelectrolítico/orina , Estudios de Factibilidad , Femenino , Humanos , Cuidado del Lactante/métodos , Recién Nacido , Masculino , Sistemas de Atención de Punto , Reproducibilidad de los Resultados , Factores de Tiempo , Urinálisis/métodosRESUMEN
OBJECTIVES: Antenatal steroids in labor improve the outcome in preterm babies. The objective in this retrospective study was to compare the efficacy of one dose of antenatal steroid against the standard course in surfactant-treated babies. METHODS: A total of 226 babies treated with prophylactic surfactant and under 31 weeks' gestation were divided into three groups: group 1 (n = 89), no antenatal steroids; group 2 (n = 68), one dose of antenatal steroids 4-24 h before delivery; and group 3 (n = 69), two or more doses of antenatal steroids 24 h to 7 days before delivery. The three groups were compared for early clinical well-being and ultimate clinical outcome. RESULTS: Apgar and Clinical risk index for babies (CRIB) scores in groups 2 and 3 were similar and both were significantly better than in group 1. Group 2 babies had a 23.5% reduction in serious intraventricular hemorrhage (IVH) (p < 0.0001, relative risk (RR) 0.2 (95% CI 0.07-0.54), numbers needed to treat (NNT) 4.6) and a 22.9% reduction in death (p < 0.001, RR 0.28 (95% CI 0.12-0.63), NNT 4.4) and group 3 babies had a 21.1% reduction in IVH (p < 0.001, RR 0.25 (95% CI 0.10-0.62), NNT 4.6) and a 24.2% reduction in death (p < 0.001, RR 0.23 (95% CI 0.10-0.57), NNT 4.2) compared to group 1. For these parameters, there was no significant difference between groups 2 and 3. CONCLUSIONS: One dose of antenatal steroids given 4-24 h before delivery was clinically comparable to the recommended schedule of the National Institutes of Health in surfactant-treated preterm infants. Should the findings of this study be confirmed in randomized controlled trials, the dosage regimen could be simplified, steroid administration reduced and the interval from delivery reduced in acute clinical conditions.
Asunto(s)
Antiinflamatorios/administración & dosificación , Betametasona/administración & dosificación , Recien Nacido Prematuro/fisiología , Atención Prenatal/métodos , Surfactantes Pulmonares/uso terapéutico , Síndrome de Dificultad Respiratoria del Recién Nacido/prevención & control , Puntaje de Apgar , Hemorragia Cerebral , Quimioprevención , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Mortalidad Infantil , Recién Nacido , Enfermedades del Prematuro/prevención & control , Trabajo de Parto , Masculino , Embarazo , Resultado del Embarazo , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Ehlers-Danlos syndrome (EDS) is a heterogeneous group of heritable disorders of connective tissue. The type III variety is characterized by joint hypermobility and minor hyperextensibility and softness of the skin. While collagen fibril structure has been shown to be abnormal in such patients, the underlying molecular defect(s) has not been determined. Here we characterize the first mutation found in a family with EDS III. Analysis of cultured fibroblasts from the affected family revealed intracellular retention of type III collagen. This is usually a biochemical characteristic of EDS IV, caused by mutations of COL3A1. Analysis of the cDNA sequence in this EDS III family revealed a glycine to serine mutation at amino acid residue 637 of the type III collagen molecule. This was confirmed by allele-specific oligonucleotide hybridization against amplified genomic DNA. Thus mutations of type III collagen can cause either EDS IV or EDS III. Two affected family members had virtually normal skin and so more closely resembled the phenotype of articular hypermobility syndrome.
Asunto(s)
Colágeno/genética , Síndrome de Ehlers-Danlos/genética , Mutación Puntual , Adulto , Secuencia de Aminoácidos , Secuencia de Bases , Preescolar , Clonación Molecular , ADN Complementario/genética , Síndrome de Ehlers-Danlos/clasificación , Síndrome de Ehlers-Danlos/fisiopatología , Femenino , Humanos , Articulaciones/fisiopatología , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Linaje , FenotipoRESUMEN
Ferromagnetic Ni-Cu alloy wires were characterized in order to obtain well-defined thermoseeds for application in interstitial hyperthermia of prostate cancer. Thermoseeds have been produced which possess Curie points in the therapeutic hyperthermia range, approximately 40 to 50 degrees C. The effect of thermal treatment and composition on the heating characteristics of the thermoseeds were investigated. The preliminary study shows that the recrystallization is crucial for altering thermoseeds' heating characteristics. Obtaining thermoseeds which behave as desired depends on changes in annealing times and temperatures. One may increase the maximum heating temperature (similar to Curie temperature) by increasing the annealing time and cooling time. Decreasing the lower annealing plateau temperature also increases the maximum seed heating temperature. Higher nickel content compositions did not affect rise time but increased the maximum heating temperature.
Asunto(s)
Aleaciones/química , Calor , Hipertermia Inducida/instrumentación , Cobre , Humanos , Ensayo de Materiales , Níquel , Neoplasias de la Próstata/terapiaRESUMEN
Contrary to popular belief, hypoglycemia is an infrequently encountered condition and its presence is questionable until confirmed by appropriate tests. In ambulatory patients, blood glucose levels obtained during intake of a normal diet are more reliable than those obtained during a glucose tolerance test. If the blood glucose is actually abnormally low and the other two criteria of hypoglycemia are also satisfied, a search for the cause is in order. In hospitalized patients, excessive doses of insulin or oral hypoglycemic agents, the effect of drugs, or chronic renal failure are the most common causes of hypoglycemia. If these factors are absent, another chronic illness known to cause hypoglycemia may be the source. If the cause is still obscure, a thorough evaluation of the endocrine status is warranted.
