BACKGROUND & AIMS: Elderly patients with malignant glioma have a poor prognosis and the benefit of standard radical radiotherapy is equivocal. Twenty-two percent of the adult referral base with malignant glioma at our centre is of age 70 years or greater. A phase II study was undertaken to determine if a shorter course of therapy yields a comparable median survival to radical radiotherapy and thus constitutes an appropriate investigational palliative regimen. 25 patients were accrued between 1988-1995, all of whom had histologically proven malignant glioma, 23 glioblastoma multiforme and 2 anaplastic astrocytoma. The median age was 73 (range 70-78) and median Karnofsky Performance Status (KPS) was 70.40% had a stereotactic biopsy only for diagnosis. Radiotherapy was delivered to limited fields to a dose of 37.5 Gy in 15 daily fractions over 3 weeks. An intention-to-treat analysis was undertaken with survival determined from date of initial consultation. The median survival of the whole group was 8.0 months (95% CI 4.8-9.6). Patients with good performance status (KPS > 70) had a median survival of 10.4 months (95% CI 9.6-14.7). 37.5 Gy in 15 daily fractions appears to yield comparable median survival to that of other series of radical radiotherapy. A phase III study of this regimen is recommended in investigating optimal palliation of elderly malignant glioma patients.

背景与目标： 老年恶性神经胶质瘤患者的预后较差，标准的根治性放疗的益处是模棱两可的。在我们中心，患有恶性神经胶质瘤的成人转诊基地中有22% 的年龄在70岁或以上。进行了一项II期研究，以确定较短的疗程是否可以产生与根治性放疗相当的中位生存期，从而构成适当的研究性姑息治疗方案。在1988-1995之间累积了25例患者，所有这些患者均经组织学证实为恶性神经胶质瘤，23例多形性胶质母细胞瘤和2例间变性星形细胞瘤。中位年龄为73岁 (范围70-78)，中位Karnofsky表现状态 (KPS) 70.40% 仅用于诊断的立体定向活检。在3周内，将放射疗法递送到有限的区域，剂量为37.5 Gy，每天15次。进行了意向性治疗分析，从初次咨询之日起确定生存率。全组的中位生存期为8.0个月 (95% CI 4.8-9.6)。表现良好的患者 (KPS > 70) 的中位生存期为10.4个月 (95% CI 9.6-14.7)。在15个每日分数中37.5 Gy似乎产生与其他系列的根治性放疗相当的中位生存期。建议对该方案进行III期研究，以研究老年恶性神经胶质瘤患者的最佳姑息治疗。

BACKGROUND & AIMS: :The primary objectives of this study were to follow the temporal patterns of testicular LH and FSH receptor (LH-R and FSH-R) concentrations and affinity (Ka) during sexual maturation in bulls and to see if such patterns could help explain the control of rapid testicular growth that occurs after 25 weeks of age, when serum gonadotropin concentrations are low. Separate groups of Hereford x Charolais calves (n = 6) were castrated every 4 weeks from 5 to 33 weeks of age and at 56 weeks of age. A week prior to castrations, from 5 to 33 weeks of age, blood was collected every 15 min for 10 h. The transition from indifferent supporting cells to Sertoli cells in seminiferous tubules was rapid between 13 and 25 weeks and rapid testis growth occurred after 25 weeks of age. Serum LH and FSH concentrations were transiently elevated at 12 weeks of age (P < 0.05). LH-R concentrations decreased from 13 to 25 weeks of age and increased to 56 weeks of age (P < 0.05). LH-RKa decreased from 9 to 17 weeks of age, increased to 29 weeks of age and declined to 33 weeks of age (P < 0.05). FSH-R concentrations declined from 17 to 25 weeks of age then increased to 56 weeks of age (P < 0.05). FSH-RKa increased from 17 to 25 weeks of age (P < 0.05). High concentrations of gonadotropins and their receptors may be critical to initiate testis growth postnatally and support it after 25 weeks of age in the face of low serum gonadotropin concentrations.

