Associations of anthropometry and lifestyle factors with HDL subspecies according to apolipoprotein C-III.

The presence of apoC-III on HDL impairs HDL's inverse association with coronary heart disease (CHD). Little is known about modifiable factors explaining variation in HDL subspecies defined according to apoC-III. The aim was to investigate cross-sectional associations of anthropometry and lifestyle with HDL subspecies in 3,631 participants from the Diet, Cancer, and Health study originally selected for a case-cohort study (36% women; age 50-65 years) who were all free of CHD. Greater adiposity and less activity were associated with higher HDL containing apoC-III and lower HDL lacking apoC-III. Per each 15 cm higher waist circumference, the level of HDL containing apoC-III was 2.8% higher (95% CI: 0.4, 5.3; P = 0.024) and the level of HDL not containing apoC-III was 4.7% lower (95% CI: -6.0, -3.4; P = <0.0001). Associations for physical activity were most robust to multivariable modeling. Each 20 metabolic equivalent task hours per week reported higher physical activity was associated with 0.9% (95% CI: -1.7, -0.1; P = 0.031) lower HDL containing apoC-III and 0.5% higher (95% CI: 0.1, 1.0; P = 0.029) HDL lacking apoC-III. Lower alcohol consumption was associated with lower HDL lacking apoC-III (percent difference per 15 g/day: 1.58 (95% CI: 0.84, 2.32; P = <0.0001). Adiposity and sedentary lifestyle were associated with a less favorable HDL subspecies profile.

A new method for analysis of non-pregnant uterine peristalsis using transvaginal ultrasound.

OBJECTIVES: To develop an objective method for analysis of uterine peristalsis using transvaginal sonography (TVS). METHODS: We performed computerized analysis of 2-5-min video recordings of TVS imaging of a midsagittal cross-section of the uterus during the proliferative and early secretory phases of 18 healthy volunteers aged 28-41 years. The contours of the fluid-endometrial interface (FEI) and the endometrium-myometrium interface (EMI) were detected in each frame, and the data from all frames were used to explore the dynamic motility characteristics of these interfaces at fixed distances from the fundus. RESULTS: The mean ± SD dominant frequency of peristalsis of the EMI along the midsagittal cross-section was 0.049 ± 0.01 Hz and that of the cavity center was 0.043 ± 0.02 Hz. The maximal amplitudes of the EMI were about 1 ± 0.25 mm, located between 7 and 17 mm from the fundus. The amplitudes of the FEI were in the range 0.05-0.2 mm. The amplitude of the cavity centerline movement was 0.94 ± 0.34 mm, located at the extremes of the unperturbed curve. CONCLUSIONS: This study provides a simple tool for analysis of uterine peristalsis characteristics using ultrasound data. This is possible at the EMI even when the FEI is invisible or incomplete, such as during the luteal phase, when an intrauterine contraceptive device is in place, and during diagnostic or medical intervention.

Prospective swallowing outcomes after IMRT for oropharyngeal cancer: Dosimetric correlations in a population-based cohort.

OBJECTIVES: To identify dose constraints to preserve swallowing after head and neck (H&N) radiotherapy using prospectively collected functional outcomes. MATERIALS AND METHODS: Stage III-IV oropharyngeal cancer patients were prospectively evaluated using the Royal Brisbane Hospital Outcome Measure for Swallowing and Performance Status Scale for H&N Cancer Patients at pre-treatment and 3, 6, 12, and 24months after intensity-modulated radiotherapy. Dosimetric parameters were correlated with swallowing function. RESULTS: Ninety-six patients were evaluated with median follow-up of 14.1months (interquartile range 9.9-26.3). Six patients (8.3%) remained feeding tube (FT) dependent at 12months. At 2years, 32.6% tolerated a normal diet without restrictions. Mean doses of 55Gy to supraglottic larynx, 44Gy to glottic larynx, 48Gy to cricopharyngeus, and 44Gy to esophageal inlet were associated with >25% risk of FT dependence at 6months. CONCLUSION: Higher mean doses to the larynx and pharyngo-esophageal junction were associated with longer duration of FT dependence and dietary restrictions.

Endoscopic extraction of an ejaculatory duct calculus to treat obstructive azoospermia.

