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PubMed1984

Postpartum insertion of modified intrauterine devices.

The immediate postpartum insertion of standard intrauterine devices (IUDs) and those specially modified for postpartum use was evaluated in a multicenter clinical trial. The immediate postpartum insertion of IUDs was not associated with any increased risk of perforation or infection, although expulsion rates were higher than with interval insertions. The expulsion rate varied widely between centers using similar devices, suggesting that training in insertion is essential. Postpartum IUD insertions can be a practical contraceptive option for patients and providers of medical services.

Adult↗
PubMed1993

Linker-insertion mutagenesis of Pseudomonas aeruginosa outer membrane protein OprF.

The oprF gene, expressing Pseudomonas aeruginosa major outer membrane protein OprF, was subjected to semi-random linker mutagenesis by insertion of a 1.3 kb HincII kanamycin-resistance fragment from plasmid pUC4KAPA into multiple blunt-ended restriction sites in the oprF gene. The kanamycin-resistance gene was then removed by PstI digestion, which left a 12 nucleotide pair linker residue. Nine unique clones were identified that contained such linkers at different locations within the oprF gene and were permissive for the production of full-length OprF variants. In addition, one permissive site-directed insertion, one non-permissive insertion and one carboxyterminal insertion leading to proteolytic truncation were also identified. These mutants were characterized by DNA sequencing and reactivity of the OprF variants with a bank of 10 OprF-specific monoclonal antibodies. Permissive clones produced OprF variants that were shown to be reactive with the majority of these monoclonal antibodies, except where the insertion was suspected of interrupting the epitope for the specific monoclonal antibody. In addition, these variants were shown to be 2-mercaptoethanol modifiable, to be resistant to trypsin cleavage in intact cells and partly cleaved to a high-molecular-weight core fragment in outer membranes and , where studied, to be accessible to indirect immunofluorescence labelling in intact cells by monoclonal antibodies specific for surface epitopes. Based on these data, a revised structural model for OprF is proposed.

Amino Acid Sequence↗
PubMed1993

An insert of seven amino acids confers functional differences between smooth muscle myosins from the intestines and vasculature.

The molecular mechanisms underlying the heterogeneity in contractile properties observed among smooth muscle tissues are unknown. We examined whether part of this diversity might be intrinsic to myosin by comparing structural and enzymatic properties of myosins from two physiologically diverse tissues. Using the reverse transcriptase polymerase chain reaction, we compared avian intestinal smooth muscle and vascular smooth muscle myosin heavy chain (MHC) mRNA. We found that intestinal, but not vascular, MHC mRNA contains an insert of 21 nucleotides, encoding 7 amino acids, in a region near the ATP binding site in the myosin head. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of purified myosin revealed that the relative mobilities of the previously described intestinal MHC isoforms SM1 (204 kDa) and SM2 (200 kDa) were slower than the corresponding vascular SM1 and SM2 isoforms. Furthermore, antibodies raised against a synthetic peptide corresponding to the deduced amino acid sequence of the intestinal insert strongly recognized intestinal SM1 and SM2 but only weakly recognized the vascular isoforms. The presence of the insert in intestinal myosin correlated with a higher velocity of movement of actin filaments in vitro and a higher actin-activated Mg(2+)-ATPase activity, compared with vascular myosin. Other than the MHC insert, one other structural difference distinguished intestinal and vascular myosins: two isoforms of the 17-kDa myosin light chain were found in vascular myosin, whereas a single isoform was found in intestinal myosin. Exchange of the intestinal myosin light chains onto the vascular MHC did not alter its activity in the in vitro motility assay, suggesting that the 7-amino acid MHC insert is responsible for the different enzymatic activities of vascular and intestinal myosins.

Adenosine Triphosphate↗
PubMed1997

[Search for insertion mutations disrupting mitosis using a transposon from the reporter gene in Drosophila melanogaster].

