3,3-Dimethyl-cis-9a,13a-diphenyl-2,3,9a,11,12,13a-hexa-hydro-1H-benzo[h][1,4]dioxino[2',3':5,6][1,4]dioxino[2,3-f]chromene.

In the title di-hydro-dioxin, C31H28O5, the dioxane ring has a chair conformation, whereas each of the pyran and dioxine rings has an envelope conformation with methyl-ene and quaternary C atoms, respectively, being the flap atoms. The phenyl rings are cis and form a dihedral angle of 82.11 (10)°. The molecular structure is stabilized by C-H⋯O contacts. In the crystal packing, supra-molecular layers parallel to (101) are sustained by C-H⋯π inter-actions.

Metagenomics analysis of the morphological aspects and bacterial composition of broiler feces.

In this descriptive study, we used metagenomics to analyze the relationship between the morphological aspects of chicken feces and its respective bacterial compositions. The microbiota composition was determined by sequencing the V4 region of the 16S rRNA genes collected from fresh broiler feces at 19 d old. In total, 48 samples were collected and divided into 8 groups of 6 samples each. The morphological changes studied were feed passage (FP) and reddish mucus (RM). Each was classified into 3 levels of intensity: 1 (slight), 2 (moderate), or 3 (intense). Thus, the 8 groups studied were feed passage (FP-1; FP-2; FP-3), reddish mucus (RM-1; RM-2; RM-3), normal ileal feces (NIF), and cecal discharge (CD). The alpha diversity (Shannon's index) revealed that the CD group showed greater diversity, and was significantly different from FP-2, FP-3, and RM-1. The beta diversity showed that the CD group samples were more homogeneous than the ileal feces groups. The relative abundance analysis revealed that Firmicutes and Proteobacteria were the most abundant phyla in the ileal feces groups. In CD, Firmicutes and Bacteroidetes were the most abundant. The relative abundance at the genus level revealed 136 different bacterial genera. In the ileal feces groups, the two most abundant genera were Lactobacillus and Escherichia/Shigella, except in the FP-1 and RM-2 groups, which had the opposite order. Unlike the others, the CD group had a higher abundance of Bacteroides and Faecalibacterium. When comparing the NIF group with the others, significant changes were found in the fecal microbiota, with nine genera for the FP groups, 19 for the RM groups, and 61 when compared to CD. The results of the present study suggest that evaluation of fecal morphology is a fundamental task that makes it possible to act quickly and assertively, as the morphological aspects of the feces may be related to the composition and structure of fecal microbiota.

Autoantibodies against inosine-5'-monophosphate dehydrogenase 2--characteristics and prevalence in patients with HCV-infection.

BACKGROUND: Indirect immunofluorescence (IIFT) on in house HEp-2 cell preparations revealed a novel antibody giving a granular cytoplasmic pattern not described before, which on two commercial cell preparations revealed a "rings and rods" pattern. This pattern was also observed in four HCV-RNA carriers and prompted the identification of the reactive antigen and the evaluation of the antibody prevalence in HCV-RNA carriers and control groups. METHODS: The antigen's molecular weight was determined by radioimmunoprecipitation of 35S-methionine labeled cell proteins. Expression library screening and sequencing was performed by standard techniques using an oligo(dT)-primed human HeLa cell cDNA expression library. Antibodies against the novel antigen Inositol-5'-monophosphatdehydrogenase 2 (IMPDH2) were analyzed by IIFT, western blot, line blot, and radioimmunoprecipitation assay (RIPA). IIFT was performed on commercial HEp-2 cells and cells cultivated in house for 24 - 60 hours, with or without the IMPDH2 inhibitors mycophenolic acid (MPA) or ribavirin, and subjected to various fixation conditions. Western and line blots were performed with IMPDH2 synthesized in E. coli, RIPA with 35S-methionine-IMPDH2 from in vitro transcription/translation products. Sera screened were positive for HCV-RNA (108), HBV-DNA (100), anti-mitochondrial (31), anti-actin (42), and anti-nuclear antibodies (51) and negative for HCV-RNA (100) and blood donors (100). RESULTS: IMPDH2 is capable of considerable intracellular rearrangements (upon action of inhibitors like MPA and ribavirin), which explains the contrasting immunofluorescence patterns in cells from different sources. By RIPA, proven to be the sole assay suitable for screening of anti-IMPDH2 in human sera, autoantibodies were found in 35.2% of HCV-RNA carriers and in low concentrations in 31% of anti-actin positive patients suspicious of autoimmune hepatitis. Antibodies reacted preferentially with conformational epitopes. Compared to the low concentration of anti-IMPDH2 found in other disease groups, high antibody concentrations were observed in HCV-RNA carriers. CONCLUSIONS: The common occurrence of anti-IMPDH2 in HCV-RNA carriers may be related to ribavirin therapy, causing intracellular aggregation of IMPDH2 thereby altering its immunogenicity. In this study the "rods and rings" immunofluorescence pattern observed could be ascribed to anti-IMPDH2. Anti-IMPDH2 may cause difficulties in interpretation of immunofluorescence patterns in routine autoantibody testing.

