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Reproductive assistance in HIV serodiscordant couples

Posted: February 19, 2013 at 9:44 am

BACKGROUND

Three quarters of individuals infected with human immunodeficiency virus (HIV) are in their reproductive years and may consider pregnancy planning. Techniques have been developed which can minimize the risk of HIV transmission in these couples, and the current literature on this topic is reviewed here.

METHODS

We reviewed the literature for the following topics: risk of HIV transmission, effects of HIV infection on fertility, reproductive assistance in industrialized and low-income countries, pre-exposure chemoprophylaxis (PrEP) and timed intercourse in HIV-discordant couples for both male and female positivity. Relevant publications were identified through searches of the EMBASE Medline and PubMed databases, the Google-indexed scientific literature and periodic specialized magazines from the on-line Library Service of the University of Milan, Italy.

RESULTS

In serodiscordant couples in which the man is positive, the primary method used to prevent HIV transmission is ‘sperm washing’, followed by IUI or IVF. Data show that sperm washing in HIV-positive men has not produced seroconversion in women or their offspring; however, the evidence is limited. Recently, increasing evidence describing PrEP for HIV prevention has been published and PrEP could be an alternative to ART for fertile couples. Usually HIV-infected women undergo self-insemination around the time of ovulation. Few studies have been published on IVF outcome in HIV-infected women.

CONCLUSIONS

Assisted reproduction programmes should be integrated into global public health services against HIV. For HIV serodiscordant couples with infected men, sperm washing should be the first choice. However, timed intercourse and PrEP for HIV prevention has been reported. Recent data highlight the possible impairment of fertility in HIV-infected women. Efforts to design a multicentric study should be strengthened.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/19/2/136?rss=1

Recommendation and review posted by G. Smith

Fertility and borderline ovarian tumor: a systematic review of conservative management, risk of recurrence and alternative options

Posted: February 19, 2013 at 9:44 am

BACKGROUND

The aim of this systematic review was to evaluate the fertility outcome after borderline ovarian tumor (BOT) management and the results of conservative management, risk of recurrence and alternative options.

METHODS

The search strategy was based on relevant terms concerning BOT using Medline and the Central Cochrane Library. Both early and advanced stages of serous and mucinous BOT were included, but not rare entities such as endometrioid, Brenner or clear-cell BOT because of their low incidence. We considered all articles—case reports, original studies, meta-analyses and reviews—in English and French.

RESULTS

Overall, 230 articles were screened of which 120 were retained for review. Most pregnancies were spontaneous but some data were obtained from studies analyzing the contribution of assisted reproductive technology (ART). However, not all studies differentiated spontaneous pregnancy from those obtained after fertility treatment including ovulation induction, intrauterine insemination and IVF. Conservative management of early stage BOT resulted in a pooled estimate for spontaneous pregnancy rate of 54% with a low risk of lethal recurrence (pooled estimate: 0.5%). In patients with advanced stage BOT, the spontaneous pregnancy rates was lower (34% in the single series reporting pregnancy rate in this context) and the risk of lethal recurrence increased (pooled estimate: 2%).

CONCLUSIONS

This systematic review underlines that fertility subsequent to treatment of BOT depends mainly on histology and initial staging to distinguish early from advanced stages. In patients with advanced stage BOT, several alternative options to conservative management are available to allow patients to conceive without compromising their prognosis.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/19/2/151?rss=1

Recommendation and review posted by G. Smith

Intercellular adhesion molecules (ICAMs) and spermatogenesis

Posted: February 19, 2013 at 9:44 am

BACKGROUND

During the seminiferous epithelial cycle, restructuring takes places at the Sertoli–Sertoli and Sertoli–germ cell interface to accommodate spermatogonia/spermatogonial stem cell renewal via mitosis, cell cycle progression and meiosis, spermiogenesis and spermiation since developing germ cells, in particular spermatids, move ‘up and down’ the seminiferous epithelium. Furthermore, preleptotene spermatocytes differentiated from type B spermatogonia residing at the basal compartment must traverse the blood–testis barrier (BTB) to enter the adluminal compartment to prepare for meiosis at Stage VIII of the epithelial cycle, a process also accompanied by the release of sperm at spermiation. These cellular events that take place at the opposite ends of the epithelium are co-ordinated by a functional axis designated the apical ectoplasmic specialization (ES)—BTB—basement membrane. However, the regulatory molecules that co-ordinate cellular events in this axis are not known.

METHODS

Literature was searched at http://www.pubmed.org and http://scholar.google.com to identify published findings regarding intercellular adhesion molecules (ICAMs) and the regulation of this axis.

