pmid
stringlengths 4
8
| title
stringlengths 1
1.27k
| text
stringlengths 1
14.3k
|
|---|---|---|
8041552 | Does recommending timed intercourse really help the infertile couple? | Timed sexual intercourse is a frequently prescribed component in the treatment for infertile couples. This recommendation is based on a combination of intuition and data from studies often lacking in methodology. With increasingly sophisticated and expensive methods available to time coitus with the presumptive evidence of ovulation, such as the urinary LH kits, the already significant stress of timed intercourse is compounded by the expense of these timing modalities. There is a complete lack of data demonstrating an increased chance of pregnancy with use of such devices. Yet there is evidence that the stress of timed intercourse is a major problem for infertile couples and may even hinder normal reproductive functioning. Available data suggest that much of the period of peak fertility during the menstrual cycle is missed if coitus is timed with the menstrual calendar, basal body temperature thermometer, or LH kit. In addition, the recommendation of a coital frequency of at least a couple of times per week would not only help reduce stress, but also ensure coitus during the period of the menstrual cycle with the greatest chance of resulting in a pregnancy. |
8041550 | Embryonic death in early pregnancy: a new look at the first trimester. | To examine the frequency of pregnancy loss following successful development of anatomical embryonic landmarks identified with endovaginal ultrasound. Two hundred thirty-two women with positive urinary pregnancy tests and no antecedent history of vaginal bleeding had endovaginal sonography performed at the initial visit and at subsequent visits as indicated clinically. The presence of anatomical and embryonic structures (gestational sac, yolk sac, embryo) and cardiac activity was recorded. Patients were followed until delivery unless sonographic evidence of nonviability was seen or spontaneous loss occurred. Twenty-seven losses occurred during the embryonic period, four losses occurred in the fetal period, and there were 201 live births. If a gestational sac developed, subsequent loss of viability in the embryonic period occurred in 11.5%; loss rates were 8.5% with a yolk sac, 7.2% for an embryo up to 5 mm, 3.3% for an embryo of 6-10 mm, and 0.5% for an embryo larger than 10 mm. No pregnancies were lost between 8.5 and 14 menstrual weeks. The fetal loss rate after 14 weeks was 2.0%. The rate of early pregnancy loss decreases successively with gestational age and is virtually complete by the end of the embryonic period (70 days after onset of the last menstrual period). Subsequent pregnancy losses in the fetal period occur between 14 and 20 weeks. This pattern of early pregnancy death suggests a period of embryonic loss distinct from one of fetal loss. Based on these data, the physiologic significance of the traditional boundary of the first trimester as an appropriate dividing time line for early pregnancy may be questioned. |
8041549 | Distribution of iron and iron-binding proteins in first-trimester human pregnancies. | To investigate the iron distribution between the maternal and embryonic compartments in the first trimester of pregnancy. Coelomic and amniotic fluids (AF) and maternal serum were collected from 36 apparently normal pregnancies at 7-13 weeks of gestation. Iron, transferrin, ferritin, and lactoferrin were measured in all samples. Iron concentrations were also measured in placental villi, liver, gut, and brain samples collected from two embryos. Significantly (median value) lower iron and transferrin levels and higher levels of ferritin were found in the coelomic fluid (iron 4.8 mumol/L; transferrin 0.22 g/L) than in maternal serum (iron 21 mumol/L; transferrin 2.5 g/L). The AF contained significantly lower levels of iron and ferritin (iron less than 1.8 mumol/L; ferritin 2.0 micrograms/L) than both coelomic fluid (iron 4.8 mumol/L; ferritin 287 micrograms/L) and maternal serum (iron 21 mumol/L; ferritin 49 micrograms/L). Transferrin was undetectable (less than 0.08 g/L) in AF samples, and lactoferrin was undetectable (less than 2 micrograms/mL) in both embryonic fluids. The iron concentration in the coelomic fluid increased significantly (P < .001) with advancing gestation (iron at 7-9 weeks 3.8 mumol/L; 9.1-11 weeks 5.9 mumol/L). There was a nonsignificant correlation between coelomic fluid and maternal serum iron and iron-binding protein levels. The highest iron levels were found in the liver (52 mmol/kg dry weight) and brain (49 mmol/kg dry weight) tissues. The distribution of iron and iron-binding proteins between the maternal and embryo-placental compartments in the first trimester is comparable to that found later in gestation, suggesting that placental iron transfer may occur as early as tertiary villi are formed. The exocoelomic fluid is probably the main iron reservoir in early pregnancy, and the secondary yolk sac is probably the principal route of entry of iron to the embryo. |
8041548 | Decrease in cytochrome c oxidase and cytochrome oxidase subunit I messenger RNA levels in preeclamptic pregnancies. | To elucidate the possible relation between mitochondrial gene expression and placental dysfunction. We measured the activity of cytochrome c oxidase and the expression of cytochrome oxidase subunit I in mitochondria from human placentas of women whose gestations were appropriate for gestational age (AGA) and those with preeclampsia. In addition, the amounts of normal mtDNA and deleted mitochondrial DNA were examined in the two groups by Southern blot analysis and polymerase chain reaction, respectively. Cytochrome c oxidase activity and expression of cytochrome oxidase subunit I were significantly lower in the preeclamptic group than in the AGA group. There were no differences between the groups in the amounts of mitochondrial DNA. In addition, no mutant mitochondrial DNA with a 4977-base pair deletion was detected in the two groups. These results suggest that reduced expression of the mitochondrial gene is involved in placental dysfunction in preeclamptic pregnancy. |
8041547 | Activin at parturition: changes of maternal serum levels and evidence for binding sites in placenta and fetal membranes. | To evaluate maternal serum activin A levels in pregnant women at parturition, correlated to the mode of delivery, and to localize activin receptor messenger RNA in human placenta and fetal membranes. A specific two-site enzyme-linked immunosorbent assay (ELISA) was used to measure maternal activin A levels. Activin receptor mRNA was localized in placenta and fetal membranes by in situ hybridization, using ActRII or ActRIIB antisense riboprobes. Serum activin A levels increased significantly in pregnant women during vaginal or cesarean delivery after spontaneous labor. No significant changes of serum activin A were found in patients undergoing elective cesarean delivery. Syncytiotrophoblast and amnion cells hybridized to radiolabeled ActRIIB probe, whereas few cells within the structure of the villi and decidual cells hybridized to radiolabeled ActRII probe. The present studies indicate that vaginal or cesarean delivery following spontaneous labor is characterized by increased activin A levels and that activin receptors are present on trophoblast and fetal membranes. |