Asunto(s)
Hipoglucemia/etiología , Ansiedad/etiología , Arritmias Cardíacas/etiología , Glucemia/metabolismo , Ingestión de Alimentos , Humanos , Hambre , Hipoglucemia/inducido químicamente , Hipoglucemia/complicaciones , Hipoglucemia/fisiopatología , Hipoglucemiantes , Insulina/efectos adversos , Insulinoma/complicaciones , Neoplasias Pancreáticas/complicaciones , Esfuerzo Físico , Sudoración , Temblor/etiologíaRESUMEN
A 14 year old girl with idiopathic hypereosinophilic syndrome is described. In addition to weight loss, anaemia, amenorrhoea, general lethargy, anorexia, mouth ulcers, blisters of hands and feet, and petechial skin rash, she had features of involvement of the cardiovascular system as the major complication. She responded well to treatment. After a comprehensive search of the published reports 18 cases of this syndrome were identified in children under 16 years. Fifteen of these children had involvement of the cardiovascular system as the major source of their morbidity and mortality. Summary of the clinical details and laboratory, biopsy, and necropsy findings of the involvement of the various organ systems of the 18 children is presented.
Asunto(s)
Eosinofilia/etiología , Adolescente , Recuento de Células Sanguíneas , Eosinofilia/sangre , Eosinofilia/tratamiento farmacológico , Eosinófilos , Femenino , Humanos , SíndromeRESUMEN
Pink disease has virtually disappeared since teething powders were withdrawn. We describe a case in a boy who was exposed to metallic mercury vapour. We discuss the potential health hazard of spilled elemental mercury in the house and the difficulties of removing it from the environment.
Asunto(s)
Acrodinia/inducido químicamente , Mercurio/efectos adversos , Descontaminación , Exposición a Riesgos Ambientales , Humanos , Lactante , MasculinoRESUMEN
A carefully selected sample of 18 3-day-old full term neonates was videotaped in 3 different positions. The time of taping was controlled for feed interval. These tapes were then analysed for state and posture using a frame by frame facility. Seventy one separate postures were documented and the existence of a 'neutral posture' was noted. These postures will provide a baseline for further work in adult-infant interaction.
Asunto(s)
Postura , Ingestión de Alimentos , Femenino , Humanos , Recién Nacido , Masculino , Actividad MotoraRESUMEN
The effect of semistarvation on the toxicity and ototoxicity of tobramycin sulfate (TO) and gentamicin sulfate (GE) was investigated in guinea pigs by electrophysiological and histopathological methods. The presented data has shown that the toxicity and ototoxicity of aminoglycoside antibiotics is substantially increased when guinea pigs were semistarved. Our results should also warn researchers using semistarvation in their conditioning experiments which investigate the toxicity of different chemicals. Toxicity was greater in GE- than TO-treated animals, which caused the GE-treated animals to die during treatment or shortly after treatment. Thus, TO should be preferentially used because it has been shown to be less toxic and ototoxic in normal and altered nutritional conditions.
Asunto(s)
Antibacterianos/toxicidad , Enfermedades del Oído/etiología , Gentamicinas/toxicidad , Inanición/complicaciones , Tobramicina/toxicidad , Animales , Electrofisiología , Gentamicinas/metabolismo , Cobayas , Células Ciliadas Auditivas/patología , Células Ciliadas Auditivas Internas/patología , Masculino , Inanición/metabolismo , Tobramicina/metabolismoAsunto(s)
Recien Nacido Prematuro , Intubación/instrumentación , Diseño de Equipo , Humanos , Recién NacidoRESUMEN
The ototoxicities of tobramycin sulfate and gentamicin sulfate were investigated in guinea pigs under conditions of normal, increased, and decreased hydration. Increased hydration was associated with no decline in the amplitude of the cochlear microphonics, a lesser decline in the eighth nerve action potentials and lesser damage to the organ of Corti. Decreased hydration was associated with an increase in the threshold of the cochlear microphonics and the eighth nerve action potentials, a decline in the amplitude of the cochlear microphonics, a greater decline in the eighth nerve action potentials, and greater damage to the organ of Corti. Tobramycin sulfate was substantially less toxic than gentamicin sulfate with normal, increased and decreased hydration. These findings suggest the preferential use of tobramycin sulfate for patients with normal renal function, and especially patients with renal impairment.
Asunto(s)
Antibacterianos/toxicidad , Oído Interno/efectos de los fármacos , Gentamicinas/toxicidad , Tobramicina/toxicidad , Potenciales de Acción/efectos de los fármacos , Animales , Cóclea/efectos de los fármacos , Oído Interno/fisiopatología , Femenino , Cobayas , Masculino , Nervio Vestibulococlear/efectos de los fármacos , AguaRESUMEN
A case report is presented of a boy with congenital myopathy associated with oculo-facial and skeletal abnormalities. The relationship of this case to patients with the Schwartz-Jampel and Marden-Walker syndromes is discussed.