Soluble CD14 in periodontitis

Lipopolysaccharide (LPS) binds to soluble (s)CD14. We investigated which factors contribute to variations in sCD14 levels in periodontitis, a chronic infectious disease of tooth-supporting tissues associated with endotoxemia and leading to inflammation and subsequently loss of teeth. The sCD14 levels were determined by ELISA in healthy controls (n = 57) and untreated patients (59 moderate and 46 severe) and their relation with markers of systemic inflammation (C-reactive protein levels, and leukocyte, neutrophil and lymphocyte counts) was assessed. Anti-Aggregatibacter actinomycetemcomitans and anti-Porphyromonas gingivalis IgG levels were established by ELISA and CD14-260 genotype was determined in a TaqMan allelic discrimination assay. Increased levels of sCD14 were more frequent among periodontitis patients (P = 0.026) and showed a severity-dependence with increasing levels of periodontal breakdown (P = 0.008). In patients, levels of sCD14 correlated positively with CRP (P = 0.043), leukocyte numbers (P = 0.011) and negatively with anti-A. actinomycetemcomitans IgG (P = 0.007). In a multivariate analysis, sCD14 levels were predicted by ethnicity, age, educational level, and in Caucasian subjects also by the severity of periodontal destruction, but not by anti-P. gingivalis IgG or the CD14-260 genotype. Periodontitis is associated with elevated levels of sCD14

Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries

<p>BACKGROUND: The aim of this study was to determine the effect of balloon atrial septostomy (BAS) on cerebral oxygenation in neonates with transposition of the great arteries (TGA).</p><p>METHODS: In term neonates with TGA, regional cerebral tissue oxygen saturation (r(c)SO(2)) was measured using, near-infrared spectroscopy (NIRS) for a period of 2 h, before BAS, after BAS, and 24 h after BAS. In neonates who did not require BAS on clinical,grounds, r(c)SO(2) was measured within 24h of admission and 24h later.</p><p>RESULTS: BAS was performed in 12 of 21 neonates. r(c)SO(2) increased from a median of 42% (before) to 48% at 2 h after BAS (P <0.05), as did transcutaneous arterial oxygen saturation (spO(2)) (from 72% to 85%, P <0.01). r(c)SO(2) increased further during the next 24 h (from 48% to 64%, P <0.05), whereas spO(2) remained stable. Although beginning from a lower baseline (42 vs. 51%, P <0.01), r(c)SO(2) Was higher in neonates treated with BAS, as compared with neonates not treated with BAS, 24h after the procedure (64 vs. 58%, P <0.05); spO(2) was, however, similar between the two groups.</p><p>CONCLUSION: BAS improves cerebral oxygen saturation in neonates with TGA. Complete recovery of cerebral oxygen saturation occurred only 24h after BAS.</p>

The impact of the absolute number and ratio of positive lymph nodes on survival of endometrioid uterine cancer patients

The aim of the study was to determine the impact of the absolute number and ratio of positive lymph nodes on the survival in node-positive endometrioid uterine cancer. Data were obtained from the National Cancer Institute Registry from 1988 to 2001. Analyses were performed using Kaplan–Meier and Cox proportional hazard methods. A total of 1222 women were diagnosed with stage IIIC-IV node-positive endometrioid corpus cancer. The 5-year disease-specific survival of women with 1, 2–5, and >5 positive nodes were 68.1, 55.1, and 46.1%, respectively (P<0.001). Increasing lymph node ratio, expressed as a percentage of positive nodes to total nodes identified (⩽10, >10–⩽50, and >50%), was associated with a decrease in survival from 77.3 to 60.7 to 40.9%, respectively (P<0.001). The absolute number of positive nodes and the lymph node ratio remained significant after adjusting for stage (IIIC vs IV) and the extent of lymphadenectomy (⩽20 vs >20 nodes). On multivariate analysis, the absolute number of positive nodes and lymph node ratio were significant independent prognostic factors for survival. Increasing absolute number of positive nodes and lymph node ratio are associated with a poorer survival in women with node-positive uterine cancers. The stratification of node-positive uterine cancer for prognostic and treatment purposes warrants further investigation