Chemosensitivity of B cell chronic lymphocytic leukemia and correlated expression of proteins regulating apoptosis, cell cycle and DNA repair.

B cell chronic lymphocytic leukemia (B-CLL) cannot be cured with conventional chemotherapy. This clinical enigma appears to be at least partially due to the fact that B-CLL cells are resistant to programmed cell death (apoptosis) and that they are arrested in G0/G1 phase of the cell cycle. The reasons for the dysregulation of these two key cellular events in B-CLL are unclear. The present study aimed at determining correlations between the expression levels of proteins regulating apoptosis, cell cycle and DNA repair in B-CLL cells and normal B cells. In addition, the differential sensitivity of B-CLL cells to drug-induced apoptosis was quantified. We show that in B-CLL cells levels of the death-suppressor Bcl-2 correlated positively with those of the pro-apoptotic protein Bax and of the cyclin-dependent kinase (cdk) inhibitor p27Kip1. In B-CLL cells levels of the anti-apoptotic Bcl-xL showed a positive correlation with levels of the 80 kDa regulatory component (Ku80) of the DNA-dependent protein kinase that is involved in DNA double-stranded break repair. These correlations were not detected in normal B cells. The sensitivity of leukemic cells to FLUD but not to ADM, CPM or to DEX was reduced in pre-treated patients. These data support the hypothesis that in B-CLL cells death-modulators and molecules modulating cell cycle and DNA repair are regulated in a coordinated manner. Leukemia (2000) 14, 40-46.

Toxoplasma gondii antibodies in pregnant women and their newborns in Dar es Salaam, Tanzania.

The sera of 849 Tanzanian pregnant women were tested at delivery for Toxoplasma gondii antibodies with the Sabin-Feldman dye test (DT) and an immunosorbent agglutination assay. A total of 296 (35%) of these women had DT titers greater than 1:4. The percentage of women with dye test titers greater than 1:4 was 34-37% regardless of the individual ages. The rate of positivity for human immunodeficiency virus 1/2 (HIV-1/2) using Western blotting was 11.5%. There was no relationship between prevalence of a positive DT result and HIV infection nor between the intensity of the DT result and HIV infection. Sixty-four parturients had a DT titer of 1:1,000 or more. From 57 newborns of these mothers, cord sera were available and were screened by the DT and the immunosorbent agglutination assay. Seven of these were found to be positive for IgM and/or IgA antibodies. It was concluded that the rate of serologic evidence for prenatal Toxoplasma infection in cord blood samples in the present study of Tanzanian pregnant women was approximately 0.8%.

Heterotopic pregnancy in a spontaneous cycle: do not forget about it!