RESULTS

Members of the ICAM family, namely ICAM-1 and ICAM-2, and the biologically active soluble ICAM-1 (sICAM-1) are the likely regulatory molecules that co-ordinate these events. sICAM-1 and ICAM-1 have antagonistic effects on the Sertoli cell tight junction-permeability barrier, involved in Sertoli cell BTB restructuring, whereas ICAM-2 is restricted to the apical ES, regulating spermatid adhesion during the epithelial cycle. Studies in other epithelia/endothelia on the role of the ICAM family in regulating cell movement are discussed and this information has been evaluated and integrated into studies of these proteins in the testis to create a hypothetical model, depicting how ICAMs regulate junction restructuring events during spermatogenesis.

CONCLUSIONS

ICAMs are crucial regulatory molecules of spermatogenesis. The proposed hypothetical model serves as a framework in designing functional experiments for future studies.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/19/2/167?rss=1

Recommendation and review posted by G. Smith

Genetic and epigenetic instability in human pluripotent stem cells

Posted: February 19, 2013 at 9:44 am

BACKGROUND

There is an increasing body of evidence that human pluripotent stem cells (hPSCs) are prone to (epi)genetic instability during in vitro culture. This review aims at giving a comprehensive overview of the current knowledge on culture-induced (epi)genetic alterations in hPSCs and their phenotypic consequences.

METHODS

Combinations of the following key words were applied as search criteria: human induced pluripotent stem cells and human embryonic stem cells in combination with malignancy, tumorigenicity, X inactivation, mitochondrial mutations, genomic integrity, chromosomal abnormalities, culture adaptation, aneuploidy and CD30. Only studies in English, on hPSCs and focused on (epi)genomic integrity were included. Further manuscripts were added from cross-references.

RESULTS

Numerous (epi)genetic aberrations have been detected in hPSCs. Recurrent genetic alterations give a selective advantage in culture to the altered cells leading to overgrowth of abnormal, culture-adapted cells. The functional effects of these alterations are not yet fully understood, but suggest a (pre)malignant transformation of abnormal cells with decreased differentiation and increased proliferative capacity.

CONCLUSIONS

Given the high degree of (epi)genetic alterations reported in the literature and altered phenotypic characteristics of the abnormal cells, controlling for the (epi)genetic integrity of hPSCs before any clinical application is an absolute necessity.

Source:
http://humupd.oxfordjournals.org/cgi/content/short/19/2/187?rss=1

Recommendation and review posted by G. Smith

Open Spots in Two Raccoon Head Taxidermy Classes–Feb 23 and March 2– with Rogue Taxidermist Katie Innamorato

Posted: February 19, 2013 at 2:43 am

We have one open spot available for each of our two previously sold out raccoon head taxidermy classes--One this Saturday, February 23 and the other the following Saturday, March 2.

If anyone is interested in either slot, please email Laetitia [at] atlasobscura.com as soon as possible! The slot will go to the first respondent.

Full details follow:

Raccoon Head Taxidermy Class with Rogue Taxidermist Katie Innamorato
Date: Saturday, February 23 and March 2
Time: 11 – 5 PM
Admission: $350
This class is part of The Morbid Anatomy Art Academy

This course will introduce students to basic and fundamental taxidermy techniques and procedures. Students will be working with donated raccoon skins and will be going through the steps to do a head mount. The class is only available to 5 students, allowing for more one on one interaction and assistance. Students will be working with tanned and lightly prepped skin; there will be no skinning of the animals in class. This is a great opportunity to learn the basic steps to small and large mammal taxidermy. All materials will be supplied by the instructor, and you will leave class with your own raccoon head mount.

Rogue taxidermist Katie Innamorato has a BFA in sculpture from SUNY New Paltz, has been featured on the hit TV show "Oddities," and has had her work featured at La Luz de Jesus gallery in Los Angeles, California. She is self and professionally taught, and has won multiple first place ribbons and awards at the Garden State Taxidermy Association Competition. Her work is focussed on displaying the cyclical connection between life and death and growth and decomposition. Katie is a member of the Minnesota Association of Rogue Taxidermists, and with all M.A.R.T. members she adheres to strict ethical guidelines when acquiring specimens and uses roadkill, scrap, and donated skins to create mounts.