Transpositions of the vector P[lArB] into the regions 78D, 61F, and 85F of chromosome 3, which result in various anomalies of mitoses in neural ganglions of homozygous larvae, were obtained by insertion mutagenesis. The tissue specificity of regulatory elements controlling the reporter gene was studied by staining for the activity of beta-galactosidase reporter gene of the vector P[lArB]. These regulatory elements are suggested to be the enhancers of the genes carrying insertions. In all studied mutants, staining for beta-galactosidase was found in tissues containing actively proliferating cells. The staining of germarium in adult female ovaries was the most pronounced. The germarium staining pattern was used for the identification of novel insertions leading to mitosis abnormalities. The P1003 (99F) insertion was found, which according to preliminary data leads to an increase in the mitotic index and anomalies of chromosome structure in neuroblasts of homozygous larvae. In addition, the 22w (42A) insertion leading to chromosome arrest in metaphase was found.

Animals↗
PubMed2002

Surgical approaches for inserting hemiarthroplasty of the hip.

BACKGROUND: The operation of insertion of a hemiarthroplasty to the hip refers to replacement of the femoral head with a prosthesis, whilst retaining the natural acetabulum and acetabular cartilage. The main surgical approaches to the hip for insertion of the prosthesis can be broadly categorised as either 'anterior' via the anterior joint capsule, or 'posterior' through the posterior joint capsule. OBJECTIVES: To evaluate, based on evidence from randomised controlled trials, the effects of different surgical approaches for the insertion of a hemiarthroplasty to the hip has on clinical outcomes. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group specialised register (up to February 2002). Articles of all languages were considered. SELECTION CRITERIA: All randomised controlled trials comparing insertion of a hemiarthroplasty by different surgical approaches. DATA COLLECTION AND ANALYSIS: Both reviewers independently assessed trial quality, using a 10 item scale, and extracted data. Wherever appropriate and possible, the data are presented graphically. MAIN RESULTS: One randomised trial was identified involving 114 patients. The trial had poor methodology (particularly in susceptibility to selection bias), inadequate follow-up of patients who withdrew, and there was limited reporting of results. Medical complications and mortality from six months to two years appeared greater in the posterior group; this difference in mortality, within the structure of the poor methodology, was statistically significant. No other differences were claimed to be significant. REVIEWER'S CONCLUSIONS: There is currently insufficient evidence from randomised trials to determine the optimum surgical approach for insertion of a hemiarthroplasty to the hip.

Arthroplasty, Replacement, Hip↗
PubMed1984

Insertion of EGF receptors into target cells in the absence of fusogenic agents.

Epidermal growth factor (EGF) receptors can be spontaneously and selectively transferred from donor plasma membranes to recipient receptorless fibroblasts in the absence of any added fusogenic agent. Studies on the time and temperature dependence of this transfer indicate that it is due to preferential insertion of the EGF receptor over the other plasma membrane proteins. The inserted receptor is exceptionally stable to dissociation or damage. The number of receptors inserted increased with increasing amounts of donor membranes and then reached a plateau, which also suggests the existence of saturable receptor 'docking' sites in recipient cells. It is interesting that both human and murine receptors are selectively inserted into the mutant mouse cell membrane. This suggests that the parts of the receptor molecule responsible for insertion are similar in murine and human receptors, and that a 'docking' factor present in the mouse recipient cells may accept both human and murine receptors.

Animals↗
PubMed2003

Unique insertional translocation in a childhood Wilms' tumor survivor detected when his daughter developed bilateral retinoblastoma.

Retinoblastoma and Wilms' tumor are rare childhood embryonic tumors associated with loss or inactivation of tumor suppressor genes, RB1 located within 13q14, and WT1 located within 11p13. Interchromosomal insertional translocations occur rarely, and such rearrangements within RB1 or WT1, even rarer. We report a unique family in which an insertional translocation of a chromosomal segment that included band 13q14 inserted into 11p13 caused childhood Wilms' tumor in the father, and whose child developed bilateral retinoblastoma. This is the first case of an insertional translocation that caused both tumors. This insertional translocation had significant consequences for genetic counseling and in utero diagnosis. The estimated risk for an offspring of this father to develop Wilms' tumor is up to 50%, to develop retinoblastoma up to 25%, to have neither tumor 25%, and to have both tumors 0%.