背景与目标： : 这项研究的主要目的是跟踪公牛性成熟过程中睾丸LH和FSH受体 (lh-r和fsh-r) 浓度和亲和力 (Ka) 的时间模式，并观察这种模式是否有助于解释25周龄后睾丸快速生长的控制,当血清促性腺激素浓度较低时。从5到33周龄和56周龄，每4周对不同的Hereford x Charolais小牛 (n = 6) 进行cast割。阉割前一周，从5到33周龄，每15分钟收集一次血液，持续10小时。在13至25周之间，生精小管中从冷漠的支持细胞向Sertoli细胞的过渡迅速，并且在25周龄后睾丸迅速生长。血清LH和FSH浓度在12周龄时短暂升高 (P <0.05)。Lh-r浓度从13至25周龄降低，并增加至56周龄 (P <0.05)。Lh-rka从9周龄下降到17周龄，增加到29周龄，下降到33周龄 (P <0.05)。Fsh-r浓度从17至25周龄下降，然后增加至56周龄 (P <0.05)。Fsh-rka从17周增加到25周龄 (P <0.05)。面对低血清促性腺激素浓度，高浓度的促性腺激素及其受体对于启动出生后睾丸生长并在25周龄后支持睾丸生长可能至关重要。

BACKGROUND & AIMS: The effect of nutritional status on IGF-I mRNA expression in the liver and brain of juvenile barramundi (Lates calcarifer) was investigated. Fish were either fed a satiety ration (SAT) or starved (STV) for 6 weeks. Starved fish demonstrated significantly lower condition factor and hepatic IGF-I mRNA expression at 3 and 6 weeks, when compared with the SAT group. IGF-I mRNA expression in the brain was 10 fold lower than the liver and was not affected by ration size. These results suggest the liver is the major site of IGF-I mRNA synthesis and hepatic but not brain IGF-I mRNA expression is regulated by food availability in juvenile barramundi.

背景与目标： 研究了营养状况对幼年barramundi (Lates calcarifer) 肝脏和大脑中igf-i mRNA表达的影响。对鱼喂食饱腹感 (SAT) 或饥饿 (STV) 6周。与SAT组相比，饥饿的鱼在3周和6周时表现出明显较低的条件因子和肝igf-i mRNA表达。大脑中igf-i mRNA的表达比肝脏低10倍，不受日粮大小的影响。这些结果表明，肝脏是igf-i mRNA合成的主要部位，而肝脏而不是大脑igf-i mRNA的表达受幼年barramundi食物的调节。

BACKGROUND & AIMS: OBJECTIVE:In the absence of immunodeficiency, only microchimerism (<0.1%) has been achieved in human fetal recipients or nonhuman primates following in utero hematopoietic cell transplantation (IUHCT). We hypothesized that enhanced long-term engraftment might be more reliably achieved in microchimeric systems if higher levels of chimerism existed during development of adaptive immunity. To evaluate this hypothesis, we stimulated the donor cells with vascular endothelial growth factor (VEGF) and stem cell factor (SCF) prior to IUHCT in a chimerism-resistant murine strain combination. METHODS:Donor Balb/c marrow was cultured in media with or without VEGF and SCF supplementation for 12 hours prior to IUHCT into B6 fetuses at 14 days postcoitum (dpc). Donor cell phenotype, homing, and chimerism were assessed at short and long-term time points and transplanted animals received skin allografts at 8 weeks. RESULTS:In pretreated allogeneic recipients, early chimerism rates were more than double that of controls (71% vs 33%, p = 0.01). These differences were associated with higher numbers of pretransplant donor cell colony-forming cells without change in donor cell homing. Despite prolonged skin allograft survival for pretreated recipients compared with controls (mean survival = 20.8 vs 8.2 days, p < 0.001), long-term engraftment was unchanged. CONCLUSIONS:These findings demonstrate that higher levels of early chimerism in recipients of cytokine-stimulated marrow result in improved short-term chimerism and tolerance. Future studies are needed to confirm the existence of a "threshold" level of chimerism necessary to sustain long-term engraftment.