8041546 | Interaction of sex steroids and oxytocin on term human myometrial contractile activity in vitro. | To investigate the interactions of progesterone, estradiol (E2), and oxytocin in regulating the contractile activity of term human myometrium in vitro. Myometrial tissues from 12 term pregnant women were obtained from the lower uterine segment at elective cesarean and immediately immersed in Hepes buffer with and without progesterone and progesterone plus E2. Oxytocin was freshly dissolved in solutions when the superfusion was started. Muscle biopsies were dissected along the bundles of smooth muscle under a stereomicroscope, and the preparations were mounted in six tissue baths superfused with different hormonal solutions. The isometric tension was recorded during the experimental time. During the 2-hour contraction period, increased frequency (P < .01 for each) and decreased activity area (P < .01 for each) and duration of contractions (P < .01 for each) resulted from superfusion of muscle strips with progesterone plus oxytocin, progesterone plus E2, and a combination of progesterone, E2, and oxytocin, compared to that found with buffer alone. The higher concentration of progesterone (5 micrograms/mL) plus oxytocin and progesterone plus E2 elevated the tonus (P < .05 and P < .01), whereas progesterone in combination with E2 and oxytocin decreased it (P < .05). The lower concentration of progesterone (0.5 microgram/mL) plus E2, or both in conjunction with oxytocin, had no significant effect on tonus as compared with buffer. The results suggest that progesterone and E2 have a direct effect on uterine excitability and a regulating influence on the oxytocin sensitivity of term human myometrium. |
8041545 | Emergency contraception alters progesterone-associated endometrial protein in serum and uterine luminal fluid. | To evaluate the effect of high-dose oral contraceptives on serum and uterine luminal fluid progesterone-associated endometrial protein in the luteal phase. Five ovulatory women participated in the study. In a control cycle, serum and uterine lavage samples were collected on luteal day 11. In the next cycle, on luteal day 9, the participants were given two 50-micrograms ethinyl estradiol-norgestrel tablets, repeated 12 hours later. Serum and uterine lavage samples were collected 48 hours (luteal day 11) after the last dose and analyzed by two-dimensional polyacrylamide gel electrophoresis and radioimmunoassays of the serum. Progesterone-associated endometrial protein levels were lower in sera from treated compared with control cycles. Analysis of serum levels of this protein by two-dimensional polyacrylamide gel electrophoresis did not reveal bands corresponding to the known size and charge characteristics (27 kd and pI of 4.9) in either control or treatment samples. On the other hand, in uterine lavage samples, a complete suppression of the 27-kd, pI-4.9 species was evident after treatment. High-dose ethinyl estradiol-norgestrel emergency contraception effectively suppresses progesterone-associated endometrial protein in the midluteal uterus, potentially altering the endometrial environment unfavorably and affecting the survival of the early embryo. |
8041544 | Gentamicin excretion and uptake from breast milk by nursing infants. | To investigate the excretion of gentamicin into human breast milk and resulting serum gentamicin levels in nursing newborn infants. Women delivered by cesarean received gentamicin, 240 mg/day (80 mg intramuscularly three times a day) for 5 days postpartum. On day 4, maternal serum samples were collected 1 and 7 hours after gentamicin administration. Milk samples were collected 1, 3, 5, and 7 hours following administration. The infants were fed 1 hour after gentamicin administration, and serum samples were collected from the newborns 1 hour later. The concentrations of gentamicin were measured by a fluorescence polarization immunoassay. The mean (+/- standard deviation) maternal serum gentamicin levels at 1 and 7 hours were 3.94 +/- 1.12 and 1.02 +/- 0.78 microgram/mL, respectively. Milk gentamicin levels were: 0.42 +/- 0.26, 0.48 +/- 0.17, 0.49 +/- 0.17, and 0.41 +/- 0.25 microgram/mL at 1, 3, 5, and 7 hours, respectively. The mean milk:plasma gentamicin ratios were 0.11 and 0.44 at 1 and 7 hours, respectively. The correlation between maternal peak serum levels and milk levels was not statistically significant (P > .05). Detectable (above 0.27 microgram/mL) gentamicin levels were found in five of the ten newborn serum samples, with a mean level of 0.41 +/- 0.05 microgram/mL. Gentamicin is transferred into breast milk, and half of nursing newborn infants have detectable serum gentamicin levels. |
8041543 | Influence of psychological stress on suckling-induced pulsatile oxytocin release. | To investigate the influence of psychological stress on suckling-induced oxytocin release. The pulsatile release of suckling-induced oxytocin was measured in 22 puerperal women. The blood samples for oxytocin assay were collected at 2-minute intervals in a manner that minimized degradation by plasma oxytocinase, and were used for radioimmunoassay after extraction. The release of suckling-induced oxytocin during nursing is pulsatile, with discrete, short pulses. The frequency of pulsatile release of oxytocin was significantly lower in the two groups in which stress was imposed by mental calculation or noise than in the control group without stress (mental calculation group, 1.28 +/- 0.76 pulses/20-minute suckling period; noise group, 1.14 +/- 0.38; control group, 2.25 +/- 0.71). However, there were no differences among the three groups in the increase of prolactin during nursing or in the milk yield. The release of suckling-induced oxytocin is pulsatile, and psychological stress reduces the pulsatile oxytocin release. Our data suggest that suckling-induced oxytocin release may be modulated by the central nervous system and that psychological relaxation is necessary for an adequate let-down response. |
8041542 | Vaginal birth after cesarean: a 10-year experience. | To report the changing incidence of previous cesarean delivery, and the increasing use and success of a trial of labor and its effect on the repeat cesarean rate. Between 1983-1992, there were 164,815 deliveries at Los Angeles County+University of Southern California Women's Hospital, of which 17,322 (10.5%) were to women with at least one previous cesarean delivery. Data were gathered on an ongoing basis from delivery logs and patient charts. Women with at least one previous cesarean accounted for 8.1% of all deliveries in 1983, increasing to 14.1% by 1992. Trial of labor was used in 80% of women with one previous cesarean, in 54% with two, and in 30% with three or more. The success rate was significantly higher with one previous cesarean (83%) than with two or more (75.3%). Furthermore, uterine rupture was three times more common with two or more previous cesareans. Compared to a policy of routine repeat cesarean, trial of labor yielded a 6.4% lower cesarean delivery rate. The majority of this benefit (5.5%) was derived by women with one previous cesarean. Among women undergoing a trial of labor, there were three rupture-related perinatal deaths and a single rupture-related maternal death. Substantial reduction in the cesarean rate is achieved safely and efficiently by encouraging a trial of labor in women with a single previous cesarean delivery. |