Chromosome Banding↗
PubMed2005

Intrachromosomal insertion mimicking a pericentric inversion: molecular cytogenetic characterization of a three break rearrangement of chromosome 20.

Intrachromosomal insertions are uncommon rearrangements, in which a chromosomal segment is intercalated into another part of the same chromosome. The insertion may occur in the same arm (paracentric) or in the other arm (pericentric). The cytogenetic recognition of these structurally rearranged chromosomes can be difficult, and intrachromosomal insertions can be easily mistaken for inversions. We describe a case of a familial pericentric insertion of chromosome 20, initially misdiagnosed as a pericentric inversion in the healthy carrier and then reinterpreted as insertion in an abnormal child with a recombinant chromosome. Fluorescence in situ hybridization (FISH) allowed us to confirm the mechanism of recombinant formation and to locate the three breakpoints precisely. Our cytogenetically unbalanced epileptic patient carried a 20q deletion and 20p duplication, and the genes, CHRNA4 and KCNQ2 that have been implicated in autosomal dominant epilepsy, were deleted. The haplo-insufficiency of these two genes may contribute to the cause of epilepsy in patients with ring chromosome 20.

Abnormalities, Multiple↗
PubMed2005

Founder SVA retrotransposal insertion in Fukuyama-type congenital muscular dystrophy and its origin in Japanese and Northeast Asian populations.

Fukuyama-type congenital muscular dystrophy (FCMD), one of the most common autosomal recessive disorders in Japan, is characterized by congenital muscular dystrophy associated with brain malformation due to a defect in neuronal migration. Previously, we identified the gene responsible for FCMD, which encodes the fukutin protein. Most FCMD-bearing chromosomes (87%) are derived from a single ancestral founder, who lived 2,000-2,500 years ago and whose mutation consisted of a 3-kb retrotransposal insertion in the 3' non-coding region of the fukutin gene. Here we show, through detailed sequence analysis, that the founder insertion is derived from the SINE-VNTR-Alu (SVA) retroposon. To enable rapid detection of this insertion, we have developed a PCR-based diagnostic method that uses three primers simultaneously. We used this method to investigate the distribution and origin of the founder insertion, screening a total of 4,718 control DNA samples from Japanese and other Northeast Asian populations. Fifteen founder chromosomes were detected among 2,814 Japanese individuals. Heterozygous carriers were found in various regions throughout Japan, with an averaged ratio of 1 in 188. In Korean populations, we detected one carrier in 935 individuals. However, we were unable to detect any heterozygous alleles in 203 Mongolians and 766 Mainland Chinese populations. These data largely rule out the possibility that a single ancestor bearing an insertion-chromosome immigrated to Japan from Korea or Mainland China and appear to confirm that FCMD carriers are rare outside of Japan.

Asia↗
PubMed1995

Functional movements of putative jaw muscle insertions.

BACKGROUND: The craniomandibular muscles control jaw position and forces at the teeth and temporomandibular joints, but little is known regarding their biomechanical behaviour during dynamic function. The objective of this study was to determine how jaw muscle insertions alter position during different jaw movements in living subjects. METHODS: Computer 3D reconstruction of MR images and jaw-tracking were combined to permit the examination of movement with six degrees of freedom. Maximum mandibular opening, protrusive and laterotrusive positions were recorded in four subjects, and the translation and rotation of the putative insertions of masseter, temporal, medial, and lateral pterygoid muscles were measured. RESULTS: The sizes and shapes of regional attachments varied markedly among subjects, and their displacement patterns were different in specific muscles. For instance, when the jaw closed to the dental intercuspal position from maximum gape, the region near the superior insertion site of the masseter moved backward and upward, whereas the region near the inferior insertion site displaced mainly forward. In three subjects, the jaw's rotational center during this act was approximately 26-34 mm below the mandibular condyles. CONCLUSIONS: Since the movements of each muscle part differ according to variations in the size and shape of insertion areas, individual musculoskeletal form, and patterns of jaw motion during function, the prediction of motion-related muscle mechanics in any one subject is unlikely to be possible without direct measurement of the motion of visualized muscle parts. The present study shows that this information can be obtained.

