Serological responses to Cryptosporidium antigens in inhabitants of Hungary using conventionally filtered surface water and riverbank filtered drinking water.

In this study the putative protective seroprevalence (PPS) of IgG antibodies to the 27-kDa and 15/17-kDa Cryptosporidium antigens in sera of healthy participants who were and were not exposed to Cryptosporidium oocysts via surface water-derived drinking water was compared. The participants completed a questionnaire regarding risk factors that have been shown to be associated with infection. The PPS was significantly greater (49-61%) in settlements where the drinking water originated from surface water, than in the control city where riverbank filtration was used (21% and 23%). Logistic regression analysis on the risk factors showed an association between bathing/swimming in outdoor pools and antibody responses to the 15/17-kDa antigen complex. Hence the elevated responses were most likely due to the use of contaminated water. Results indicate that waterborne Cryptosporidium infections occur more frequently than reported but may derive from multiple sources.

The utility of the predictive scores in polytrauma with abdomino-pelvic injuries: a series of 38 patients.

UNLABELLED: Trauma is the principal cause of mortality among the population under 40 years. The aim of our study was to compare predictive trauma scores and demonstrate their utility in the evaluation of the quality of care in polytrauma. MATERIAL AND METHODS: A retrospective study was performed between 2000-2011 including polytrauma patients with abdominal lesions and pelvic fracture who under went emergency laparotomy. We calculated ISS, GCS, RTS,TRISS, ASCOT trauma scores and W score for evaluation of treatment quality. RESULTS: We obtained the necessary data to calculate the predictive scores in 38 cases. Comparing the scores of the survivals and non-survivals we noted the following regarding mortality predictive scores: GCS 13.74 vs. 6.13 (p 0.0001),ISS 28.52 vs. 35 (p=0.0169), RTS 6.96 vs. 3.07 (p 0.0001),TRISS 84.67% vs. 28.7% (p 0.0001), ASCOT 10.34% vs.64.32% (p 0.0001). The W score in TRISS and ASCOT methodology was -2.05 (p=0.7997) and -7.81 (p=0.336),respectively. There was no statistically significant difference between actual and predicted mortality, the former being 39.47%. CONCLUSION: We did not observe differences between the two methodologies TRISS and ASCOT in mortality prediction (p=0.5401). Both of them can be used to predict polytrauma patient evolution. The W score is useful in treatment quality assessment.

Evidence for a bound H dibaryon from lattice QCD.

We present evidence for the existence of a bound H dibaryon, an I=0, J=0, s=-2 state with valence quark structure uuddss, at a pion mass of m(π)∼389 MeV. Using the results of lattice QCD calculations performed on four ensembles of anisotropic clover gauge-field configurations, with spatial extents of L∼2.0, 2.5, 3.0, and 3.9 fm at a spatial lattice spacing of b(s)∼0.123 fm, we find an H dibaryon bound by B(∞)(H)=16.6±2.1±4.6 MeV at a pion mass of m(π)∼389 MeV.

[Spleno-renal distal and proximal shunts for hypersplenism due to hepatic cirrhosis]. / Suntul spleno-renal distal si proximal pentru hipersplenismul datorat cirozei hepatice.

The secondary hypersplenism appears from 30-50% in liver cirrhosis with portal hypertension. The mechanism of the complication is the splenic congestion as the result of the progress of the portal hypertension. Between 1997-2005, 16 patients with hypersplenism due to liver cirrhosis were operated in the service. The aim of the operation was to decompress the portal hypertension, by spleno-renal shunt (Warren), in 6 patients, truncular shunts in 2 patients, and splenectomy with spleno-renal shunts in 8 patients. No postoperative death was noted on the series. The platelets number and the white blood cells, destroyed by the reticuloendothelial system of the spleen, were counted in the first month and the first year, as well as the spleen volume. In patients with non-splenectomy operations the improvement of the blood elements number was remarked in the first week, but the volume of the spleen remained increased during 1-6 month. In patients with splenectomy the platelets and the white cells dramatically increased, with the risk of coagulation disfunction. The survival rate at five years was 12 patients.