8041541 | Erythropoietin in pregnancies complicated by pyelonephritis. | To determine whether antepartum pyelonephritis causes an acute or delayed alteration in erythropoietin production. Serum erythropoietin concentrations were determined prospectively using an enzyme-linked immunosorbent technique in 36 pregnant women admitted to Parkland Hospital with pyelonephritis. Healthy nonanemic pregnant women served as controls. Serum erythropoietin levels in women with antepartum pyelonephritis were not different from those measured in normal pregnant women. Specifically, there were no differences in erythropoietin levels in women who had anemia at admission (n = 6; 13.8 mU/mL), hemolysis (15.4 versus 12.9 mU/mL), or renal insufficiency (14.5 versus 12.9 mU/mL) secondary to renal infection as compared to controls. We conclude that antepartum pyelonephritis does not alter erythropoietin production either acutely or within several days of infection. Because erythropoietin production was not decreased, we suggest that hemolysis is the major factor contributing to anemia associated with renal infection. |
8041540 | Pregnancy-induced carpal tunnel syndrome requiring surgical release longer than 2 years after delivery. | To determine the percentage of patients in whom carpal tunnel syndrome was induced by pregnancy, the presence of any risk factors causing persistent symptoms after delivery, and the outcome of surgical decompression in these patients. We reviewed retrospectively the records of 100 consecutive women treated by carpal tunnel release in our unit from 1988-1991. Seven patients had the onset of hand symptoms during pregnancy. One patient was diabetic and worked as a machine operator, but none of the others had predisposing factors that could have led to persistent postpartum symptoms. The hand symptoms persisting after delivery initially required conservative treatment only. However, 2-16 years later, symptoms became severe enough to warrant surgical release of the carpal tunnel. All patients had resolution of symptoms after surgery. Some patients with mild residual hand symptoms due to carpal tunnel syndrome may initially respond to conservative treatment, but 2-16 years later, symptoms may become severe enough to warrant surgical release. We recommend long-term follow-up of patients with residual postpartum hand symptoms. |
8041539 | Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. | To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy. Symptomatic pregnant women were randomized to one of two acupressure groups: one treatment group using an acupressure point (PC-6) and one sham control group using a placebo point. Subjects were blind to the group assignment. Each evening for 10 consecutive days, the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred. Data from the first 3 days were used as pre-treatment scores. Beginning on the morning of the fourth day, each subject used acupressure at her assigned point for 10 minutes four times a day. Data from day 4 were discarded to allow 24 hours for the treatment to take effect. Data from days 5-7 were used to measure treatment effect. Sixty women completed the study. There were no differences between groups in attrition, parity, fetal number, maternal age, gestational age at entry, or pre-treatment nausea and emesis scores. Analysis of variance indicated that both groups improved significantly over time, but that nausea improved significantly more in the treatment group than in the sham control group (F1,58 = 10.4, P = .0021). There were no differences in the severity or frequency of emesis between the groups. There was a significant positive correlation (r = 0.261, P = .044) between maternal age and severity of nausea. Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women. |
8041538 | Maternal mortality in Sweden, 1980-1988. | To assess recent maternal mortality in Sweden according to the different definitions of the eighth, ninth, and tenth editions of the International Classification of Diseases (ICD). All maternal deaths in Sweden during 1980-1988 were sought in the Medical Birth Registry and in the Registers of Births and Deaths. Hospital records and autopsy reports were requisitioned. According to ICD-9, the maternal mortality ratio in Sweden for 1980-1988 was 7.4 per 100,000 live births. Of the 58 deaths, 36 were direct maternal deaths. Embolism, hemorrhage, preeclampsia, and infection were the predominant causes in the direct cases. Advanced age was the most pronounced risk factor. Suboptimal standard of care was a contributing cause in almost one-third of the direct maternal deaths. Accidental or incidental deaths, including suicide, accidents, and pregnancy-related deaths, added six cases. There were 76 late maternal deaths, occurring 43-365 days postpartum. Malignancy, stroke, and heart disease were the predominant causes. After malignant disease, suicide constituted the leading cause of pregnancy-related deaths within 1 year of delivery. Regular reviews of maternal mortality are still important in a country with a low rate of maternal deaths. The new classification of maternal deaths allows a better international comparison of mortality risks. Continuous surveillance of maternal deaths and pregnancy-related deaths requires record linkage of birth and death registrations. |
8041537 | Possible improvement in uteroplacental blood flow during atrial natriuretic peptide infusion in preeclampsia. | To study the effects of low doses of the hormone atrial natriuretic peptide (ANP) on uteroplacental blood flow in patients with preeclampsia. Eleven women with preeclampsia were infused intravenously with ANP (10 ng/kg/minute). Uteroplacental blood flow index was measured using dynamic placental scintigraphy with indium-113m. Regional blood flows were assessed by pulsed Doppler ultrasound and expressed as pulsatility index (PI). Hemodynamic measurements and blood sampling for peripheral venous plasma analysis of cyclic guanosine monophosphate (cGMP), an ANP second messenger, were performed before and after 30 minutes of infusion. Nonparametric statistics were used. The uteroplacental blood flow index increased by 28% (-2 to 58%; mean and 95% confidence interval). The Doppler findings were unaffected. Mean arterial blood pressure decreased from 112 (108-117) to 108 (103-114) mmHg (P < .01). Cyclic GMP increased significantly from 9.2 (6.2-12.3) to 17.4 (12.3-22.6) nmol/L (P < .01). Subjects exhibiting a substantial increase in uteroplacental blood flow index (25% or more) demonstrated a significantly greater cGMP response (P < .01) than those who did not (6% or less increase). A tendency to an increased uteroplacental blood flow index combined with minor blood pressure reduction after ANP infusion suggest the possibility of uteroplacental vasodilatation. |
