Genetic-Quantitative Study of the First-Service Pregnancy Probability of Murrah Heifers.

Because of the importance of reproduction in stock breeding systems, it is necessary to find selection criteria that increase reproductive efficiency. The aim of this study was to estimate genetic parameters for the probability of conception on first service (PROB) in Murrah heifers, and its association with other traits of economic interest [age at first calving (AFC), service period, calving interval and milk yield at 270 days], with the purpose of evaluating their use as selection criteria. Reproductive information and first lactation records of 1200 Murrah heifers were used to perform two-trait analyses between PROB and the other characteristics. Bayesian inference was used to estimate the variance components, considering PROB as threshold and the other as linear factors. The results demonstrate that this trait has heritability of 0.15, indicating the possibility of a genetic gain by using it for selection. With respect to the genetic correlation estimates, the only high-magnitude association was with AFC (-0.899), which is the current criterion indicating sexual precocity of females. In the light of the parameters estimated, the first-service pregnancy rate is an alternative for indication of sexual precocity, although presenting a smaller genetic gain than the current standard AFC. Nevertheless, additional research should be conducted regarding this trait to assess the economic importance of its use in dairy buffalo production systems.

Efficacy of a single intramuscular injection of porcine FSH in hyaluronan prior to ovum pick-up in Holstein cattle.

Plasma FSH profiles, in vitro embryo production (IVP) after ovum pickup (OPU), and establishment of pregnancy with IVP embryos were compared in untreated Holstein oocyte donors and those superstimulated with multiple injections or a single intramuscular (IM) injection of porcine FSH (pFSH) in hyaluronan (HA). Plasma FSH profiles were determined in 23 heifers randomly allocated to one of four groups. Controls received no treatment, whereas the F200 group received 200 mg of pFSH in four doses, 12 hours apart. The F200HA and F300HA groups received 200- or 300-mg pFSH in 5 mL or 7.5 mL, respectively of a 0.5% HA solution by a single IM injection. Plasma FSH levels were determined before the first pFSH treatment and every 6 hours over 96 hours. All data were analyzed by orthogonal contrasts. Circulating FSH area under curve (AUC) in pFSH-treated animals was greater than that in the control group (P = 0.02). Although the AUC did not differ among FSH-treated groups (P = 0.56), the total period with elevated plasma FSH was greater in the F200 group than in the HA groups (P < 0.0001). However, the F300HA group had a greater AUC than the F200HA group (P = 0.006), with a similar total period with elevated plasma FSH (P = 0.17). The IVP was performed in 90 nonlactating Holstein cows randomly allocated to one of the four treatment groups as in the first experiment. A greater proportion of medium-sized (6-10 mm) follicles was observed in cows receiving pFSH, regardless of the treatment group (P < 0.0001). Also, numbers of follicles (P = 0.01), cumulus-oocyte complexes (COCs) retrieved (P = 0.01) and matured (P = 0.02), cleavage rates (P = 0.002), and blastocysts produced per OPU session (P = 0.06) were greater in cows receiving pFSH, regardless of the treatment group. Cows in the F200HA group had a greater recovery rate (P = 0.009), number of COCs cultured (P = 0.04), and blastocysts produced per OPU session (P = 0.06) than cows in the F300HA group. Similar pregnancy rates were observed 50 to 60 days after transferring IVP embryos from donors in the different treatment groups (P > 0.05). In conclusion, a single IM injection of pFSH combined in 0.5% HA resulted in similar plasma FSH profiles as twice-daily pFSH treatments. Treatment of nonlactating donors with pFSH, with or without HA, resulted in increased IVP over untreated controls. A single dose of 200 mg of pFSH in 0.5% HA resulted in greater IVP than 300-mg pFSH in HA. Finally, pregnancy rates with IVP embryos were similar, regardless donor treatment.

Management of a late-presenting complex--an unclassified uterine anomaly in the presence of large leiomyomas.

This is a case report of a unique, late-presenting, Müllerian anomaly in an infertile patient. The authors discuss the diagnostic challenges of characterizing distorted gynecological anatomy by Müllerian anomalies in the presence of sizeable coexisting fibroids. This case report adds new insight to the already-existing understanding of Müllerian anomalies by demonstrating how a symptomatic and benign uterine pathology can complicate the diagnosis and management of patients with Müllerian defects.