背景与目标：

BACKGROUND & AIMS: :The objective of this study was to determine whether paclitaxel and a strong antioxidant, pyrrolidinedithiocarbamate (PDTC), can affect the activation of nuclear factor-kappa B (NF-kappaB) in SKOV-3 human ovarian cancer cell line and the effect of these two agents on the growth and apoptosis of the cancer cells. The cells were treated with various concentrations of paclitaxel and/or PDTC at various time intervals. Following treatments, cell growth and apoptosis were determined by 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulphonyl)-2H-tetrazolium (WST-8) (WST) assay and flow cytometry, respectively. Western blot assay was used to determine the nuclear p65 protein and cytoplasmic IkappaB-alpha protein. High doses of PDTC significantly inhibited the growth of SKOV-3 cells and caused apoptosis. Paclitaxel and lower doses of PDTC combined demonstrated additive inhibition of cell growth and increased levels of apoptosis. Treatment of paclitaxel alone showed increased nuclear p65 protein and decreased cytoplasmic IkappaB-alpha protein expression, while pretreatment of PDTC reversed this function. PDTC blocks the paclitaxel-induced activation of NF-kappaB leading to increased chemosensitivity to paclitaxel and enhanced apoptosis. Combining antioxidants and paclitaxel has significant potential to overcome the risk of paclitaxel resistance.

背景与目标： : 这项研究的目的是确定紫杉醇和强抗氧化剂吡咯烷二硫代氨基甲酸酯 (PDTC) 是否会影响SKOV-3人卵巢癌细胞系中核因子-κ B (NF-κ B) 的活化以及这两种药物对癌细胞生长和凋亡的影响。在不同的时间间隔用各种浓度的紫杉醇和/或PDTC处理细胞。处理后，通过2-(2-甲氧基-4-硝基苯基)-3-(4-硝基苯基)-5-(2,4-二硫酰基)-2h-四唑 (WST-8) (WST) 测定和流式细胞仪测定细胞生长和凋亡。Western blot测定法用于测定核p65蛋白和细胞质IkappaB-α 蛋白。高剂量的PDTC显著抑制SKOV-3细胞的生长并引起细胞凋亡。紫杉醇和较低剂量的PDTC组合显示出对细胞生长的加性抑制和凋亡水平的增加。单独治疗紫杉醇显示核p65蛋白增加，胞质IkappaB-α 蛋白表达降低，而PDTC的预处理逆转了这一功能。PDTC阻断紫杉醇诱导的NF-κ b激活，从而增加对紫杉醇的化学敏感性并增强细胞凋亡。结合抗氧化剂和紫杉醇具有克服紫杉醇耐药性风险的巨大潜力。

BACKGROUND & AIMS: :Several mutations in the leucine-rich repeat kinase 2 gene (LRRK2) have been identified both in familial and sporadic cases of Parkinson's disease (PD). G2019S, located at a kinase (MAPKKK) domain, is the most common mutation in the LRRK2 gene in PD, Two adjacent mutations (I2012T and I2020T) were mapped to the same domain suggesting shared pathogenic mechanism of these mutations. Since phenotypes of PD overlap with essential tremor (ET), we investigated LRRK2 G2019S, I2012T, and I2020T mutations in a cohort of 272 patients with ET. No mutations were found in our ET cohort and, therefore, we conclude that LRKK2 I2012T, G2019S and I2020T variants are rare causes of Caucasian ET.