Her website and blogs-
http://www.afterlifeanatomy.com
http://www.afterlifeanatomy.tumblr.com
http://www.facebook.com/afterlifeanatomy
http://www.etsy.com/shop/afterlifeanatomy

More here.Source:
http://morbidanatomy.blogspot.com/2013/02/one-open-spot-in-this-saturdays-raccoon_19.html

Recommendation and review posted by G. Smith

Macabre Saints and "Holy Bones," From the Book "Several Ways to Die in Mexico City," Kurt Hollander

Posted: February 18, 2013 at 2:30 pm

 

Just before I left New York, Kurt Hollander--Mexico City-based writer, photographer, filmmaker, editor and translator--sent me a copy of his new book Several Ways to Die in Mexico City: An Autobiography of Death in Mexico City. I was so taken with it that I asked if I could publish an excerpt, along with a series of his photographs of unusually macabre saints and martyrs featured in the book. Thankfully for us, Mr. Hollander kindly obliged; text (slightly abridged) follows and images--all by Kurt Hollander--above:

Holy Bones

After the conquest of Mexico, the Catholic Church, which viewed all indigenous beliefs of life after death as superstition and blasphemy, prohibited Aztec burial ceremonies and quickly monopolized the afterlife, establishing itself as the indispensable intermediary between life and eternity. Just as it altered the way natives were to live, the Spanish Conquest radically transformed the way human beings in Mexico City died and the way in which their bodies were disposed.

A Catholic death in Colonial Mexico consisted of a funeral service presided over by a priest and with the corpse being buried in a grave. Before they were laid into the ground, however, the eyes and mouth of the deceased were shut, the body covered in a white sheet or cloth, placed in a wooden coffin and stretched out in the same way as Christ when taken down from the cross (on one’s back, arms crossed over the chest, one foot on top of the other). The coffin was then carried from the deceased’s home and mourners carrying torches (symbolizing the soul) accompanied the coffin into the church. The corpse and tomb were sprinkled with holy water to keep the deceased’s soul safe from the devil and the priest prayed for their safe passage into heaven.

In Mexico, funerals were often national events of the highest order. Between 1559 and 1819, dozens of major funeral services were held in Mexico City for local archbishops and royalty (as well as funerals in abstensia for the kings, queens and popes in Spain). The funeral pyres that housed the noble corpses, usually erected inside the Metropolitan Cathedral, provided the centerpiece of the elaborate ceremonies. These funeral pyres, also called catafalques and commonly referred to as death machines, were multi-floor temples covered in black cloth and gold leaf and often constructed in the shape of a pyramid. Prominent architects, sculptors, painters, poets and artisans adorned these death machines with images, figures and texts depicting the life and death of the dearly departed (accompanied by skeletons and skulls). More than just mourning a public figure, these funerals served to illustrate the divine status of certain human beings. According to the Catholic Church, death is punishment for one’s sins. Sins, however, affect more than just a person’s death and the final destination of their soul, they also affect their physical remains.

As the state of a corpse revealed the spiritual purity and divinity of the departed, the preservation of the bodily remains of the ruling elite was an important affair. Perfume and anointing processes (a nice word for embalming) ensured that the mortal remains of these personages did not give rise to gossip or speculation. Either as the result of natural gases or from post-mortem procedures, the corpses of religious figures that eventually mummified instead of becoming worm meat stood a much better chance of attaining sainthood, and they also provided living proof that Catholics, if they live a righteous life, can attain immortality in their death.

When these grand funeral processions ended, certain of the personage’s body parts (eyes, heart, liver, intestines, bones) would be donated to different churches or convents where each body part would receive its own elaborate funeral ceremony. Post-mortem organ and skeletal donations were warmly welcomed, although churches and royalty often bought body parts on the black market, as well.

The physical remains of saints have always been considered holy relics, believed to possess curative, even magical powers. No matter how small the fragment, each relic contains all of a saint’s miraculous power. As the existence of holy relics within a church meant an increased influx of worshippers and alms, there was a great demand for such objects. The wealthy in Mexico would often pay large sums of money to obtain body parts or relics of saints, which conferred not only social distinction but also provided their owners with extra spiritual blessings. To meet the demand, priests began to hack up the corpses of Christian saints into increasingly smaller bits.