Evaluación de la efectividad del colirio de suero autólogo en el tratamiento de patologías oculares / Effectiveness of 100% autologous serum drops in ocular surface disorders

Objetivo: Evaluar la efectividad del tratamiento con colirio de suero autólogo al 100% en pacientes con diversas patologías oculares. Métodos Estudio descriptivo, observacional, prospectivo de mayo de 2005 a febrero de 2009. La población del estudio fueron los pacientes que iniciaron tratamiento con colirio de suero autólogo al 100% elaborado en dosis unitarias. Para la evaluación de la efectividad del estudio se valoraron la desaparición o la mejoría de la sintomatología ocular en los pacientes mediante un cuestionario sobre los signos y los síntomas apreciados por el paciente al inicio y al final del tratamiento. Resultados Se evaluó a un total de 15 pacientes (24 ojos). Los síntomas, como el ojo rojo, el ardor o la quemazón, los pinchazos y la pesadez de los ojos, mejoraron en el 100% de los pacientes que los sufrían, mientras que la sensación del ojo seco y la arenilla mejoraron en el 92% de los casos. Para el 66,7% de los pacientes evaluados la mejoría en los síntomas justificó la incomodidad por la extracción de sangre. Con respecto a la tolerancia del colirio al 100%, solo un paciente presentó alguna molestia relacionada con la instilación del colirio. Conclusión La utilización de colirio de suero autólogo al 100% se asoció a una mejoría de la sintomatología ocular en la mayoría de los pacientes evaluados(AU)

Objective: To evaluate the effectiveness of 100% autologous serum eye drops for the treatment of various ocular surface disorders. Methods: A descriptive prospective observational study carried out from May 2005 to February2009 which included patients with ocular surface disorders treated with single-dose autologous serum eye drops. Treatment effectiveness was evaluated by using a clinical questionnaire inorder to assess symptoms experienced by patients at the beginning and end of treatment. Results: A total of 15 patients (24 eyes) were evaluated. Clinical symptoms such as redness, burning, sharp pain and tired eyes improved in 100% of the patients, whereas dryness and sandy/gritty sensation improved in 92% of the patients. The overall improvement of clinical symptoms was worth the inconvenience of venipuncture according to 66.7% of the patients. Regarding tolerance for autologous serum eye drops, only one patient experienced some discomfort when using the single-dose eye drops. Conclusion: The treatment with 100% autologous serum eye drops improved ocular symptoms for most patients (AU)

Effectiveness of 100% autologous serum drops in ocular surface disorders.

OBJECTIVE: To evaluate the effectiveness of 100% autologous serum eye drops for the treatment of various ocular surface disorders. METHODS: A descriptive prospective observational study carried out from May 2005 to February 2009 which included patients with ocular surface disorders treated with single-dose autologous serum eye drops. Treatment effectiveness was evaluated by using a clinical questionnaire in order to assess symptoms experienced by patients at the beginning and end of treatment. RESULTS: A total of 15 patients (24 eyes) were evaluated. Clinical symptoms such as redness, burning, sharp pain and tired eyes improved in 100% of the patients, whereas dryness and sandy/gritty sensation improved in 92% of the patients. The overall improvement of clinical symptoms was worth the inconvenience of venipuncture according to 66.7% of the patients. Regarding tolerance for autologous serum eye drops, only one patient experienced some discomfort when using the single-dose eye drops. CONCLUSION: The treatment with 100% autologous serum eye drops improved ocular symptoms for most patients.

Do computed tomography and magnetic resonance imaging add to temporomandibular joint disorder treatment? A systematic review of diagnostic efficacy.

A question frequently asked in the clinical practice of the professional who treats temporomandibular joint disorders (TMJD) is 'To make the cost/benefit ratio worthwhile for the patient, when should I request a temporomandibular joint (TMJ) computed tomography (CT) or magnetic resonance imaging (MRI)?' To evaluate the evidence of the efficacy of CT and MRI in the diagnosis of disc displacement, local inflammatory disorders, and arthrosis of the TMJ at therapeutic efficacy level, PubMed and Cochrane literature searches with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, three examiners selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a previously established protocol. Publications considered relevant were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and publications that critically evaluate systematic reviews. The literature search yielded 584 titles and abstracts, of which 257 were selected and read in full text. One study was judged relevant. This study evaluated evidence of the efficacy of MRI in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy. In conclusion, the absence of studies on the therapeutic efficacy of MRI and CT on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.