8041536 | The value of a negative antepartum test: contraction stress test and modified biophysical profile. | To examine the outcome of pregnancies in high-risk patients whose last antepartum fetal assessment was a negative contraction stress test (CST) or a negative modified biophysical profile. Twenty-nine hundred ninety-four women who received modified biophysical profiles were compared with 2450 who had CSTs during the preceding 3 years. Pregnancy outcomes were evaluated in patients whose last test was negative. Seventeen hundred fifty-three patients had negative modified biophysical profiles as the last test before delivery, and 1337 had negative CSTs as the last test before delivery. Adverse perinatal outcomes included perinatal death or death before nursery discharge, cesarean delivery for fetal distress within the first 2 hours of labor, 5-minute Apgar score less than 7, neonatal seizures, or grade III or grade IV central nervous system hemorrhage. Adverse outcomes occurred in 90 patients (5.1%) whose last test before delivery was a negative modified biophysical profile and in 93 patients (7.0%) whose last test was a negative CST (P = .04, odds ratio 1.38, 95% confidence interval 1.01-1.88). Overall, there were 11 perinatal deaths, nine of which resulted from lethal congenital abnormalities. In this population, the frequency of adverse perinatal outcome following a negative modified biophysical profile was no greater than that following a negative CST. Further, the incidence of potentially preventable perinatal death following a negative modified biophysical profile or CST was less than one per 1000 tested high-risk pregnancies. |
8041535 | A prospective evaluation of the signs and symptoms of preterm labor. | To describe the time relation between symptoms, contractions, and the clinical diagnosis of preterm labor. We analyzed the records from 57 women who were enrolled in a previously reported trial of home uterine monitoring and who developed preterm labor while using the monitor. In a post hoc descriptive study of signs and symptoms during the 7 days preceding a diagnosis of preterm labor, we reviewed uterine contraction records and study records of the responses to a standard list of questions about potential symptoms of preterm labor. Monitored contraction frequency increased on the day of preterm labor diagnosis, from an average of fewer than three per hour to five per hour, but was not increased on any of the days before the day of diagnosis. Neither symptoms nor contraction monitoring strips indicated any significant changes more than 24 hours before the clinical diagnosis was made. Self-palpated and monitored contractions were the most common symptoms of preterm labor. A clinical diagnosis of preterm labor is preceded by an increase in self-palpated and monitored contractions and other symptoms for less than 24 hours. |
8041534 | Long-term effects of oral and transdermal hormone replacement therapies on serum lipid and lipoprotein concentrations. | To see whether the short-term changes in serum lipid and lipoprotein concentrations induced by postmenopausal estrogen-progestin therapy are maintained in the long term. Sixty-one healthy postmenopausal women were randomized to either oral therapy (continuous conjugated equine estrogens at 0.625 mg/day with sequential dl-norgestrel at 0.15 mg/day for 12 days each cycle) or transdermal therapy (patches delivering continuous 17 beta-estradiol [E2] at 0.05 mg/day with sequential norethindrone acetate at 0.25 mg/day for 14 days each cycle). Twenty-nine healthy postmenopausal women who did not request therapy served as a reference group. Fasting serum lipid and lipoprotein concentrations were monitored for 3 years. Studied in the estrogen-progestin phase, oral and transdermal therapies reduced serum total cholesterol concentrations by 12.1% (P < .001) and 8.4% (P < .001), respectively, and those of low-density lipoprotein (LDL) by 14.2% (P < .001) and 6.6% (P < .01), respectively. These changes, apparent at 3 months, were maintained over 3 years. Serum triglyceride concentrations fell by 2.5% (P < .05) and 16.4% (P < .01), respectively. These decreases were evident after 6 months in both groups but were maintained over 3 years only in the transdermal group. High-density lipoprotein (HDL) concentrations fell in women given oral therapy (7.8%, P < .05) and transdermal therapy (10.7%, P < .001), as well as in untreated women (7.0%, P < .05). The potentially beneficial effects of estrogen-progestin therapy on serum total and LDL cholesterol and on triglycerides were maintained over 3 years. Interpretation of the potentially detrimental effects on HDL concentrations was hindered by the changes seen in untreated women. |
8041533 | Clinical evaluation of luteal function. | To determine the ability of luteal phase length determined by basal body temperature (BBT) pattern and a midluteal serum progesterone level to predict the result of an endometrial biopsy in a subsequent cycle. We performed a retrospective analysis of 141 women with a history of infertility who were being evaluated for luteal function. The luteal phase length determined from a BBT chart of one menstrual cycle was compared to a single midluteal serum progesterone level from a second menstrual cycle. These findings were compared to a luteal phase endometrial biopsy performed in a third menstrual cycle. Subjects were divided into four groups depending upon luteal phase length (normal 11 or more days) and serum progesterone level (normal at least 10 ng/mL). The four groups were designated "normal," "short luteal phase," "low progesterone," and "abnormal," depending upon the results of the two tests. The frequency of in- and out-of-phase endometrial biopsy results in the four groups was compared. There was no difference in the occurrence of an in- or out-of-phase endometrial biopsy when the four groups were compared. Neither luteal phase length nor a single midluteal serum progesterone level was predictive of subsequent in-phase or out-of-phase endometrial biopsy. |
8041532 | Vaginal administration of low-dose conjugated estrogens: systemic absorption and effects on the endometrium. | To test the hypothesis tha a very-low-dose regimen of vaginal estrogen would provide effective relief from atrophic vaginitis without endometrial proliferation. Twenty postmenopausal women with symptoms, signs, and cytologic evidence of atrophic vaginitis were enrolled. Each subject was treated with 0.3 mg of conjugated estrogens, administered vaginally 3 nights per week for 6 months. We examined the following outcomes: symptoms, vaginal cellular (cytologic) maturity, endometrial histology, sonographic evaluation of endometrial thickness, Doppler measures of uterine artery blood flow, and serum levels of estrone and estradiol. Pre- and post-treatment data were compared for each subject. Satisfactory relief of symptoms occurred in 19 of 20 cases. Vaginal cellular maturation improved significantly with therapy (P < .01). There were no significant changes in endometrial thickness, uterine artery blood flow, or serum estrogen levels. Endometrial proliferation was observed in one case. Relief from atrophic vaginitis can be achieved with 0.3 mg of conjugated estrogens administered vaginally three times per week. Endometrial proliferation may occur at this low dose, albeit rarely. |