Adult↗
PubMed2004

The "enthesis organ" concept: why enthesopathies may not present as focal insertional disorders.

OBJECTIVE: The Achilles tendon insertion is associated with a complex of adjacent fibrocartilages, a bursa, and a fat-pad, and is functionally much more than a focal insertion. This has important implications for a better understanding of the spondylarthropathies (SpA). However, the degree to which other insertions form comparable "enthesis organs" has not been established. The aim of this study was to demonstrate the applicability of the enthesis organ concept to other insertion sites. METHODS: Both joint-related (articular) and extraarticular entheses were removed from 28 sites in the limbs of formalin-fixed cadavers (age at death 70-101 years) that had been donated for anatomic study. The samples were prepared for paraffin histologic analysis and sectioned longitudinally. The presence and extent of enthesis organs was evaluated at each site in serial sections stained with Masson's trichrome and toluidine blue. RESULTS: Articular enthesis organs were found at 14 entheses, including the attachments of the digital extensor tendons and collateral ligaments, the cruciate ligaments, tibialis anterior, the lateral collateral ligament of the knee, and the popliteal tendon. Extraarticular enthesis organs were seen at 2 sites, the biceps brachii and patellar tendon insertions. In all enthesis organs, sesamoid and/or periosteal fibrocartilage was present in close association with synovium. CONCLUSION: The concept of an enthesis organ is of general significance in understanding attachment sites and may explain the diverse pathologic changes, including synovitis, bursitis, and extracapsular changes, seen adjacent to tendon/ligament entheses in SpA. These findings may provide insight into the reason the target tissues in SpA are apparently so diverse.

Aged↗
PubMed1980

The insertion of oesophagogastric tubes in malignant oesophageal strictures: endoscopy or surgery?

Oesophagogastric tubes were inserted into 16 patients with malignant strictures of the distal oesophagus by a method employing the flexible fibreoptic endoscope, and these patients were compared with 28 patients in the same hospital whose tubes were inserted by surgical methods. Four patients (25 per cent) in the endoscopic group died in the immediate post-insertion period as a result of the procedure, compared with 13 patients (45 per cent) in the surgical group. Of the remainder, the majority were mobilized and taking diet on the day following the procedure, and the morbidity associated with the surgical method was not seen in the endoscopic group. It is concluded that the endoscopic insertion of oesophagogastric tubes has advantages over surgical insertion in the palliation of malignant oesophageal strictures.

Aged↗
PubMed1993

Transesophageal echocardiography: increased risk by repeated attempts to insert the transducer in patients with coronary artery disease?

The question of whether several attempts at transducer insertion increase the risk of performing transesophageal echocardiography (TEE) in patients with coronary artery disease (CAD) has not been addressed to date. In the course of performing TEE in 45 patients with CAD, two or more attempts to insert the transducer were necessary in 9 cases. During various attempts, heart rate, blood pressure and ST-segment depression were recorded and correlated with the findings of the exercise electrocardiogram (ECG) and coronary angiography. Insertion was successful in six patients after two attempts and in three other patients after three, four, and five attempts, respectively. Heart rate rose significantly (p < 0.005) with the increase of insertion attempts. In one patient, it continued to rise at the fourth attempt, reaching 216% compared with the initial heart rate. Systolic blood pressure rose by 5%, whereas there was hardly any change in diastolic blood pressure. As the number of insertion attempts increased, we recorded a continuous ST-segment depression in eight patients with angiographic changes of the coronary artery system. The depression was already significant at the first attempt (p < 0.05). Compared with the initial reading (0.053 mV), the increase was 335% (p < 0.01) after the second attempt (0.231 mV). One patient whose angiographic findings were normal had no ST-segment depression during TEE. In all eight patients with CAD ST-segment depression during TEE was > 0.2 mV. Since none of the patients complained of angina pectoris, the ST-segment depressions satisfied all the criteria of silent myocardial ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2002