Patients with coronary stenosis and a fractional flow reserve of ≥0.75 measured in daily practice at the VU University Medical Center.

Objectives. The aim of this study was to analyse the rate of major adverse clinical events in patients with coronary artery disease and a fractional flow reserve (FFR) of ≥0.75 and deferred for coronary intervention in daily practice. Methods. From 1 January to 31 December 2006, FFR measurement was initiated in 122 patients (5%) out of 2444 patients referred for coronary angiography. In two patients FFR measurement failed and in one patient the FFR value could no longer be traced in the documents. Thus, 119 patients (84 men, 64 years, range 41-85) were included in the evaluation (145 lesions). Major adverse clinical events (death, myocardial infarction, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG)) and the presence of angina were evaluated at follow-up. Furthermore a cost-effectiveness analysis was performed.Results. In 93 patients (76%) the FFR value was ≥0.75. Seventy of these 93 patients (76%) were treated with medication alone or underwent PCI for a different lesion (medical treatment group). Average duration of follow-up of all 119 patients was 22 months (range 4 days to 30 months). In the medical treatment group seven patients (10%) experienced a major adverse clinical event related to the FFR-evaluated lesion during follow-up. In this study population, the use of FFR measurement is cost-reducing provided that at least 65% of the patients in the medical treatment group has had a PCI with stent implantation when the use of FFR measurement is impossible. In this case, the decision to use PCI with stent implantation is purely based on the angiogram. Conclusions. In patients with a coronary stenosis based on visual assessment and an FFR of ≥0.75 deferral of PCI or CABG is safe in daily clinical practice and saves money. (Neth Heart J 2010;18:402-7.).

The immunomodulator glatiramer acetate influences spinal motoneuron plasticity during the course of multiple sclerosis in an animal model.

The immunomodulador glatiramer acetate (GA) has been shown to significantly reduce the severity of symptoms during the course of multiple sclerosis and in its animal model--experimental autoimmune encephalomyelitis (EAE). Since GA may influence the response of non-neuronal cells in the spinal cord, it is possible that, to some extent, this drug affects the synaptic changes induced during the exacerbation of EAE. In the present study, we investigated whether GA has a positive influence on the loss of inputs to the motoneurons during the course of EAE in rats. Lewis rats were subjected to EAE associated with GA or placebo treatment. The animals were sacrificed after 15 days of treatment and the spinal cords processed for immunohistochemical analysis and transmission electron microscopy. A correlation between the synaptic changes and glial activation was obtained by performing labeling of synaptophysin and glial fibrillary acidic protein using immunohistochemical analysis. Ultrastructural analysis of the terminals apposed to alpha motoneurons was also performed by electron transmission microscopy. Interestingly, although the GA treatment preserved synaptophysin labeling, it did not significantly reduce the glial reaction, indicating that inflammatory activity was still present. Also, ultrastructural analysis showed that GA treatment significantly prevented retraction of both F and S type terminals compared to placebo. The present results indicate that the immunomodulator GA has an influence on the stability of nerve terminals in the spinal cord, which in turn may contribute to its neuroprotective effects during the course of multiple sclerosis.

The immunomodulator glatiramer acetate influences spinal motoneuron plasticity during the course of multiple sclerosis in an animal model

The immunomodulador glatiramer acetate (GA) has been shown to significantly reduce the severity of symptoms during the course of multiple sclerosis and in its animal model - experimental autoimmune encephalomyelitis (EAE). Since GA may influence the response of non-neuronal cells in the spinal cord, it is possible that, to some extent, this drug affects the synaptic changes induced during the exacerbation of EAE. In the present study, we investigated whether GA has a positive influence on the loss of inputs to the motoneurons during the course of EAE in rats. Lewis rats were subjected to EAE associated with GA or placebo treatment. The animals were sacrificed after 15 days of treatment and the spinal cords processed for immunohistochemical analysis and transmission electron microscopy. A correlation between the synaptic changes and glial activation was obtained by performing labeling of synaptophysin and glial fibrillary acidic protein using immunohistochemical analysis. Ultrastructural analysis of the terminals apposed to alpha motoneurons was also performed by electron transmission microscopy. Interestingly, although the GA treatment preserved synaptophysin labeling, it did not significantly reduce the glial reaction, indicating that inflammatory activity was still present. Also, ultrastructural analysis showed that GA treatment significantly prevented retraction of both F and S type terminals compared to placebo. The present results indicate that the immunomodulator GA has an influence on the stability of nerve terminals in the spinal cord, which in turn may contribute to its neuroprotective effects during the course of multiple sclerosis.