8041531 | A prospective study of symptomatic gallstones in women: relation with oral contraceptives and other risk factors. | To examine the relation between oral contraceptives (OCs), body mass index (BMI), weight change, alcohol use, parity, smoking, and symptomatic gallstones in women less than 45 years of age. In this prospective study, associations between the various self-reported exposures and symptomatic gallstones were assessed in 96,211 female United States nurses with 425 cases of gallstones, using multiple logistic regression. We found little relation between ever-use of OCs and symptomatic gallstones (relative risk [RR] 1.2, 95% confidence interval [CI] 0.9-1.6), although there was a modest elevation in risk for long-term use (RR 1.5, 95% CI 1.0-2.2 for 10-14 years; RR 1.6, 95% CI 1.0-2.4 for 15 or more years). There was also an increased risk in current users of OCs (RR 1.6, 95% CI 1.1-2.4). The risk of symptomatic gallstones increased with increasing BMI and weight gain since age 18. Women with four or more births had an elevated risk of symptomatic gallstones (RR 2.0, 95% CI 1.3-3.2), and current cigarette smokers had a slightly higher risk than never-smokers (RR 1.3, 95% CI 1.0-1.7). The risk decreased with increasing alcohol intake. We found no substantial increase in the risk of symptomatic gallstones among ever-OC users, although current and long-term users had somewhat elevated risks. Body mass index remains the strongest predictor of symptomatic gallstones among young women. |
8041530 | Abuse history and chronic pain in women: II. A multivariate analysis of abuse and psychological morbidity. | To assess the potential role of childhood and adulthood physical and sexual abuse and complaints of chronic pain in accounting for psychiatric symptomatology in adult women. We assessed sexual abuse, physical abuse, depression, anxiety, and somatization in 64 women with chronic pelvic pain, 42 women with chronic headache, and 46 women without chronic pain complaints. Using multiple regression analyses, we tested a model comprising sociodemographic, chronic pain, childhood sexual abuse and physical abuse, and adulthood sexual abuse and physical abuse variables in the prediction of depression, anxiety and somatization. This model significantly predicted all three outcomes. However, childhood sexual abuse was not significant in the prediction of any of the outcome variables, whereas childhood physical abuse was significant in the prediction of all three. Further, the adulthood abuse variable set contributed significantly to the prediction of somatization, and the individual variable of adulthood sexual abuse was predictive of anxiety. The relation observed between childhood sexual abuse and the outcomes of depression, anxiety, and somatization in women may be a function of its association with other forms of abuse, particularly childhood physical abuse. Further investigation is clearly needed of the nature of the relations between the various categories of abuse and psychological morbidity. |
8041529 | Abuse history and chronic pain in women: I. Prevalences of sexual abuse and physical abuse. | To compare the prevalences of childhood and adult physical and sexual abuse in women with chronic pelvic pain to those in women with chronic nonpelvic pain (headache) and pain-free women. Using a structured interview, we assessed the prevalence rates of both sexual abuse and physical abuse in 64 women with chronic pelvic pain, 42 women with chronic headache, and 46 pain-free women. Abuse histories were stratified by age at occurrence and severity. Demographic characteristics of the three groups were also assessed. Women with chronic pelvic pain were found to have a higher lifetime prevalence of sexual abuse, involving penetration or other contact with the unclothed genitals or anus (ie, major sexual abuse), than either comparison group. Further, more women in the chronic pelvic pain group had experienced major sexual abuse in both childhood and adulthood than women in the headache group, but there was no difference with the pain-free group. With respect to physical abuse, women in the chronic pelvic pain group had a higher lifetime prevalence than pain-free women, but not compared to those with chronic headache. In addition, more women with chronic pelvic pain reported physical abuse in both childhood and adulthood and both major sexual abuse and physical abuse at some time in their lives than did either comparison group. These results support a specific association between major sexual abuse and chronic pelvic pain and a more general association between physical abuse and chronic pain. Moreover, the global nature of the abuse histories of the women in the chronic pelvic pain group suggests that more rigorous studies of the relation between abuse history and chronic pelvic pain are needed. |
8041528 | Predicting intrinsic urethral sphincter dysfunction in women with stress urinary incontinence. | To determine whether specific clinical characteristics can be used to identify women with stress urinary incontinence due to intrinsic urethral sphincter dysfunction without the aid of urodynamic testing. A retrospective analysis was performed of 263 consecutive patients who underwent complete urodynamic evaluation for complaints of urinary leakage. Intrinsic sphincter dysfunction was defined as a maximum urethral closure pressure of 20 cm H2O or less in the sitting position at maximum cystometric capacity. Women with sphincter dysfunction were then compared to the group with normal pressure (greater than 20 cm H2O) using t test, chi 2, and logistic regression analyses for 13 clinical indices, endoscopic appearance of the proximal urethra, and eight urodynamic criteria. The group with intrinsic sphincter dysfunction totaled 132 women (50.2%). Univariate analysis revealed that women in this group were older and were more likely to have undergone a hysterectomy and at least one anti-incontinence procedure compared to the women with normal urethral pressure. However, multivariate analysis revealed that age greater than 50 years was the only independent variable that could predict the presence of intrinsic sphincter dysfunction in women with stress incontinence (odds ratio 1.6, 95% confidence interval 1.2-2.2). The two groups were similar in all other preoperative clinical characteristics. The only preoperative clinical index that predicted the presence of intrinsic urethral sphincter dysfunction, as defined by low urethral closure pressure, was age over 50 years. In view of previous studies reporting a higher rate of surgical failure in women with low urethral pressure, urodynamic testing should be considered in surgical candidates over age 50 to allow adequate preoperative counseling. |