Heterotopic pregnancies are estimated to be less frequent than 1:30000 if no assisted reproduction technologies (ART) are performed. After ART this entity is more frequent and in the range of 1:100. In the case reported here an ectopic pregnancy was detected in the right fallopian tube at 7+ 1 weeks of gestation. It was misdiagnosed as an ectopic singleton, and treated by laparoscopic salpingectomy, because of a previous ectopic in the same tube. Rising hCG after laparoscopy during the subsequent days followed by ultrasound evaluation revealed a viable intrauterine pregnancy. The pregnancy continued uneventfully and a healthy child was delivered at term. The problems, which lead to the misdiagnosis are discussed. The problem of rare cases in medicine, and the problems of a 'modern' medicine are discussed.

A new indication for an intracytoplasmic sperm injection procedure outside the cases of severe male factor infertility.

OBJECTIVE: To show the success of intracytoplasmic sperm injection (ICSI) in cases of a low number of oocytes retrieved. STUDY DESIGN: 715 microinjection cycles, which were performed at our center, were analyzed retrospectively. RESULTS: Within the analyzed cycles, there were 50 cycles with less than four oocytes retrieved. Twelve, 18, and 20 cases were treated with one, two, and three oocytes, respectively. The rate of metaphase II oocytes injected and subsequently fertilized, and intact oocytes was similar in the three groups. The transfer rate was not significantly different from those cases with more than three oocytes (84% vs. 94%). Therefore, the rate of fertilization failure was not higher in the low-number group. The number of embryos transferred was statistically significantly lower in the group with one and two oocytes compared to the group with three oocytes (1, and 1.31 vs. 2.27; P < 0.01) and the group of all patients (2.63; P < 0.01), as well as between the group of less than four oocytes and all patients (1.63 vs. 2.63; P < 0.01). There was no statistically significant difference between the pregnancy rates of the three groups (36.4% vs. 20% vs. 22.2%), and also no difference was found between the group with less than four oocytes and the data of all patients (22% vs. 26.9%). CONCLUSION: In our opinion, these data show that ICSI guarantees a successful treatment even if only as many oocytes are present as embryos are planned to be transferred, i.e. three embryos. This has been accepted to be a new indication in our center. Therefore it should be possible to stimulate patients mildly, with e.g. clomiphene citrate, to avoid unnecessary hyperstimulation syndromes, and to lower the cost of hormonal superstimulation.

Preserved pituitary response under ovarian stimulation with HMG and GnRH antagonists (Cetrorelix) in women with tubal infertility.

OBJECTIVE: To examine the pituitary response in patients undergoing short-term application of the GnRH antagonist Cetrorelix in the mid-cycle phase for hypophysial suppression of premature LH surges within an IVF-program. DESIGN: Twenty patients suffering from primary or secondary tubal infertility were stimulated with hMG from cycle day 2. From day 7 till ovulation induction Cetrorelix was administered in two different dose regimens (15 patients 3 mg s.c. daily; 5 patients 1 mg s.c. daily). Three hours before ovulation induction a GnRH test was performed using 25 micrograms of native GnRH and the pituitary response examined by measurement of the serum LH concentration after 30 min. RESULTS: Premature LH surges could be avoided in the 3-mg group and in the 1-mg group, respectively. Due to this, none of the cycles had to be cancelled. Oestradiol profiles and ultrasound demonstrated a satisfactory follicular maturation. All patients showed pronounced suppression of the serum LH levels before ovulation induction. The mean increase of serum LH due to the performed GnRH test was 10 mIU/ml for the 3-mg group, while the average maximum in the 1-mg group was about 32.5 mIU/ml. CONCLUSIONS: The pituitary response is preserved by the treatment with the GnRH antagonist Cetrorelix. The extent of suppression of the adenohypophysis, as expressed by the different reactions on GnRH test, can be modulated by the dosage administered. This should allow ovulation induction by GnRH or one of its agonists instead of hCG, which could be beneficial in patients at high risk of Ovarian Hyperstimulation Syndrome (OHSS) and those suffering from Polycystic Ovary Disease (PCOD).

Limited ovarian stimulation (LOS), prevents the recurrence of severe forms of ovarian hyperstimulation syndrome in polycystic ovarian disease.