[Cervical anastomotic fistula in surgery of the esophagus]. / Fistulele anastomozelor cervicale din chirurgia esofagului.

Cervical anastomotic fistula are reported in the surgical literature in 10-30% of the patients, providing a much longer hospitalisation, a higher morbidity and in some cases even mortality. Between 1997-2003, 91 patients underwent surgical treatment for esophageal cancers and 14 patients for chemical burns. In the cancer group the rate of resection was 67,03% (61 patients). In 8 patients with non-resection tumours a retrosternal esophageal by-pass with stomach was carried out. Cervical anastomosis were performed in 68 patients, by hand sutures. Anastomotic fistula were noted in 9 patients (13,24%). In 6 cases temporarily fistula occurred, with spontaneous healing by local treatment, in 8-28 days. 2 patients required reoperation and one patient a definitive feeding jejunostomy. Most common causes of fistula are technical problems, ischemic gastric or colonic tube, postoperative respiratory failure, with prolonged hypoxia. An anastomosis in the neck results in less postoperative complications than one of the lower level.

Evidence for transformation of glucagon-like immunoreactivity of gut into pancreatic glucagon in vivo.

The effect of gut glucagon-like immunoreactivity (GLI) devoid of pancreatic glucagon was studied in piglets. All glucagon-like peptides with an accessible C-terminal were removed from the gut extract by specific antibodies reacting with the C-terminal of the glucagon molecule. Endogenous secretion of pancreatic and gut glucagon was blocked by somatostatin infusion, and then the purified gut glucagon preparation was infused. The latter prevented the hypoglycemia resulting from somatostatin infusion, and increased the glucagon level detectable by C-terminal specific antibodies in the blood of the animals. This rise was significant statistically from the 30th min of GLI administration (26.7 +/- 7.2 pg/ml versus 137.0 +/- 67.0 pg/ml; P less than 0.05) and increased until the end of the infusion (90th min, 218 +/- 60 pg/ml; P less than 0.005). It has been suggested that, owing to the in vivo enzymatic degradation of the infused gut glucagon, biologically active "pancreatic" glucagon fractions are formed extracellularly.

Primary afferent origin of substance P-containing axons in the superficial dorsal horn of the rat spinal cord: depletion, regeneration and replenishment of presumed nociceptive central terminals.

Substance P-like immunoreactivity (SPLI) was localized in the superficial spinal dorsal horn of the rat by means of light and electron microscopic immunocytochemical techniques. Serial immunocytochemical sections were subjected to densitometric measurements with an electronic Image Analyser, and with aid of a computer program, a two-dimensional reconstruction of the fine neuroanatomical structure of the SPLI-active regions of the lumbosacral upper superficial spinal dorsal horn was obtained. SPLI activity in the superficial dorsal horn outlines four well-marked and distinctly differing regions, called, in the mediolateral sequence, areas A, B, C, and D, plus Cajal's noyeau interstitiel ("lateral spinal nucleus" = "nucleus of the dorsolateral fascicle," L). Lumbosacral dorsal rhizotomy results in an almost complete depletion of SPLI from ipsilateral areas A, B, C, and D; it induces decreased SPLI in the area of the lateral spinal nucleus (L), ipsi- or contralaterally in an alternating fashion. Transection of the segmentally related, ipsilateral peripheral nerve induces a marked depletion of SPLI from areas A, B, and C but only a slight decrease in area D and virtually none in the area of L. Whereas a simple crush of the peripheral nerve (axocompression) induces only a slight depletion of SPLI, if any, semiautomatic densitometric analysis of serial immunocytochemical sections proves that a controlled crush injury (axocontusion) results in depletion of SPLI from the upper dorsal horn, similar to transection of the peripheral nerve. Following regeneration of the ipsilateral, segmentally related peripheral nerve, the original immunocytochemical structure of the superficial dorsal horn is re-established by SPLI-positive axonal sprouts originating from previously damaged dorsal root axons.