Characteristics of the flow velocity-pressure gradient relation in the assessment of stenoses: an in vitro study.

OBJECTIVES: The flow velocity-pressure gradient (v-dp) relation is clinically used to assess coronary stenoses. This in vitro study aimed to investigate the ability to determine the impact of each individual stenosis in the setting of two consecutive stenoses, the effect of variable stenosis reference diameters and the impact of one or two wires in a stenosis, on the v-dp relation. METHODS: The model consisted of a reservoir and different sized tubes and stenoses. Pressure gradient and flow velocity were assessed with a pressure and a Doppler wire. By plotting flow velocity and pressure gradient on an X-Y plot, the v-dp relation was determined. RESULTS: The v-dp relation of a proximal stenosis was not influenced by a distal stenosis. The diameter of the segment where flow velocity was measured influenced the v-dp relation. This could be corrected by substituting flow velocity with volume flow. The presence of one or two wires in a stenosis made the v-dp relation substantially steeper. CONCLUSIONS: The v-dp relation can be used to determine the significance of each individual stenosis in arteries with consecutive stenoses, provided that the distance between the stenoses is large enough. The diameter of the segment where flow velocity is measured and the presence of one or two wires substantially affect the v-dp relation. (Neth Heart J 2008;16:156-62.).

Right ventricular contractility in systemic sclerosis-associated and idiopathic pulmonary arterial hypertension.

Since systemic sclerosis (SSc) also involves the heart, the aim of the present study was to evaluate possible differences in right ventricular (RV) pump function between SSc-associated pulmonary arterial hypertension (PAH; SScPAH) and idiopathic PAH (IPAH). In 13 limited cutaneous SScPAH and 17 IPAH patients, RV pump function was described using the pump function graph, which relates mean RV pressure ((RV)) and stroke volume index (SVI). Differences in pump function result in shift or rotation of the pump function graph. (RV) and SVI were measured using standard catheterisation. The hypothetical isovolumic (RV) ((RV,iso)) was estimated using a single-beat method. The pump function graph was approximated by a parabola: (RV) = (RV,iso)[1-(SVI/SVI(max))(2)], where SVI(max )is the hypothetical maximal SVI at zero (RV), enabling calculation of SVI(max). There were no differences in SVI and SVI(max). Both (RV) and (RV,iso) were significantly lower in SScPAH than in IPAH ((RV) 30.7+/-8.5 versus 41.2+/-9.4 mmHg; (RV,iso) 43.1+/-12.4 versus 53.5+/-10.0 mmHg). Since higher pressures were found at similar SVI, the difference in the pump function graph results from lower contractility in SScPAH than in IPAH. Right ventricular contractility is lower in systemic sclerosis-associated pulmonary arterial hypertension than in idiopathic pulmonary arterial hypertension.

Spinal motoneuron synaptic plasticity during the course of an animal model of multiple sclerosis.

During the course of experimental autoimmune encephalomyelitis, a massive loss of motor and sensitive function occurs, which has been classically attributed to the demyelination process. In rats, the clinical signs disappear within 5 days following complete tetraplegia, indicating that demyelination might not be the only cause for the rapid evolution of the disease. The present work investigated the occurrence of experimental autoimmune encephalomyelitis-induced changes of the synaptic covering of spinal motoneurons during exacerbation and after remission. The terminals were typed with transmission electron microscopy as C-, F- and S-type. Immunohistochemical analysis of synaptophysin, glial fibrillary acidic protein and the microglia/macrophage marker F4/80 were also used in order to draw a correlation between the synaptic changes and the glial reaction. The ultrastructural analysis showed that, during exacerbation, there was a strong retraction of both F- and S-type terminals. In this sense, both the covering as well as the length of the remaining terminals suffered great reductions. However, the retracted terminals rapidly returned to apposition, although the mean length remained shorter. A certain level of sprouting may have occurred as, after remission, the number of F-terminals was greater than in the control group. The immunohistochemical analysis showed that the peak of synaptic loss was coincident with an increased macro- and microglial reaction. Our results suggest that the major changes occurring in the spinal cord network during the time course of the disease may contribute significantly to the origin of the clinical signs as well as help to explain their rapid recovery.