OBJECTIVES: We aimed to test the possibility that LOS could be used to avoid the risk of occurrence of severe OHSS in PCOD patients with past history of severe OHSS in their previous IVF treatment. STUDY DESIGN: A prospective study, with patients stood as their own controls. Twenty patients with history of severe OHSS in their previous IVF treatment were included in the study. The patients received LOS cycles during the six months period commencing January 1998, a full dose of human chorionic gonadotropin (10,000 IU) was administered when the leading follicle reached a mean diameter of 12 mm, and oocytes retrieval 36 h later was followed by intracytoplasmic sperm injection (ICSI) and embryo transfer. Signs and symptoms of severe OHSS were recorded. RESULTS: All patients produced mature oocytes, achieved fertilisation and eight clinical pregnancies were diagnosed. None of the patients re-experienced the symptoms of severe OHSS, and none required hospitalisation. CONCLUSION: We confirm that, in the studied group of patients, LOS helped in the prevention of the severe forms of OHSS in PCOD patients with past history of severe OHSS.

Organic trace compounds in the water of the River Elbe near Hamburg. Part I.

Water samples of the River Elbe near Hamburg were analyzed for 145 organic chemical compounds. In part I results of the investigations concerning the following groups of compounds are presented (57 individual compounds): volatile chlorinated hydrocarbons, chloroalkylethers (haloethers), chlorobenzenes, nitrobenzenes, chloronitrobenzenes, and chloroanilines. Highest concentrations were found for the chlorinated bispropylethers and 1,7-dichloro-3,5-dioxaheptane (haloethers). Other important compounds were nitrobenzene, nitrotoluenes, and chloronitrobenzenes. The results were assessed on the basis of German surface water quality criteria.

Organic trace compounds in the water of the River Elbe near Hamburg. Part II.

Part II of the quantitative determination of altogether 145 distinct organic compounds is presented (88 organic compounds). Elevated amounts of some pesticides concerning triazines and especially dimethoate were recorded as well as of O,O,O-trimethylthiophosphate and O,O,S-trimethyldithiophos-phate, which are related to the chemistry of dimethoate. A comparison of the results of PCB-quantification in unfiltered water samples with the results for solid phase material (SPM-phase) in river water is presented. The occurrence of organic trace compounds in the River Elbe is discussed in comparison to corresponding investigations of the River Rhine.

The description of Paralongicollum nemacheili n. gen., n. sp. (Acanthocephala: Pomphorhynchidae) from freshwater fishes in Kazakh S.S.R.

Paralongicollum nemacheili n. gen., n. sp. is described from Salmo gairdneri Richardson and Nemacheilus stoliczkai Steindacher in Lake Kul'say in the basin of Lake Balkhash, Kazakh S.S.R. Its long uniformly cylindrical neck and nonfiliform proboscis distinguish it from the other 3 genera of the family. Tenuiproboscis Yamaguti, 1935, has a filiform proboscis. The neck of Pomphorhynchus Monticelli, 1905, has a bulb anteriorly, and that of Longicollum Yamaguti, 1935, is spirally twisted with expansions. A key to the genera of Pomphorhynchidae is provided. The relatively longer necks in juveniles than in larger worms probably enhance the establishment of new infections. A large proportion of worms had extensive body wall deformities. Longicollum sergenti (Choquette and Gayot, 1952) Golvan, 1969, is relegated to the new genus Paralongicollum.

Pelvic assessment and cephalo-pelvic disproportion in Central Tanzania.

Among 201 primigravidae, pelvic assessment was analyzed prospectively during the third trimester to detect patients likely to suffer from cephalo-pelvic disproportion (CPD). If the sacral promontory (SP) was reached by the index finger (9.0-9.5 cm true conjugate) the pelvis was regarded as "suspect". All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Pelvic assessment is an important screening tool during antenatal care to detect high-risk primigravidas.