Cytochemical restoration in the upper dorsal horn after transganglionic degenerative atrophy: temporospatial and fine structural correlates.

Reorganization of synaptic circuitry has been studied in the upper dorsal horn (Lamina II, substantia gelatinosa Rolandi) of the lumbar spinal cord in the adult rat, by means of electron histochemical visualization of thiamine monophosphatase after transganglionic degenerative atrophy. Thiamine monophosphatase, a highly specific and selective marker of Type C (small) dorsal root neurons, was demonstrated at light and electron microscopic levels by means of a Gömöri-type cytochemical reaction, using thiamine monophosphate chloride (Sigma) as substrate and Pb2+ as a capturing agent. Transganglionic degenerative atrophy, induced by a crush injury of the sciatic nerve, results in partial depletion of thiamine monophosphatase from ipsilateral segments L2-S1. The extent of depletion was determined in a complete series of frozen cross-sections, by means of measuring the projections of active and depleted areas and their distances from the midline. Values were fed into a personal computer and maps demonstrating the distribution of intact and impaired areas were generated. The V-shaped area of depletion starts to shrink due to incipient regeneration on the 23rd postoperative day, in caudorostral and mediolateral gradients. Replenishment of thiamine monophosphatase is completed on the 60th postoperative day. Electron microscopic cytochemistry revealed the presence of the thiamine monophosphatase reaction end product in axonal growth cones, filopodia, young axons and their varicous swellings that are transformed into scallopped en passant terminals in the later course of regeneration. Axonal growth cones and regenerating sprouts undergo Wallerian degeneration and simultaneous redepletion of the marker enzyme after transection of dorsal roots L3, L4 and L5. Thiamine monophosphatase, located initially within the axoplasms of regenerating fibers, is successively translocated to the external axolemmal surfaces. Functional maturity of the terminals is achieved only later. The resulting redundant and transient wiring is thinned out in a following maturation period, in a manner resembling the sequence of events in embryonic development. The regenerative potency of central terminals of primary sensory neurons is not restricted to a single regeneration. By repeatedly crushing the sciatic nerve, four successive degenerative-regenerative cycles have been evoked, resulting in replenishment of the marker enzyme thiamine monophosphatase.

Influence of serotonin on progesterone and estradiol secretion of cultured human granulosa cells.

OBJECTIVE: To explore the direct action of serotonin on progesterone (P) and estradiol (E2) secretion of human granulosa cells cultured in serum-free medium. DESIGN: Progesterone and E2 production was measured in the presence and absence of serotonin, propranolol, or cycloheximide using radioimmunoassays; statistical analysis of the data was performed by ANOVA. SETTING: In vitro fertilization and embryo transfer (IVF-ET) for infertility treatment at the University Women's Hospital, University of Tübingen, Germany. PATIENTS, PARTICIPANTS: Fourteen women, 30 +/- 3 years old, undergoing IVF-ET. RESULTS: Serotonin stimulated a dose-related increase in P secretion with a maximal stimulatory effect at 10(-4) M. This response was blocked specifically by the beta-receptor antagonist propranolol (10(-4) M). Estradiol secretion in response to serotonin was dose-independent stimulation, which was highest at 10(-6) M and was inhibited by 10(-4) M propranolol. The protein synthesis inhibitor cycloheximide markedly reduced the stimulatory effect of serotonin on P secretion. Estradiol production in the presence of cycloheximide was significantly reduced; serotonin had no stimulatory effect under these conditions. CONCLUSION: Serotonin may have a physiological role in the corpus hemorrhagicum, when luteinization is initiated.

The mechanism of the inhibitory effect of progesterone on lymphocyte cytotoxicity: II. Relationship between cytotoxicity and the cyclooxygenase pathway of arachidonic acid metabolism.