背景与目标： : 在帕金森氏病 (PD) 的家族性和散发性病例中，已经发现了富含亮氨酸的重复激酶2基因 (LRRK2) 的几个突变。G2019S位于激酶 (MAPKKK) 结构域，是PD中LRRK2基因中最常见的突变，两个相邻的突变 (I2012T和I2020T) 被定位到同一结构域，表明这些突变的共同致病机制。由于PD的表型与原发性震颤 (ET) 重叠，我们在272例ET患者队列中研究了LRRK2 G2019S，I2012T和I2020T突变。在我们的ET队列中未发现突变，因此，我们得出结论，LRKK2 I2012T，G2019S和I2020T变体是高加索ET的罕见原因。

BACKGROUND & AIMS: :Gonorrhea is essentially out of control in many settings and high disease rates are coupled with the spread of multiresistant gonococci. Increases in quinolone resistance have followed loss of the penicillins and tetracyclines as useful treatments. Decreasing susceptibility to third-generation cephalosporins is also reported. Over-reliance on antibiotic treatment as a disease control measure in settings with high disease rates and poor control of antibiotic usage is a significant contributor to the antimicrobial resistance reported. Conversely, containment of resistance is more likely to be achieved when combined with disease control principles shown to be effective. However, until a higher priority is given to funding for sexually transmitted diseases, this prospect is unlikely to eventuate and the possibility of untreatable gonorrhea becomes more real.

背景与目标： : 淋病在许多情况下基本上是失控的，高发病率与多重耐药淋球菌的传播相结合。作为有用的治疗方法，青霉素和四环素类药物的丧失导致喹诺酮类药物耐药性增加。还报道了对第三代头孢菌素的敏感性降低。在疾病率高且抗生素使用控制不佳的环境中，过度依赖抗生素治疗作为疾病控制措施，是导致报告的抗菌素耐药性的重要因素。相反，当结合显示出有效的疾病控制原则时，更有可能实现对抵抗力的控制。然而，在对性传播疾病的资金给予更高的优先考虑之前，这种前景不太可能实现，无法治愈的淋病的可能性变得更加现实。

BACKGROUND & AIMS: :Oral tolerance, an important feature of the mucosal immune system, appears to protect against immune-mediated disease by blunting production of systemic IgG and IgM antibody directed toward immunogens chronically present at mucosal surfaces. In this study, we explored the role of oral tolerance and mucosal immunoregulation in an experimental model of IgA nephropathy (IgAN), an important form of nephritis in humans. Cyclophosphamide and estradiol were used to inhibit the expression of oral tolerance, which otherwise develops after chronic oral presentation of Ag. BALB/c mice given drinking water containing 0.1% bovine gamma globulin (BGG) continuously for 14 wk were randomly assigned to groups given either 2 mg of cyclophosphamide i.p., 2 mg of estradiol s.c. or both drugs. Groups of control mice received neither BGG nor drugs. In three separate experiments, a low percentage of saline-treated orally immunized mice had microscopic hematuria (0 to 20%), as did nonimmunized controls (0 to 20%). However, 58 to 83% of mice given estradiol and/or cyclophosphamide at appropriate times developed significant hematuria. If drugs were given at suboptimal times, only 25 to 56% of mice developed hematuria. Drug-treated immunized mice also had more serum IgG and IgM anti-BGG antibodies than control and saline groups. Immunofluorescence showed significantly more glomerular deposits of IgG, IgM, and C3 in drug-treated immunized mice compared to saline-treated immunized and normal untreated control mice. Hematuria and glomerular deposits of IgG, IgM, and C3 paralleled serum IgG and IgM antibody. All immunized mice showed significant mesangial IgA and BGG deposits and there were no differences in such deposits between saline- and drug-treated immunized mice. We suggest that blunting of oral tolerance with promotion of systemic IgG and IgM antibody production leads to nephritis in chronically orally immunized mice and that glomerular immune complexes containing IgG and/or IgM promote complement deposition and hematuria in IgAN. Analogous defects in oral (or more generally mucosal) tolerance could play a role in the genesis of symptomatic human IgAN.