Real-time tumor-tracking radiation therapy for lung carcinoma by the aid of insertion of a gold marker using bronchofiberscopy.

BACKGROUND: The authors developed fluoroscopic real-time tumor-tracking radiation therapy (RTRT) by insertion of a gold marker using bronchofiberscopy to reduce uncertainties in organ motion and set-up error in external radiotherapy for moving tumors. The purpose of the current study was to evaluate RTRT's feasibility in lung carcinoma treatment. METHODS: The three-dimensional position of a 1.0-2.0 mm gold marker in or near the tumor was detected by two sets of fluoroscopies every 0.03 seconds. The treatment beam was gated to irradiate the tumor only when the position of the marker coincided with its planned position using the RTRT system. Bronchofiberscopic equipment for insertion of the marker into the lung tumor was developed and used for 20 lung tumors in 18 patients. Patients were given high dose hypofractionated focal irradiation (35-48 Gy in 4-8 fractions in 4-10 days) with a planning target volume margin of 5 mm for the tumor. RESULTS: The markers were successfully inserted and maintained at the inserted position during and after the radiotherapy in 14 (88%) of 16 peripheral-type lung tumors and in none of four central-type lung tumors, indicating that this method of RTRT was not feasible for central-type lung tumors. Tracking of the marker was successfully performed in 1 of 2 tumors with a 1.0 mm marker and in all of 12 tumors with a 1.5-2.0 mm marker. On the whole, 13 (65%) of the 20 tumors were successfully treated with RTRT. Local tumor control was achieved and maintained for all 12 patients (13 tumors), who were treated with RTRT, with a median followup of 9 months (range, 5-15). Localized radiation pneumonitis was found radiographically at the lung volume that was irradiated with about 20 Gy, without symptoms in all but one patient. CONCLUSIONS: The insertion of a gold marker into or near peripheral-type lung tumors using bronchofiberscopy is a feasible and safe technique. Excellent initial response and low incidence of clinical complications suggest that the high dose hypofractionated focal irradiation using the RTRT system can be a good local treatment for peripheral-type lung tumors.

Adult↗
PubMed2005

Selecting patients for flexible sigmoidoscopy. Determinants of incomplete depth of insertion.

BACKGROUND: Flexible sigmoidoscopy (FS) is an effective method to prevent and reduce mortality from colorectal carcinoma (CRC). Incomplete depth of insertion (IDI) during FS may result in missed polyps and carcinomas. To determine whether it is possible to predict IDI, the authors analyzed factors that affected the depth of insertion in FS. METHODS: For the current study, FS results were recorded prospectively over a 5-year period. A questionnaire was administered to the patient by the investigator prior to FS to collect data, including age, gender, weight, comorbid illnesses, history of prior abdominal and pelvic surgeries, family history of colon carcinoma or polyps, and prior FS or colonoscopies. The depth of insertion of the flexible sigmoidoscope from the anal verge, which was defined as the reading on the outside of the instrument at its maximal insertion, was measured in centimeters. IDI was defined as a depth of insertion < 50 cm. Classification and regression tree analysis was used to develop a model that included variables predictive of IDI. RESULTS: The best classification tree included gender, age < 69 years (in women), and a history of hysterectomy. Men had a < 5% risk of an IDI and women age < 69 years without a hysterectomy fared as well (6.6%). Older women and younger women who underwent hysterectomy had higher rates of IDI (29.2% and 22.3%, respectively.) CONCLUSIONS: The authors developed a model based on age, gender, and hysterectomy status that, after further validation, may be useful for predicting which patients likely will have an incomplete examination. In those patients who have a high probability of IDI, the choice can be made to offer colonoscopy or perform FS under sedation, with analgesia, or with the help of distraction techniques.