In the previous paper we have demonstrated that progesterone-treated lymphocytes of healthy pregnant women produce a 34,000 MW protein that inhibits cytotoxic activity and prostaglandin F2 alpha synthesis. Since recently it has been shown that certain leukotrienes have a stimulatory effect on natural killer activity, in this study an attempt was made to determine whether there is a relationship between cytotoxicity and PGF2 alpha synthesis or if alterations in the values of these parameters are independent. Arachidonic acid increased cytotoxic activity of healthy pregnant women's peripheral blood mononuclear cells (PBMC) in a concentration-dependent manner. Exogenous arachidonic acid was able to counteract the blocking effect of the above-mentioned protein produced by progesterone-treated lymphocytes. To determine whether the products of the cyclooxygenase or the lipoxygenase pathway of arachidonic acid metabolism are responsible for increased cytotoxicity, both enzyme systems were blocked separately. Both indomethacin and the lipoxygenase inhibitor BW 755C reduced cytotoxicity in a dose-dependent fashion. However, the lipoxygenase inhibitor prevented prostaglandin synthesis to the same extent, or even more than indomethacin, in all concentrations used; so, its blocking effect cannot be considered as supportive evidence for the role of leukotrienes in cytotoxicity. On the other hand, lipopolysaccharide, with a selective stimulatory effect on prostaglandin synthesis, increased cytotoxicity. Lipopolysaccharide had no effect on progesterone-pretreated PBMC. The above data allow the assumption that besides leukotrienes, cyclooxygenase products may also increase cytotoxicity.

The mechanism of the inhibitory effect of progesterone on lymphocyte cytotoxicity: I. Progesterone-treated lymphocytes release a substance inhibiting cytotoxicity and prostaglandin synthesis.

Progesterone-treated lymphocytes (generator lymphocytes) of healthy pregnant women release a nondialyzable factor that inhibits both cytotoxic activity and prostaglandin F2 alpha synthesis of test lymphocytes. Production of this factor is blocked by protein synthesis inhibitors (cycloheximide and actinomycin D). Sodium dodecylsulfate polyacrylamide electrophoresis of the partially purified material revealed a main 34,000 MW protein band. Progesterone-treated lymphocytes of pregnant women showing clinical symptoms of threatened preterm delivery (risk group) failed to release this substance.

Effects of intracerebroventricular injection of delta sleep-inducing peptide (DSIP) and an analogue on sleep and brain temperature in rats at night.

The effects of ICV injections of DSIP and omega-amino-caprilyl-DSIP (C-DSIP) on the sleep-wake activity and brain temperature (Tbr were studied in rats. The substances (7 nmol/kg) were injected at dark onset, and the sleep-wake activity and Tbr were recorded for 24 hr (dark and light periods, 12 hr each). Relative to the control recordings obtained after artificial CSF injection, the duration of sleep did not increase after either DSIP or C-DSIP. The only significant reaction was an increase of W 6 to 9 hr after the injection of either peptide. The course of Tbr after DSIP and C-DSIP was also identical to that recorded after the injection of artificial CSF. It seems that DSIP administered in a single ICV injection at dark onset does not promote sleep. The increase in W might be attributed to an indirect effect of DSIP or to a degradation product of the peptide.

Structure-activity relationship in the effects of delta-sleep-inducing peptide (DSIP) on rat sleep.

DSIP and its analogues, [D-Trp1]-DSIP, [D-Tyr1]-DSIP, and [D-Trp1]-DSIP1-6, were injected ICV (7 nmol/kg) into rats at dark onset, and the sleep-wake activity was recorded during the 12-hr dark period and the subsequent 12-hr light period. The effects were evaluated with respect to baseline records obtained after artificial CSF injections. DSIP did not increase sleep, whereas both [D-Trp1]-DSIP and [D-Tyr1]-DSIP promoted sleep in the first part of the night. [D-Trp1]-DSIP1-6 had a prompt arousing effect. It is suggested that the sleep-promoting analogues act by facilitating slight endogenous sleep tendencies at some time after dark onset, while DSIP is degraded quickly and is therefore not effective. The increase of W after [D-Trp1]-DSIP1-6 may indicate that DSIP contains a fragment with an arousing effect. The results corroborate the notion that the active DSIP molecule has a pseudo-cyclic structure.