8041527 | Urinary incontinence in elite nulliparous athletes. | To determine the prevalence of the symptom of urinary incontinence during athletic endeavors among a group of nulliparous, elite college varsity female athletes. All women currently participating in varsity athletics at a large state university were asked to fill out a questionnaire about the occurrence of urinary incontinence while participating in their sport and during activities of daily life. One hundred forty-four of 156 eligible women (92%) responded. The mean age was 19.9 years, and all women were nulliparous. Overall, 40 athletes (28%) reported urine loss while participating in their sport. The proportions in different sports were: gymnastics 67%, basketball 66%, tennis 50%, field hockey 42%, track 29%, swimming 10%, volleyball 9%, softball 6%, and golf 0%. Two-thirds of the women who noted urine loss during athletics were incontinent more often than rarely. There were no statistically significant relations between incontinence and amenorrhea, weight, hormonal therapy, or duration of athletic activity. Activities most likely to provoke incontinence included jumping, high-impact landings, and running. Forty percent and 17% of the women first noted incontinence during their sport while in high school and junior high school, respectively. Incontinence during physical stresses is common in young, highly fit, nulliparous women. This suggests that there is a continence threshold which, when exceeded, can result in urine loss, even in the absence of known risk factors for incontinence. |
8041526 | Cervical cancer complicated by pregnancy: episiotomy site recurrences following vaginal delivery. | To determine the optimal diagnostic and therapeutic modalities relevant to episiotomy site recurrence of cervical cancer after vaginal delivery. Records from the past 30 years were reviewed to identify patients treated at the Mayo Clinic with episiotomy site recurrence of cervical cancer complicated by pregnancy with vaginal delivery. Four patients with episiotomy site recurrence of squamous cell carcinoma of the cervix were treated primarily at the Mayo Clinic. These cervical cancers were originally diagnosed at delivery or in the immediate postpartum period and were treated by radical hysterectomy. Episiotomy site recurrences were detected less than 12 weeks after surgery in three patients and at 2 years in one patient. Three patients have died of recurrent cancer and one is disease-free at 1 year. Careful screening and examination of cervical abnormalities during pregnancy is required. The primary cancer was not diagnosed until delivery or postpartum in all patients who developed episiotomy site recurrences. If vaginal delivery is elected in a patient with cervical cancer, perineal inspection becomes critical. Including other cases reported in the literature, six of nine with stage IB disease were diagnosed with episiotomy site recurrence within 12 weeks of primary therapy. Consideration should be given to colposcopy of the episiotomy site or random biopsy in these women preoperatively to rule out occult implantation, and this site warrants careful postoperative surveillance. |
8041525 | Appraisal of the modalities used to evaluate an initial abnormal Papanicolaou smear. | To examine the efficacy of the different modalities used to evaluate an initial abnormal Papanicolaou smear. The study population comprised 214 nonpregnant women referred with a Papanicolaou smear diagnosis of cervical intraepithelial neoplasia. Each patient was evaluated by a repeat Papanicolaou smear, colposcopy, and colposcopically directed cervical biopsies. Immediate loop excision was performed to remove the entire transformation zone in all patients. Kappa statistics were calculated to determine agreement among the modalities, and logistic regression was used for determining relative risks (RR). There was 53% agreement between the initial and repeat Papanicolaou smears. When low-grade squamous intraepithelial lesion (SIL) was diagnosed by Papanicolaou smear, there was 89% agreement with the colposcopic impression. However, a colposcopic impression of high-grade SIL was found in only one-third of the women diagnosed with high-grade SIL by Papanicolaou smear. A comparison of the histology of the cervical biopsy and the loop specimen revealed 57% agreement. Univariate analysis indicated that each modality was able to predict the RR of high-grade dysplasia in the loop specimen at a statistical significance level of .05. A colposcopic impression of high-grade dysplasia conferred an RR of 7.43 (95% confidence interval [CI] 2.17-25.49) for high-grade dysplasia in the loop specimen. An initial Papanicolaou smear diagnosis of high-grade SIL did not contribute to the multivariate model for calculating the risk of high-grade dysplasia, as the RR was 1.6 (95% CI 0.68-3.81). Patients with an initial Papanicolaou smear showing low-grade SIL would benefit from a repeat Papanicolaou smear and colposcopically directed biopsies before proceeding with loop diathermy. In contrast, patients with a colposcopic impression of high-grade dysplasia combined with high-grade SIL on Papanicolaou smear appear to be candidates for immediate loop excision. |
8041524 | A comparison of the three most common Papanicolaou smear collection techniques. | To evaluate three common instruments for sampling the endocervical canal: the Q-tip applicator, the Cytobrush, and the Cervex brush. Clinical, cytologic, and histologic data were collected from patients enrolled in the colposcopy clinic at the National Naval Medical Center. Subjects were assigned to one of three techniques: a combination of spatula and swab, a combination of spatula and Cytobrush, and the Cervex brush alone. There was no significant difference in the ease of use or the amount of patient discomfort among the three methods, although the Cytobrush caused an increase in mild cervical bleeding. The Cytobrush yielded the greatest number of endocervical cells. The swab produced the lowest number of endocervical cells and the greatest cellular distortion. The ability to identify patients with biopsy-proven dysplasia was comparable for each of the three methods. The Cytobrush was the best device for sampling the endocervical canal, but it was no more sensitive in detecting cervical dysplasia. |