背景与目标： : 口服耐受性是粘膜免疫系统的重要特征，似乎可以通过钝化针对慢性存在于粘膜表面的免疫原的全身性IgG和IgM抗体的产生来预防免疫介导的疾病。在这项研究中，我们探讨了口服耐受性和粘膜免疫调节在IgA肾病 (IgAN) 实验模型中的作用，IgA肾病是人类肾炎的重要形式。环磷酰胺和雌二醇用于抑制口服耐受性的表达，否则口服耐受性会在Ag的慢性口服表现后发展。连续14周饮用含有0.1% 牛丙种球蛋白 (BGG) 的BALB/c小鼠被随机分配到给予2 mg环磷酰胺i.p.，2 mg雌二醇的组。或者两种药物。对照组小鼠既未接受BGG也未接受药物。在三个单独的实验中，低百分比的经生理盐水处理的经口服免疫的小鼠具有显微镜下血尿 (0至20%)，与未免疫的对照 (0至20%) 一样。然而，在适当的时间给予雌二醇和/或环磷酰胺的小鼠中有58至83% 出现明显的血尿。如果在次优时间给予药物，只有25至56% 的小鼠出现血尿。药物处理的免疫小鼠的血清IgG和IgM抗BGG抗体也比对照组和盐水组多。免疫荧光显示，与盐水处理的免疫小鼠和正常未经处理的对照小鼠相比，药物处理的免疫小鼠中IgG，IgM和C3的肾小球沉积明显更多。IgG，IgM和C3的血尿和肾小球沉积物与血清IgG和IgM抗体平行。所有免疫小鼠均显示出明显的系膜IgA和BGG沉积物，并且在盐水和药物处理的免疫小鼠之间此类沉积物没有差异。我们建议，通过促进全身IgG和IgM抗体产生而使口服耐受性减弱会导致慢性口服免疫小鼠的肾炎，而含有IgG和/或IgM的肾小球免疫复合物会促进IgAN的补体沉积和血尿。口腔 (或更一般的粘膜) 耐受性的类似缺陷可能在有症状的人IgAN的发生中起作用。

BACKGROUND & AIMS: :A mouse perfusion model using fluorescently labeled dextran has been developed to investigate the functionality of blood vessels during cutaneous wound healing. By immunostaining cryostat sections of perfused wounds with antibodies that identify vessels, we were able to assess their functionality. There was an increase in the proportion of CD31(+)-perfused vessels in all wound regions with time, although the vessels of the wound margins and superficial granulation tissue (GT) took the longest to become perfused. More than 50% of the latter vessels were not perfused at 10 days postwounding. This is consistent with the growth of functional vessels from the wound base proceeding to the more superficial GT. The CD34 marker was expressed by a subpopulation of CD31(+) vessels. However, in contrast to CD31(+) vessels, the functionality of CD34(+) vessels did not change significantly with time and 50-75% of CD34(+) vessels in the GT and wound margins were nonfunctional. This might be explained either by apoptosis of the CD34(+) vessels or the loss of the marker with time. This study has important implications for assays of wound-healing angiogenesis based on histology and immunohistochemical markers for vessels, because vessel functionality differs both spatially and temporally during wound healing.

背景与目标： : 已经开发了使用荧光标记的葡聚糖的小鼠灌注模型，以研究皮肤伤口愈合过程中血管的功能。通过用识别血管的抗体对灌注伤口的低温恒温器切片进行免疫染色，我们能够评估其功能。尽管伤口边缘和浅表肉芽组织 (GT) 的血管灌注时间最长，但所有伤口区域中CD31 () 灌注血管的比例随时间增加。超过50% 的后一种血管在伤后10天没有灌注。这与从伤口基部到更浅表的GT的功能性血管的生长是一致的。CD34标记由CD31 () 血管的亚群表达。然而，与CD31(+) 血管相反，CD34(+) 血管的功能没有随时间显着变化，并且GT和伤口边缘中的50-75% CD34(+) 血管无功能。这可以通过CD34 () 血管的凋亡或标记物随时间的丢失来解释。这项研究对基于血管的组织学和免疫组织化学标记的伤口愈合血管生成测定具有重要意义，因为在伤口愈合过程中，血管功能在空间和时间上均不同。