[Diagnosis of pulmonary hypertension: experiences with 187 patients referred to the VU Medical Center]. / Diagnostiek van pulmonale hypertensie: ervaringen bij 187 patiënten verwezen naar het VU Medisch Centrum.

OBJECTIVE: To describe the results of a multidisciplinary diagnostic protocol in patients referred due to suspected pulmonary hypertension. DESIGN: Descriptive. METHOD: In 187 patients who were referred to the VU Medical Centre, Amsterdam, the Netherlands, between May 1998 and February 2003, due to suspected pulmonary hypertension, the diagnosis was established by means of a multidisciplinary diagnostic protocol. The referral and final diagnoses were analysed, as well as the treatment the patients had received. RESULTS: In 56 patients (30%), the application of the protocol lead to a modification of the diagnosis; 16 patients (9%) were found not to have pulmonary hypertension; in 20 of the 89 patients referred with 'primary pulmonary hypertension' (48% of all referrals), an underlying disease was still identified: 6 cases of a connective tissue disease, 5 cases of a chronic thromboembolic process, 5 cases of a condition of the left heart, and 4 cases of an atrial septal defect. CONCLUSION: The diagnosis 'primary pulmonary hypertension' can only be made once all secondary types of the disease have been ruled out. The application of a multidisciplinary diagnostic protocol together with a contribution of specialists with specific expertise can help to adjust the initial diagnosis and sometimes even reject it.

A review of pulmonary arterial hypertension: Part 1. Novel insights and classification.

Pulmonary arterial hypertension (PAH) is a disease characterised by an increased pulmonary artery pressure. The precapillary pulmonary arteries show distinct pathobiological changes, i.e. medial hypertrophy, intimal fibrosis, microthrombi and plexiform lesions. Although the pathogenesis is not completely understood, pulmonary vascular proliferation and remodelling, due to a variety of mediators, is believed to play the pathogenetic key role. Genetic research reveals molecular deformities and gene mutations associated with phenotypic PAH. This article covers novel insights into pathobiology, pathogenesis and genes of PAH, which led to a novel classification system and a diagnostic work-up, emanated from the World Health Organisation Symposium on Pulmonary Hypertension in Venice in June 2003.

A review of pulmonary arterial hypertension: Part 2: Current and expected treatments.

Medical therapy for pulmonary arterial hypertension (PAH) focuses on pulmonary vascular remodelling and smooth muscle cell proliferation. This article covers the drugs which are approved or are in sight and the evidence-based treatment strategies that target the different pathobiological pathways, emanated from the World Health Organisation Symposium on Pulmonary Hypertension in Venice, June 2003. In addition we briefly look at the 'Venice consensus' on surgical treatment. In the past five and a half years more than 360 patients were seen for pulmonary hypertension in the Free University Medical Centre (VUmc). Present-day treatment, research studies and novel treatment strategies in the VUmc will be reviewed. Future treatments will be on the basis of insights into pathobiology, pathogenesis and genes in PAH and should focus on drug combinations, which theoretically target different or similar pathobiological pathways.

Comparative proteomics to establish genetic relationships in the Brassicaceae family.

The comparisons of the same proteome (aerial part of etiolated seedlings) in different species and genus of the plant family Brassicaceae (cabbages, mustards, rapes, radishes and Arabidopsis) was undertaken to establish genetic proximities between them. Genetic distances were calculated on the basis of common and distinct spots. The construction of phenetic trees and factorial correspondence analysis that were performed are in very good agreement with our actual knowledge of the taxonomy of the Brassicaceae. The position of the tetraploids, for instance, is in between the positions of their constitutive genome donor representatives. Comparative proteomics may be helpful to shorten the transfer between model and agronomic target species.