8041523 | Intraoperative lymphatic mapping for vulvar cancer. | To determine the feasibility of intraoperative lymphatic mapping in patients with vulvar cancer. Isosulfan blue was injected intradermally at the junction of tumor and normal skin in nine patients. We then attempted to identify the dye in the superficial lymphatic channels and in a superficial groin lymph node. The sentinel node was identified in seven of 12 groins in seven of the nine subjects studied. Six of the successful cases had unilateral lesions. The cases in which a sentinel node was not identified were both patients with midline lesions, including one whose scar was injected following a prior wide local excision of a perineal tumor and one who appeared to have direct drainage to the deep pelvic nodes. There were no technique-related complications. In no case was there a positive non-sentinel node in the presence of a negative sentinel node. Intraoperative lymphatic mapping is technically feasible in patients with vulvar cancer, particularly those with unilateral disease. Further experience is needed to evaluate the reliability of the technique in identification of groin node metastases. |
8041522 | A new animal model of dopamine supersensitivity using s.c. implantation of haloperidol releasing polymers. | Dopamine supersensitivity was induced by either the continuous daily release of 1.0 mg/kg haloperidol from controlled release polymers implanted subcutaneously in rats or by daily bolus injection. In vitro, these polymers were found to release haloperidol for more than 250 days. After implantation in vivo, supersensitivity was quantified by locomotor activity following apomorphine injection and specific [3H]spiroperidol binding to striatal synaptic membranes. Supersensitivity in rats with haloperidol implants was remarkably similar to that evoked by daily drug applications after 3 weeks without producing the detrimental daily sedations, typically seen after bolus administration. Furthermore, no difference in specific binding between both group was seen. A continuous delivery of haloperidol for 8 weeks also resulted in comparable denervation supersensitivity. Controlled release polymers may thus be a superior tool to induce denervation supersensitivity in a gradual, continuous fashion. |
8041521 | Coherent modulations of human motor unit discharges during quasi-sinusoidal isometric muscle contractions. | Spectral analysis of single-unit discharges, multi-unit EMG and muscle force during voluntary quasi-sinusoidal isometric contractions of two hand muscles revealed corresponding modulations of the firing rates of motor units at the frequency of the force oscillation. These rate modulations were correlated; and they showed a phase advance over the force oscillation, which is consistent with a cause-effect relationship between changes in firing rate and variations in force. These effects, observed over wide ranges of modulation amplitudes and frequencies, confirm the role of rate coding in the generation of time-varying muscle contractions; and they support the idea that during voluntary contraction of a given muscle, the motoneuron pool is subject to a common drive. |
8041520 | Calpeptin, a calpain inhibitor, promotes neurite elongation in differentiating PC12 cells. | Calpain activity of nerve growth factor (NGF)-induced rat pheochromocytoma (PC12) cells shows a transient diminution in the early phase of differentiation. Calpain activity can be further decreased by a cell-permeable calpain inhibitor, calpeptin, which enhances the effect of NGF by stimulating neurite elongation. The number of neurites sprouted by one cell is not increased by calpeptin. A possible role of calpain inhibition during PC12 cells' early differentiation is discussed. |
8041519 | Expression of mRNA for the N-methyl-D-aspartate (NMDAR1) receptor by the enteric neurons of the rat. | In this study, in situ hybridization techniques were employed to map the distribution of enteric neurons which express mRNA for the glutamate N-methyl-D-aspartate receptor 1 (NMDAR1). We hybridized tissue sections from the stomach, duodenum, ileum and descending colon of adult rats with a 1.43-kB riboprobe cleaved from a clone of the NMDA receptor. Enteric neurons expressing the mRNA were found in both myenteric and submucosal ganglia at each of the sampling sites. Possible functions of NMDA receptors on enteric neurons are discussed. |
8041517 | Appearance of localized immunoreactivity for the alpha 4 integrin subunit and for fibronectin in brains from Alzheimer's, Lewy body dementia patients and aged controls. | The localization of alpha 4 integrin subunit and of fibronectin in Alzheimer's disease (AD), Down's syndrome, Lewy body dementia (DLB) and normal brains was immunohistochemically investigated. Antibodies against the alpha 4 subunit and a fibronectin specific antibody stained 'neuritic' plaques in AD and Down's syndrome, while 'preamyloid' and 'burned-out' plaques remained negative. No alpha 4 integrin subunit or fibronectin immunoreactivity was detected in the plaques of DLB consistent with the absence of neuritic plaques. In addition, hippocampal pyramidal neurons and some neocortical neurons showed immunoreactivity with alpha 4 subunit and fibronectin antibodies in all aged individuals, but not in younger controls. These results suggest an age-related and localized expression of alpha 4 integrin subunit and fibronectin in the brain. |
8041518 | Left/right nigrostriatal asymmetry in susceptibility to neurotoxic dopamine depletion with 6-hydroxydopamine in rats. | Male Sprague-Dawley rats were investigated for the existence of a left/right hemispheric population asymmetry in the extent of striatal dopamine depletion following unilateral lesions with 6-hydroxydopamine (6-OHDA) in the left or right substantial nigra. Four doses of 6-OHDA were employed (with left and right lesion groups at each dose). Analysis of striatal dopamine depletion revealed significant main effects not only for dose of 6-OHDA, but also for side of lesion, with right-lesioned rats having greater dopamine depletion across doses. In a group of non-lesioned rats, randomly selected from this population, striatal dopamine turnover showed a significant right-sided bias. It is suggested that the latter functional asymmetry may have been responsible for the neurotoxic depletion asymmetry seen in lesioned animals, and that side of lesion should be considered when attempting to produce consistent and maximal dopamine depletion in large scale studies with the unilateral 6-OHDA lesion paradigm. |
8041516 | Calcitonin gene-related peptide (human alpha-CGRP) counteracts vasoconstriction in human subarachnoid haemorrhage. | Calcitonin gene-related peptide (CGRP) is a neuropeptide co-stored with tachykinins (substance P, neurokinin A) in cerebrovascular sensory fibers in the trigeminal ganglion. Preceding studies on subarachnoid hemorrhage (SAH) revealed that an enhanced release of CGRP resulted in the selective loss of perivascular CGRP. Therefore, the present study was designed to evaluate the effects of intravenous administration of human alpha-CGRP on cerebral vasoconstriction in the postoperative course after SAH in 5 patients (8 infusions). Cerebral vasoconstriction was evaluated with transcranial Doppler sonography. The increase in the relationship between middle cerebral artery (MCA) velocity and internal carotid artery (ICA) velocity (the hemodynamic index) was used as an indicator of vasoconstriction and compared to the contralateral side. A significant reduction was found in the hemodynamic index during the CGRP infusion (4.3 +/- 0.5, P < 0.05) as to compared to before infusion (6.2 +/- 0.5). There was no measurable change in the hemodynamic index on the contralateral side. No significant change was observed in pulsatility index, blood pressure or consciousness during the peptide infusion. A significant increase in heart rate was observed during the infusion as compared to before and after infusion (90 +/- 4 vs. 76 +/- 5). Cardiac ultrasound data indicated a mean cardiac output increase of 1.9 liter/min, and a mean decrease in total peripheral resistance of 538 dynes s/cm5. The results obtained show that infusion of human alpha-CGRP may induce normalisation of cerebrovascular tone in SAH. |