BACKGROUND & AIMS: Controversy exists on the merits of the various approaches to inguinal repair. Evolution of the classic open repair has culminated in the Shouldice repair. Challenges from newcomers, namely, tension-free repair and laparoscopy, are being examined. These two techniques have a number of disadvantagesthe presence of foreign bodies (prostheses) and their implication in cases of infection; the cost of prosthetic material, which is no longer negligible (particularly with expanded polytetrafluoroethylene); and problems of safety in that the laparoscopic approach is no longer a dependable asset except in the hands of a highly specialized and dextrous operator. Still, complications occur with laparoscopic repair that should not be associated with a surgical procedure that is considered benign, safe and cost-effective. Surgeons must recognize the pertinent facts and decide according to their conscience which method of repair to use.

背景与目标： 腹股沟修复的各种方法的优点存在争议。经典开放式维修的演变最终导致了Shouldice维修。正在研究新来者的挑战，即无张力修复和腹腔镜检查。这两种技术有许多缺点: 异物 (假肢) 的存在及其在感染情况下的影响; 假体材料的成本不再可忽略不计 (特别是使用膨胀的聚四氟乙烯); 以及安全性问题，因为腹腔镜方法不再是可靠的资产，除非由高度专业和灵巧的操作员掌握。尽管如此，腹腔镜修复术仍会发生并发症，而不应与被认为是良性，安全且具有成本效益的外科手术相关联。外科医生必须认识到相关事实，并根据自己的良心决定使用哪种修复方法。

BACKGROUND & AIMS: DiSSU1 is an optional group I twintron present in the nuclear extrachromosomal ribosomal DNA of the myxomycete Didymium iridis. DiSSU1 appears to be complex both in structure and function. At the RNA level it has a twin-ribozyme organization composed of two group I ribozymes with different functions, separated by an open reading frame. Here, we show that DiSSU1 is mobile when haploid intron-containing and intron-less amoebae are mated. The mobility process is fast, being completed in 5-10 nuclear cycles after mating in the developing zygote and plasmodia. Analyses of progeny from genetic crosses confirm intron mobility. DiSSU1 is the first example of a mobile group I twintron. The intron-encoded protein was expressed in Escherichia coli and found to be an endonuclease, I-DirI, that cleaves an intron-less ribosomal DNA allele at the intron-insertion site, and is probably involved in intron homing. The endonuclease I-DirI seems to be a rare example of a protein that is expressed from a ribozyme-processed RNA polymerase I transcript in vivo.

背景与目标： DiSSU1是一种可选的I族双冠子，存在于粘菌素二钕虹膜的核染色体外核糖体DNA中。DiSSU1在结构和功能上似乎都很复杂。在RNA水平上，它具有一个双核酶组织，该组织由两个具有不同功能的I族核酶组成，并由开放阅读框隔开。在这里，我们表明，当单倍体内含子和无内含子的阿米巴交配时，DiSSU1是可移动的。迁移率过程很快，在发育中的合子和疟原虫交配后，在5-10个核循环中完成。对遗传杂交后代的分析证实了内含子的迁移率。DiSSU1是移动组I twintron的第一个示例。内含子编码的蛋白在大肠杆菌中表达，发现它是一种内切核酸酶I-DirI，在内含子插入位点切割无内含子核糖体DNA等位基因，并且可能参与内含子归巢。核酸内切酶I-DirI似乎是从核酶处理的RNA聚合酶I转录本体内表达的蛋白质的罕见例子。