Mapping the distribution of thiamine monophosphatase, fluoride-resistant acid phosphatase, and substance P in the spinal cord with a personal computer compatible program.

Distribution of the marker enzymes fluoride-resistant acid phosphatase (FRAP) and thiamine monophosphatase (TMPase) as well as that of the marker neuropeptide substance P (SP) has been mapped by means of the semi-automatic computer program MUDH, in various experimental conditions, including degeneration, regeneration, and anti-Nerve Growth Hormone treatment of the sciatic nerve. The program is written in standard Pascal language; it is applicable to Commodore 64 and IBM compatible personal computers. Graphical illustration of values obtained in serial sections is a powerful and highly valuable contribution in the analysis of various biodynamic reactions related to transganglionic regulation of primary sensory neurons.

Induced priapism and its management.

The authors present the seamy side of the beneficial practice to handle erectile impotence with papaverine or with the papaverine-Regitin combination. Attention is called to danger. The various forms of priapism are defined. In connection with 72 cases of priapism the attained results and the way to stop the priapic condition are described.

Dynamic cavernosography as a means to test coital impotence.

In our days the radiologic examination method of dynamic cavernosography is still in the state of infancy but has already passed the test as an indispensable means to locate the site of a venous leak and to diagnose other pathologic penile conditions. Its field of application covers penile fracture, the extension of induratio penis plastica, the degree of fibrosis in the postpriapic state, the testing of tumour penetration. The method being invasive it is important to apply it in the proper diagnostic order, as soon as clear proof has been furnished that the potency disorder is not due to impaired reflex activity, has not developed on a psychic background and the Doppler test has revealed normal arterial flow conditions.

Papaverine-induced erection.

Sixty-one patients suffering from impotentia coeundi were treated with local dosages of papaverine hydrochloride, injected into the corpus cavernosum. In patients with neurogenic, psychogenic or a mild form of vascular disorders the injection induced erections which lasted on from 20 minutes to between 4 and 5 hours. Sixteen volunteers who were taught to self-administer the solution, injected the preadjusted dosage into the corpus cavernosum each time before the intended sexual act.

Surgical treatment of impotence due to venous outflow.

Coital impotence was studied in 94 patients. In 14 of them the history, as well as the papaverine-induced erection, penile Doppler test and dynamic cavernosography suggested venous outflow as a basic process. In 13 who underwent surgery, the draining vein visualized by dynamic cavernosography was tied down. Seven patients now have spontaneous erection, four present it upon intravenous papaverine injection. Two operations failed: one for an existent spongiocavernous fistula, the other for the development of collateral circulation in the early phase.

Diagnostic accuracy of lymphangiography in the demonstration of histologically verified retroperitoneal lymph node metastases of testicular tumours.

Bipedal lymphangiography was performed in 101 cases of testicular tumour for the detection of retroperitoneal lymph node deposits. The lymphangiograms of 51 patients have been checked against the results of microscopic study of lymphadenectomy specimens. The radiogram was false-positive in 3, false-negative in 7 cases. The lymphangiographic diagnosis was accurate in 81 per cent of the cases. The other diagnostic possibilities--computerized tomography, ultrasonography, isotope lymphangiography--are also discussed. The main advantage of bipedal lymphangiography is to provide information on the structures of the lymph nodes and on the lymphatic channels as well. Combination of several diagnostic methods provides for a high accuracy of staging.

[Management of drug-induced priapism]. / Gyógyszer indukálta priapismus kezelése.

The authors demonstrate the management of erectile impotence by using Papaverin or the combination of Papaverin-Regitin and its overdosing. The overdosing should be put in mind when using these drugs. The authors also demonstrate three types of priapisms. In according to the management of 72 cases priapism, the authors are advising the irrigation of the corpus cavernosum with Dopamin after punction.