Relics are given Latin names depending upon their origin: corpois (from the body), ex capillus (hair), ex carne (muscle), ex ossibus (bones), ex praercordis (stomach or intestines), ex pelle (skin) and ex cineribus (ashes). Body parts of saints, including their bones, blood or cremated ashes, are considered first-class relics. Second-class relics are a saint’s clothes or religious accessories, while items that have come in contact with the body or grave of a saint are referred to as representative relics. Many exotic body parts or paraphernalia from saints and religious figures have been collected and are prominently displayed in the Vatican and other reputable houses of worship, including: mother’s milk from the Virgin Mary; Christ’s circumcision knife and foreskin (14 churches claim that theirs is the one, true foreskin); the tail of the donkey that Christ rode into Jerusalem; a sneeze from the Holy Spirit and a sigh from Saint Joseph. The holiest of all relics in Mexico, safeguarded within the Metropolitan Cathedral, is a splinter from the cross Christ was crucified upon.

After the Conquest, a large number of saints’ body parts were sent by boat to Mexico to help convert souls in the New World. The arrival of these relics would often be accompanied by a large procession from the port town of Veracruz all the way to Mexico City. Relics are still very popular, and major collections travel from church to church around the world, bringing in the crowds of faithful who believe that proximity to the bones and other sacred scraps will provide them with miracle cures. (In order to receive blessings or pardon from the saints, the Church insists that worshippers must approach these relics without any morbid curiosity.) Pope John Paul II, who passed away in 2005, had somewhat of a revival in 2011 when a vial of his blood was flown to Mexico City and displayed in churches around the country.

The Chapel of Relics, located within the Metropolitan Cathedral, contains the skeletons, craniums, molars, hands, fingers, feet, intestines, hair and bones of 150 saints, including Maria Magdalena, Saint Gonzaga, Saint Francis, Saint Augustine, as well as a few of the legendary 10,000 Virgins. Within the exquisitely carved wooden floor-to-ceiling altar inside this chapel lie two wax figures of women encased in elaborate glass cubicles. These life-size figures are themselves merely display cases for the bits of bone that are set within their wax bodies, a window having been sewn into their clothes to permit them to be seen. Several bone fragments are also displayed within gold and silver hands and trophies and inside framed tapestries.

Like Catholic saints, Mexican political leaders also have a history of being brutally murdered. Depending on which history you believe, Moctezuma was killed either by an angry mob throwing rocks while he was paraded around on a roof by Cortés, or he was stabbed in the groin by Cuauhtémoc as punishment for allowing himself to become Cortés’ chicken boy. The great warrior Cuauhtémoc became emperor of Mexico-Tenochtitlan after Moctezuma’s successor Cuitlahuac died from small pox, but he was soon captured by the Conquistadores trying to escape the siege of the city in a canoe dressed as a woman, and was tortured and eventually murdered.

Miguel Hidalgo was shot by a firing squad in 1811, as was José Maria Morelos in 1815, both leaders of the Mexican Independence movement. Mexico’s Emperor Agustin de Iturbide and President Vicente Guerrero were both shot and killed by a firing squad in 1831, and Emperor Maximilian and President Miguel Miramón were also both shot and killed by firing squad in 1867. President Manuel Robles Pezuela was assassinated in 1873, President Francisco I. Madero in 1913, Emiliano Zapata in 1919, President Venustiano Carranza in 1920, Pancho Villa in 1923, and President Álvaro Obregón in 1928. Colossio, the man who would have been president in 1994, was shot and killed (the mystery of his murder has never been cleared up although his predecessor, ex-President Carlos Salinas, is generally believed to have been behind the assassination).

Death is not always a leader’s last act. Emperor Maximilian’s corpse was embalmed in order to keep it from rotting on its way back to Mexico City, but during the trip the coffin fell out of the cart and his corpse was thrown into the mud. In Mexico City, his body was embalmed once more and black glass balls were placed in his eye sockets. His corpse was by then so degraded that even his own mother couldn’t recognize him. The doctor who performed the second embalming and others who passed through the room he was kept in stole several items of his blood-stained clothes, the bullets extracted from his body, and even some hair off his head and chin. The bronze cast of Emperor Maximilian’s face, the table upon which the second embalming was performed, and the coffin he had been transported in are currently displayed in three different museums, while the face cast and the deathbed of Benito Juarez, the man who killed Maximilian, are exhibited in the National Palace. The bones of Emperor Iturbide are currently on display in the Metropolitan Cathedral, while Anastasio Bustamante, the man responsible for bringing Iturbide’s bones back to Mexico City, requested his own heart be plucked from his body and placed in an urn to be buried alongside Iturbide...

You can find out more about this fantastic book--and order a copy of your own!--by clicking here. All photos are © Kurt Hollander and are drawn from the book. You can find out more about Kurt by clicking here.

Source:
http://morbidanatomy.blogspot.com/2013/02/holy-bones-from-book-several-ways-to.html

Recommendation and review posted by G. Smith


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