Calculous obstruction of an ejaculatory duct is an uncommon cause of azoospermia or low-volume oligospermia in the infertile man. We report the case of a 32-year-old man with azoospermia, low ejaculate volume, and transrectal ultrosonography (TRUS) findings of bilateral seminal vesicle distention. On cystoscopy for planned transurethral resection of the ejaculatory ducts, a calculus obstructing the right ejaculatory duct at the verumontanum was discovered and removed. Three months later, semen analysis showed improvements in volume, sperm concentration, and sperm motility. An ejaculatory duct calculus should be included in the differential diagnosis of obstructive azoospermia or low-volume oligospermia. Magnetic resonance imaging or TRUS may be advisable to identify ductal calculi.

In vitro simulation of placental transport: part I. Biological model of the placental barrier.

INTRODUCTION: The placental barrier (PB) is the thin biological membrane made of endothelial cells (EC), trophoblast cells (TC) and basal membrane that separates between maternal and fetal blood circulations within the placenta and facilitates feto-maternal transport characteristics, which are not completely understood. METHODS: An in vitro biological model of the PB model was co-cultured of human TC (HTR8) and human umbilical vein EC (HUVEC) on both sides of a denuded amniotic membrane (AM) using custom designed wells. RESULTS: Confocal and transmission electron microscopy (TEM) imaging confirmed the morphology expressions of human EC and TC. Further support on the integrity of the new PB model was obtained from the existence of tight junctions and permeability experiments with fluorescence markers of small and large molecules. The monolayer of EC demonstrated the limiting layer for the transport resistance across this complex barrier. DISCUSSION AND CONCLUSION: This new in vitro viable model mimics the architecture of the human PB and can be used in in vitro simulations of transplacental transport studies.

Anthropometry of fetal vasculature in the chorionic plate.

Normal fetal development is dependent on adequate placental blood perfusion. The functional role of the placenta takes place mainly in the capillary system; however, ultrasound imaging of fetal blood flow is commonly performed on the umbilical artery, or on its first branches over the chorionic plate. The objective of this study was to evaluate the structural organization of the feto-placental vasculature of the chorionic plate. Casting of the placental vasculature was performed on 15 full-term placentas using a dental polymer mixed with colored ink. Observations of the cast models revealed that the branching architecture of the chorionic vessel is a combination of dichotomous and monopodial patterns, where the first two to three generations are always of a dichotomous nature. Analysis of the daughter-to-mother diameter ratios in the chorionic vessels provided a maximum in the range of 0.6-0.8 for the dichotomous branches, whereas in monopodial branches it was in the range of 0.1-0.3. Similar to previous studies, this study reveals that the vasculature architecture is mostly monopodial for the marginal cord insertion and mostly dichotomous for the central insertion. The more marginal the umbilical cord insertion is on the chorionic plate, the more monopodial branching patterns are created to compensate the dichotomous pattern deficiency to perfuse peripheral placental territories.

Extraintestinal pathogenic Escherichia coli-induced acute necrotizing pneumonia in cats.

Extraintestinal pathogenic Escherichia coli (ExPEC) are pathogens involved in several disease conditions, ranging from urinary tract infection to meningitis in humans and animals. They comprise epidemiologically and phylogenetically distinct strains, affecting most species and involving any organ or anatomical site. Here, we report fatal cases of necrotizing pneumonia in cats. Over a 1-week period, 13 cats from an animal shelter in Stamford, Connecticut were presented for necropsy. All had a clinical history of acute respiratory disease. The gross and microscopic findings for all the cats were consistent. Escherichia coli was uniformly isolated from the lungs of all the tested cats. All the isolates were haemolytic, genetically related as determined by enterobacterial repetitive intergenic consensus PCR, and harboured genes encoding for cytotoxic necrotizing factor-1 and fimbriae and adhesions that are characteristic of ExPEC, implying a point source clonal outbreak. As cats are common household pets, this report raises concerns regarding zoonotic potential (in either direction) for these ExPEC strains.

Obliterated urethra: holmium:yttrium-aluminum-garnet cut-to-light with urolume stenting.

Antegrade-retrograde urethrotomy, or the cut-to-light procedure, performed for obliterated urethra is associated with a high rate of recurrence of urethra] stricture. With the goal of reducing the stricture recurrence rate, we performed a modified cut-to-light procedure using a holmium:yttrium-aluminum-garnet laser and UroLume stenting in a 76-year-old man with urethral obliteration.