BACKGROUND & AIMS: BACKGROUND:Cases of malignant mesothelioma (MM) in the non-asbestos textile industry have recently been described, but asbestos exposure in spinning and looming has seldom been reported. Nevertheless, on a national level the Italian Mesothelioma Registry (Re.Na.M) contains numerous cases of MM with past non-asbestos textile work but classified as "unknown" exposure due to poor information. OBJECTIVES:The aim of this research was to investigate possible past occupational exposure to asbestos in this specific industrial sector. METHODS:The MM cases were collected from the Mesothelioma Registry of Brescia. Work histories were obtained via a standardized questionnaire. Investigations were conducted in textile machinery manufacturing plants in order to collect information regarding the possible use of asbestos parts; at the same time, the use of asbestos friction materials and the use of sprayed asbestos for noise abatement purposes or thermal insulation was checked in the cotton industry by interviewing the management of two companies where a cluster of MM was observed. RESULTS:The Mesothelioma Registry of Brescia retrieved and collected 15 MM cases with past work in the cotton spinning industry, 4 of them employed in the same company. Further search of asbestos use gave positive results as the use of friction materials has been widespread since the fifties, while sprayed asbestos was not found anywhere in the cotton industry. On the other hand, half of the cases were employed during the thirties and forties, when friction materials appear to have been asbestos-free. Therefore the other hypothesis of exposure could be direct manufacture of asbestos yarn. CONCLUSION:The results of this investigation indicate the attribution, at least, of possible asbestos exposure"for those cases employed in textile industries since the fifties, according to the Re.Na.M guidelines; for those cases employed before that period the same classification can be attributed on an epidemiological basis. Previous work periods need further investigation in order to demonstrate the circumstances of the occupational asbestos exposure, given the heterogeneity of work processes and machinery characteristic of this industrial sector.

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BACKGROUND & AIMS: BACKGROUND:Borderline parovarian tumors are found incidentally at surgery or autopsy. They are extremely rare. The majority have been reported in young women and rarely are they large enough to be clinically significant. CASE:A 53-year-old multiparous female with a symptomatic paraovarian serous borderline cystadenoma is presented. DISCUSSION:The clinical aspects and subsequent management of related cases are discussed.

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BACKGROUND & AIMS: Recent evidence suggests that Chlamydia trachomatis can persist in the female upper genital tract in an unculturable state. Since unsuspected C. trachomatis infection has been associated with adverse in-vitro fertilization (IVF) outcome we sought to detect further evidence of C. trachomatis in the genital tracts of women undergoing IVF. The prevalence and distribution of antibodies to the major structural proteins of C. trachomatis in paired follicular fluid and sera of women undergoing IVF were examined. Sera and follicular fluid samples from 149 women were assayed for immunoglobulin (Ig)G and IgA antibodies to two C. trachomatis antigens, the major outer membrane protein (MOMP) and a recombinant lipopolysaccharide (rLPS) fragment. Additionally, the expression of human 60 kDa heat shock protein (hsp 60) in follicular fluid was determined. All cervical and follicular fluid samples were negative for C. trachomatis by polymerase chain reaction, ligase chain reaction and DNA probe. Sera from 60% of the subjects were positive for antichlamydial rLPS IgG; 36% were positive for anti-MOMP IgG. Similarly, rLPS-directed and MOMP-directed IgA were detected in sera of 34 and 14% of the subjects respectively. IgG antibodies to MOMP and rLPS were detected in 42 and 41% of the follicular fluid examined respectively. Anti-MOMP IgA was identified in 8.7% of the follicular fluid while 27.5% were positive for anti-rLPS IgA. Human hsp 60 expression was documented in 11.6% of the follicular fluid tested. IgA antibodies to both MOMP (P = 0.03) and rLPS (P = 0.02) in follicular fluid were associated with a failure to become pregnant after embryo transfer. IgG antibodies in sera and follicular fluid and IgA antibodies in sera were unrelated to IVF outcome. Similarly only anti-MOMP IgA (P = 0.02) and anti-rLPS IgA (P = 0.04) in follicular fluid were correlated with human hsp 60 expression in follicular fluid. The unique association between IgA antibodies to two chlamydial antigens in follicular fluid and both hsp 60 expression and IVF failure provides further support for the possibility that a persistent upper genital tract chlamydial infection contributes to IVF failure in some women.

