Gene expression confirms a potentially receptive endometrium identified by histology in fertile women.

BACKGROUND: To use contemporary biochemical markers to characterize mRNA/gene expression in the potentially fertile secretory endometrium to confirm its identification based on histological characteristics in order to develop a clinically applicable test. METHODS: Nine, fertile, cycling Caucasian women were sampled from one IVF clinic. Endometrial samples were collected from them in two to four menstrual cycles at 2 and 7 days post first significant rise in blood LH. Separate endometrial glands and stroma populations were obtained by laser microdissection. Linear polymerase chain reaction amplified mRNAs which were hybridized to both Affymetrix U133 Plus2 and Agilent 4 × 44K microarrays followed by gene set analysis. Four histopathologists reviewed the sample set using the same histological criteria to date and characterize the non-receptive and potentially receptive samples. RESULTS: mRNA expression of microdissected glands and stroma provided molecular signatures that characterized the two specific phases of the cycle with distinct clustering patterns. Cell proliferation and five other associated biological pathways were significantly down-regulated when the endometrium is considered potentially receptive accompanied by an increase in secreted glycoproteins mRNAs in the potentially receptive glands. Reported histological findings identified the presence of one histological feature characteristic of each phase: glandular mitoses indicated a non-receptive endometrium, whereas a potentially receptive endometrium was distinguished by supranuclear vacuolation. CONCLUSIONS: This study defined a transcriptome characteristic of active cell proliferation in the non-receptive samples with a marked overall down-regulation of this pathway in potentially receptive samples-suggesting a transitional state associated with receptivity but not implantation. However, microarrays involve expensive, specialized testing and require significant post-data analysis. Sampling according to endocrinological and molecular prediction improved the consistency of histological assessment and allowed reliable histological markers of glandular mitosis in the non-receptive phase and supranuclear vacuolation of the potentially receptive endometrium to be identified. Thus, histology can provide an affordable, clinically applicable test in the context of reproduction.

Treatment of canine atopic dermatitis with cetirizine, a second generation antihistamine: a single-blinded, placebo-controlled study.

Cetirizine and placebo were administered orally as individual agents to 23 dogs with atopic dermatitis. The pruritus was satisfactorily reduced in 4/22 (18%) dogs that completed the trial with cetirizine. Two dogs vomited after administration of the active drug.

Treatment of canine atopic dermatitis with a commercial homeopathic remedy: a single-blinded, placebo-controlled study.

A commercial homeopathic remedy and a placebo were administered orally as individual agents to 18 dogs with atopic dermatitis. The pruritus was reduced by less than 50% in only 2/18 dogs; 1 of these dogs was receiving the homeopathic remedy, the other was receiving the placebo. One dog vomited after administration of the homeopathic remedy.

Vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors.

We present a case of vaginal adenosis with adenocarcinoma in situ in a woman with no recognised antecedent factors. This case demonstrates the importance of continuing thorough colposcopic assessment of the entire lower genital tract with repeated biopsies of all abnormal epithelium in women with persistent or recurrent cervical cytology abnormalities. Successful management requires accurate definition of the vaginal lesion.

An international survey of long-term video/EEG services.

To determine current practices in the provision of video-EEG services, the authors conducted an international survey by post. The aim of the survey was to evaluate, by reference to other centres, how and why certain things are done, be assured that their own center is providing a quality service, identify weaknesses in their service, and from this, set improvement goals and objectives. A purposive sampling method was used by sending questionnaires to 78 hospitals where it was believed a long-term video-EEG monitoring service existed. Completed survey questionnaires were returned from 42 centers. Although the survey mechanism may have resulted in self-selection bias, evaluation of the responses provides information on patient management, staffing levels, equipment, and equipment management. Ultimately, these data may aid in identifying a minimum set of requirements for the provision of a video-EEG telemetry service.

Pathology of the ductus arteriosus treated with prostaglandins: comparisons with untreated cases.

Our histological study of the ductus arteriosus compared 12 infants who were treated with E-type prostaglandins with 12 control infants matched as closely as possible for age and diagnosis. Distinguishing histological features were seen in five of the treated cases and in none of the untreated cases. These features were intimal tears in two and hemorrhage into the media in five. Medial edema, mural thrombosis, and interruption of the internal elastic lamina at sites not beneath intimal cushions occurred both in treated and untreated infants and therefore were not distinguishing features. The gross anatomical features of the ductus arteriosus were assessed in these 24 and in another 85 cases. Significant differences in the ductus arteriosus were noted between cases with pulmonary atresia or aortic atresia and normals, but not between those treated with E-type prostaglandins and controls.

The clinical features of migraine as a manifestation of allergic disease.

Patients with a clinical history of migraine were evaluated psychiatrically, and by electroencephalography. They were challenged with food antigens by skin-prick test, and abdominal symptoms were evaluated following oral ingestion of food allergens. A significant correlation was found between challenge with specific food allergens and the development of migraine headaches, the appearance of abdominal symptoms and the occurrence of positive skin reactions. Psychiatric abnormalities and EEG alterations were associated with the occurrence of headaches and allergic clinical features. It is suggested that the clinical features of migraine can be explained as a result of release of chemical mediators following antigen-antibody reactions in the brain and other tissues where specific antibodies are localized. The continuous ingestion of the responsible food allergens would account for the raised tissue concentrations of noradrenaline, histamine and other mediators to which the clinical features of migraine are attributed.

Self poisoning: who supplies the drugs? 100 examples.

One hundred self-poisoners, consecutively referred to the psychiatric liaison service at Auckland Hospital were questioned regarding the source of the substances taken, the taking of regular medication and their last contact with a doctor. In total, 82 percent took legitimately prescribed medications, in 67 cases prescribed for themselves, while 12 percent bought over-the-counter preparations. Alcohol was associated in one-third of all cases. In one half of all cases the substance ingested had been prescribed at the last visit to a doctor. These patients were statistically more likely to be depressed, to be taking regular medication and to have taken a previous overdose. Two-thirds of all cases had seen a doctor no more than a month prior to self-poisoning.