PIP: Among 201 primigravida, pelvic assessment was analyzed prospectively during the 3rd trimester to detect patients likely to suffer from cephalo-pelvic disproportion (CPD). Patients were attending the Kondoa Hospital in Central Tanzania for prenatal assessment. Patients were divided into 3 groups: 1) Sacral promontory not reached; 2) Sacral promontory just reached; and 3) Sacral promontory easily reached. If the sacral promontory was reached by the index finger (9.0-9.5 cm true conjugate) the pelvis was regarded as 'suspect.' All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Compared to other simple methods, pelvic assessment required more skill and some equipment, but performed properly, it may affect patient compliance positively by removing fear of hospital admission in case of emergency. We believe that pelvic assessment is a simple method, associated with a high sensitivity and a very high specificity, to detect patients at risk for CPD. In a series only measuring maternal height, a full 15% of actual CPD cases were not detected by Aitken and Walls.

[Accidents of the elderly]. / Idóskori balesetek.

The topic of accidents in elderly population has been studied on 2055 injured older than 65 years. The severity of injuries indicates the importance of accidents in this age-group. The proportion of fractures in the elderly population is twice of the average-in females over 75 years of age they take the half of the total number of injuries. While the incidence rate of males in the whole material with all of the age groups is twice of that of females, in elderly population it turns into equal. The rate of home-accidents grows with ageing. The elderly people specially the males suffer a high number of road traffic accidents as pedestrians or riding their bicycles. The severity of injuries and the broken health status in elderly people is a major problem both for the health care and the whole society.

[Freshwater bryozoans (Bryozoa: Phylactolaemata) as vectors of salmonid disease]. / Presnovodnye mshanki (Bryozoa: Phylactolaemata)--perenoschiki bolezni lososevykh.

Relations of PKX [vector of proliferative kidney disease (PKD)] of reared and wild Salmonoidea and Tetraspora bryozoides, the only genus and species of Myxozoa found in fresh water Bryozoa, is discussed using recent publications. Both organisms were found in several European countries as well as in North America. It seems that PKX is a Bryozoa parasite which do not undergo full cycle of sporulation in fish.

[A new genus of parasitic ciliata from tropical fishes]. / Novyi rod paraziticheskikh resnichnykh iz tropicheskikh ryb.

Ichthyophthirius schlotfeldti Yunchis, 1997 (Ophryoglenidae) was described by the junior author from aquarium fishes from South-East Asia. In the present paper this species is separated into a new genus Neoichthyophthirius gen. n. The reproduction of this species takes place within the epithelium of fishes and not in water as in Ichthyophthirius multifilius. Neoichthyophthirius schlotfeldti has a ring-shaped macronucleus with ends overlapping. Maximum temperature, when the reproduction is possible, is about +34 degrees. The parasite is pathogenous and causes a mortality of aquarium fishes.

Neuromyelitis optica and NMO-IgG in European pediatric patients.

OBJECTIVE: Neuromyelitis optica (NMO) is currently considered a severe relapsing CNS demyelinating disorder that is associated with aquaporin-4 immunoglobulin G (NMO-IgG) while in earlier reports of NMO in childhood it has been described as a benign and monophasic disorder. This study was performed to analyze the prevalence and the clinical course of NMO in a European pediatric cohort of patients with demyelinating CNS disorders. METHODS: A cohort study was performed evaluating 118 pediatric patients presenting at the Center for Multiple Sclerosis in Childhood and Adolescents, Göttingen, Germany, with demyelinating CNS disorders between 2000 and 2009. In all patients, NMO-IgG status was determined. RESULTS: The majority of patients (94%) were diagnosed with remitting recurrent multiple sclerosis. Six patients fulfilled the clinical criteria for NMO but only 1 was seropositive for NMO-IgG. This patient had a severe relapsing course in contrast to the seronegative patients who showed a mild and in the majority of cases monophasic course. CONCLUSIONS: The diagnostic criteria clearly distinguished the patients with NMO from patients with other demyelinating CNS disorders. In the European pediatric population, NMO is very rare and in the majority of patients not associated with NMO-IgG. These seronegative cases have a benign and predominantly monophasic course and therefore do not need the immunosuppressant therapy that is recommended for NMO in the recent literature.