背景与目标： 最近的证据表明，沙眼衣原体可以在女性上生殖道中以不可培养的状态持续存在。由于未经怀疑的沙眼衣原体感染与不良的体外受精 (IVF) 结果有关，因此我们试图在接受IVF的妇女的生殖道中进一步发现沙眼衣原体的证据。检查了成对的卵泡液和接受IVF的妇女血清中沙眼衣原体主要结构蛋白的抗体的患病率和分布。对来自149名妇女的血清和卵泡液样品进行了免疫球蛋白 (Ig)G和IgA抗体的检测，该抗体针对两种沙眼衣原体抗原，主要外膜蛋白 (MOMP) 和重组脂多糖 (rLPS) 片段。此外，测定了人60 kDa热休克蛋白 (hsp 60) 在卵泡液中的表达。通过聚合酶链反应，连接酶链反应和DNA探针，所有宫颈和卵泡液样品均阴性沙眼衣原体。来自60% 名受试者的血清中抗衣原体rLPS IgG阳性; 36% 抗MOMP IgG阳性。同样，分别在34和14% 名受试者的血清中检测到rLPS导向和MOMP导向的IgA。分别在42和41% 的卵泡液中检测到针对MOMP和rLPS的IgG抗体。在卵泡液8.7% 中鉴定出抗MOMP IgA，而27.5% 对抗rLPS呈阳性igA。人类hsp 60的表达在测试的卵泡液11.6% 中被记录。卵泡液中MOMP (P = 0.03) 和rlp (P = 0.02) 的IgA抗体与胚胎移植后未能怀孕有关。血清和卵泡液中的IgG抗体和血清中的IgA抗体与IVF结果无关。同样，只有卵泡液中的抗MOMP IgA (P = 0.02) 和抗rLPS IgA (P = 0.04) 与人hsp 60在卵泡液中的表达相关。针对两种衣原体抗原的IgA抗体与hsp 60表达和IVF失败为某些女性持续的上生殖道衣原体感染导致IVF失败的可能性提供了进一步的支持。

BACKGROUND & AIMS: INTRODUCTION:Frequent use of modern imaging methods (such as ultrasound, CT and MRI) results in high incidence of accidentally discovered adrenal mass. Adrenal incidentalomas are accidentally discovered adrenal tumors by imaging methods without any prior suspicion of adrenal disease. Some studies have shown decreased insulin sensitivity in patients with adrenal incidentaloma. OBJECTIVE:The objective of our study was to assess the insulin sensitivity in patients with adrenal incidentalom a. METHOD:A total of 22 patients with accidentally discovered adrenal mass confirmed by CT/MRI were evaluated in our study. Average age was 53.31 +/- 26.5 years and average BMI 25.84 +/- 3.65 kg/m2. Control group consisted of 33 healthy subjects. Insulin sensitivity was assessed by short ITT (insulin tolerance test). Blood samples were taken before, 3, 6, 9, 12, 15, 20 and 30 minutes after i.v. bolus of regular insulin (0.05 IU/kg BW). Glycemia was determined by glucose oxidase method. Statistical analysis was done by ANCOVA, using BMI as covariate. RESULTS:Our results showed significantly lower insulin sensitivity in patients with adrenal incidentalomas comparing to the control group (4.95 +/- 0.58 vs. 6.62 +/- 0.47, p=0.015). CONCLUSION:Our patients with adrenal incidentalomas manifested lower insulin sensitivity what suggested further follow up and assessment of insulin sensitivity during endocrine evaluation of these patients.

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