Climate-mediated diversification of turtles in the Cretaceous

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Laparoscopic findings in women with chronic pelvic pain

Objective: This study was undertaken to assess the spectrum of pelvic pathology observed at laparoscopy in women with chronic pelvic pain, and to compare women with an identifiable cause of pain to those with no visible pelvic pathology, with regard to symptomatology and demography. Design: Retrospective case control study reviewing laparoscopy reports and patient records. Setting: Department of Obstetrics and Gynaecology, Groote Schuur Hospital. Patients: One hundred and thirty-six consecutive women undergoing laparoscopic assessment for undiagnosed pelvic pain of at least 6 months' duration, between 1989 and 1991. Main outcome measures: The presence of endometriosis, pelvic adhesions, other pelvic pathology and 'negative' laparoscopic findings was assessed. The association between pelvic pathology and specffic symptomatOlogy, fertility, contraceptive use, past pelvic surgery, ethnic group and smoking is examined. Results: No cause of pain was identified at laparoscopy in 30% of these patients, while endomemosis was found in 16% of women and pelvic adhesions in 40%. The 41 women with no identifiable laparoscopic abnonnality did not differ significantly from the 95 with pelvic abnonnalities in respect of age, parity, duration of pain, frequency of dysmenorrhoea and dyspareunia or the presence of gastro-intestinal or urinary symptoms. However, injectable honnonal contraception use was more common in the group with negative laparoscopic findings and smoking was more common among the women with pelvic pathology. Conclusion: Chronic pelvic pain with a laparoscopically normal pelvis is a common problem in Cape Town, occurring with a frequency similar to that reported from various overseas centres. Women with this problem are not readily identified by demographic profile or symptom complex.S Afr Med J 1995; 85: 1200-120

Therapeutic anti-integrin (α4 and αL) monoclonal antibodies: two-edged swords?

Anti-α4 and anti-αL integrin chain monoclonal antibodies have shown a clear-cut beneficial effect in different animal models of autoimmune and inflammatory disorders as well as in human diseases, including multiple sclerosis, inflammatory bowel disease, and psoriasis. It has been widely assumed that this therapeutic effect is mainly consequence of the blockade of leucocyte adhesion to endothelium, inhibiting thus their extravasation and the inflammatory phenomenon. However, it is evident that both α4β1 (very late antigen-4) and αLβ2 (leucocyte function-associated antigen-1) integrins have additional important roles in other immune phenomena, including the formation of the immune synapse and the differentiation of T helper 1 lymphocytes. Therefore, it is very feasible that the long-term administration of blocking agents directed against these integrins to patients with inflammatory/autoimmune conditions may have undesirable or unexpected effects

Tetraspanins CD81 and CD82 Facilitate α4β1-Mediated Adhesion of Human Erythroblasts to Vascular Cell Adhesion Molecule-1

The proliferation and terminal differentiation of erythroid progenitors occurs in human bone marrow within erythroblastic islands, specialised structures consisting of a central macrophage surrounded by developing erythroid cells. Many cell-cell and cell-matrix adhesive interactions maintain and regulate the co-ordinated daily production of reticulocytes. Erythroid cells express only one integrin, a4b1, throughout differentiation, and its interactions with both macrophage Vascular Cell Adhesion Molecule-1 and with extracellular matrix fibronectin are critical for erythropoiesis. We observed that proerythroblasts expressed a broad tetraspanin phenotype, and investigated whether any tetraspanin could modulate integrin function. A specific association between a4b1 and CD81, CD82 and CD151 was demonstrated by confocal microscopy and co-immune precipitation. We observed that antibodies to CD81 and CD82 augmented adhesion of proerythroblasts to Vascular Cell Adhesion Molecule-1 but not to the fibronectin spliceoforms FnIII12-IIICS-15 and FnIII12–15. In contrast, different anti-CD151 antibodies augmented or inhibited adhesion of proerythroblasts to Vascular Cell Adhesion Molecule-1 and the fibronectin spliceoform FnIII12-IIICS-15 but not to FnIII12–15. These results strongly suggest that tetraspanins have a functional role in terminal erythropoiesis by modulating interactions of erythroblast a4b1 with both macrophages and extracellular matrix