Age Distribution↗
PubMed1995

Flanking region sequences and internal repeat structure of the pYNH24 (D2S44) 2 kbp insert analyzed by polymerase chain reaction and partial digestion with RsaI.

The 2 kbp YNH24 pUC18 insert was partially sequenced, amplified with fluorescence-labeled primers, and characterized by incomplete digestion with the restriction enzyme RsaI. A characteristic RsaI profile with one restriction site in each repeat unit was obtained when the fragments were analyzed on a DNA sequencer. We developed this procedure with the specific aim of analyzing the internal repeat structure in recombinant alleles often observed in the YNH24 variable number of tandem repeat system (D2S44). Nonetheless, it should also be possible to apply the method when analyzing other tandem repeats, even when little information regarding their sequences is available. In addition, when the repeat array is amplified, either a 5' or a 3' fluorescence-labeled primer can be used to enable analysis from both directions of fairly long (> 3.6 kbp) alleles. The RsaI fragments obtained by partial digestion of the amplified pYNH24 insert corresponded well to the RsaI sites found in the sequenced regions. The 5' flanking region contained eight 30-34 bp sequences similar to the repeat unit and also several RsaI sites, whereas only a few RsaI sites and no repeat units were found in the 3' flanking region. Twenty-five consecutive RsaI sites were revealed, in the center of the pYNH24 insert, indicating a region with strictly repeated core sequences; this repetitive block comprised less than half of the total insert. Two approximately 2.24 kbp HinfI alleles from two different heterozygous individuals were found to have identical internal structure, which was very similar to that of the insert although it exhibited only 15 RsaI repeats.

Alleles↗
PubMed2003

Mandibulotomy and implant insertion.

BACKGROUND: A mandibulotomy can be necessary to approach a tumor in the oral cavity or oropharynx. The aim of this study was to develop and prospectively evaluate a technique enabling simultaneous performance of a mandibulotomy and insertion of endosseous implants in the same area. METHODS: In five edentulous patients such a procedure was performed. The pilot drilling of the implants was done before performing the mandibulotomy. After tumor resection, reconstruction, and restoration of the continuity of the mandible, the final drilling and insertion of the implants were completed. In total, 20 implants were inserted. All patients received radiation therapy within 6 weeks after surgery. Implant-supported overdentures were fabricated 6 months after irradiation. At regular time intervals, a standardized clinical and radiographic evaluation was performed. RESULTS: No complications with respect to the combination of implant insertion and mandibulotomy were observed either during or after surgery. In addition, no adverse mucosal reactions were observed during the course of radiotherapy, no cases of osteoradionecrosis developed, and no implants were lost. Clinical and radiographic evaluation revealed healthy peri-implant parameters. CONCLUSION: From this study it is concluded that, when following the technique described, a mandibulotomy can be combined safely with the insertion of implants in the ventral part of the edentulous mandible.

Aged↗
PubMed1982

Nucleosome reconstitution on plasmid-inserted poly(dA) . poly(dT).

Chromatin was reconstituted from core histones and recombinant plasmid DNAs carrying poly(dA) . poly(dT) inserts of various lengths. A 97-bp insert was found to occupy discrete and regularly-spaced positions on the edges of the nucleosome. This insert cannot, however, be entirely included due to a block in the center of the particle. In contrast, nucleosomes reconstitute on a shorter 20-bp insert. In this case, the insert shows a marked preference for the edges of the particle. Possible structural and physiological implications of these observations are discussed.

Animals↗