8041515 | Expression of peripherin in solid transplants of foetal spinal cord and dorsal root ganglia grafted to the injured cervical spinal cord of adult rats. | The expression of the neuronal type III intermediate filament protein peripherin was studied in E14 spinal cord fragments and E15 dorsal root ganglia 1-30 weeks after their transplantation to the injured cervical spinal cord of the adult rat. In the dorsal root ganglion transplants, the surviving neurons generally appeared as a rather healthy looking population of small strongly immunoreactive cells which are very similar to the small dorsal root ganglion neurons of adult control rats. In the spinal cord transplants, there were only a few peripherin-immunoreactive neurons, morphologically close to the motoneurons or to the preganglionic sympathetic neurons of adult rats. In both types of transplants, peripherin expression of the immunoreactive neurons was apparently correlated with the previously established ability of these transplanted neurons for extensive axonal growth into a co-grafted peripheral nerve. |
8041514 | alpha-Tocopherol protects against radical-induced injury in cultured neurons. | The effect of alpha-tocopherol on neurons in protecting against radical-induced injuries caused by cumene hydroperoxide was assessed using a culture system. Structural and biochemical deteriorations in both clonal neuroblastoma cells and primary cultured neurons were induced by cumene hydroperoxide. These deteriorative changes were prevented prevented by pretreatment of alpha-tocopherol. Since simultaneous supplementation of alpha-tocopherol and cumene hydroperoxide had limited protective effects, prophylactic administration of alpha-tocopherol for risk patients with brain diseases concerned with damages induced by free radical is recommended to hamper the progression of neuronal impairment after attacks. |
8041513 | A subpopulation of corticotropin-releasing hormone neurosecretory cells in the paraventricular nucleus of the hypothalamus also contain NADPH-diaphorase. | The coexistence of ND with CRH 41 was explored in the parvicellular neurons of the PVN, using dual histochemical and radioimmunocytochemical labelling with the light microscope, in rats treated with colchicine. Even though the ND staining was scarce, a clear colocalization was evidenced in the parvicellular part of the PVN. Under these conditions, the ratio of neurons expressing both markers, ND and CRH, amounted about 15% of the CRH-containing neuron population. This result provides a useful tool to study morphological plastic changes in the PVN in response to environmental variations. |
8041512 | Adenosine enhances intracellular Ca2+ mobilization in conjunction with metabotropic glutamate receptor activation by t-ACPD in cultured hippocampal astrocytes. | 2Cl-Adenosine, a non-metabolized adenosine agonist, enhanced the increase in intracellular Ca2+ concentration ([Ca2+]i) in cultured hippocampal astrocytes induced by (+-)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (t-ACPD), a metabotropic glutamate agonist. In the absence of 2Cl-adenosine, the half effective concentration (EC50) of t-ACPD was about 80 microM. On the other hand, in the presence of 1 microM 2Cl-adenosine, the EC50 of t-ACPD shifted to about 5 microM, although the maximum [Ca2+]i did not change. The synergistic effect of 2Cl-adenosine with t-ACPD on [Ca2+]i elevation was not inhibited by the elimination of extracellular Ca2+, but was inhibited by A1-specific adenosine antagonists. These results indicate that adenosine can act via the A1 receptor as an endogenous co-activator of the metabolic processes induced by metabotropic glutamate receptor activation. |
8041511 | Monoclonal antibody (VOM2) specific for the luminal surface of the rat vomeronasal sensory epithelium. | Monoclonal antibodies were raised and selected for reactivity with the luminal surface of the rat vomeronasal organ. Among the monoclonal antibodies generated, the one named VOM2 showed specific immunoreactivity within the luminal surface of the rat vomeronasal sensory epithelium. The VOM2 antigen appeared weakly on the luminal surface at postnatal day 14 (P14). After P21, VOM2 immunoreactivity as strong as that in the adult vomeronasal organ was observed. Immunofluorescence staining using VOM2 antibody showed no reactivity on the luminal surface of the adult mouse or hamster vomeronasal organ. An immunoblotting analysis showed that the VOM2 antigen was a protein with a molecular weight of 24,500. |
8041508 | Cerebral energy metabolism during hypoxia-ischemia correlates with brain damage: a 31P NMR study in unanesthetized immature rats. | The association between the ultimate brain damage resulting from unilateral hypoxic-ischemic insult (HI) and the changes in high-energy metabolites, measured by noninvasive phosphorus-31 nuclear magnetic resonance (31P NMR) spectroscopy during the insult, was evaluated in 7-day postnatal rats. When the NMR metabolite levels were integrated over the last 1.5 h out of 2.5 h of HI, there was a significant correlation of both the estimator of phosphorylation potential (P < 0.001) and ATP levels (P < 0.01) with histologic score of damage and area morphometry. In particular, the development of cerebral infarction could be predicted from the NMR evaluation (P < 0.005). These findings suggest that a large disturbance in cellular energy metabolism is a prerequisite for the subsequent neuropathological alterations in this model. |
8041510 | NMDA receptor (NMDAR1) expression in the rat hippocampus after forebrain ischemia. | The influence of transient forebrain ischemia on the temporal alteration of NMDA receptor (NMDAR1) mRNAs in the hippocampal formation was analysed by in situ hybridization, RNA blot and in vitro receptor autoradiography ([3H]3-((+)2-carboxypiperazin-4-yl)-propyl-1- phosphonic acid). In the CA1 subfield of the hippocampus, decrease of NMDAR1 mRNA levels was not observed until death of the CA1 pyramidal cells. Reactive astrocytes, which appear after CA1 pyramidal cell death, expressed few NMDAR1. The CA3 and dentate gyrus also showed a reduction of NMDAR1 mRNA levels 7 days after ischemia. Temporal profiles of NMDAR1 mRNA levels correlated well with those of NMDA receptor-binding in the CA1 and CA3/dentate gyrus. These results indicate that NMDA receptors in the CA1 are predominantly located on the CA1 pyramidal cells and that these receptors are preserved during early recirculation period. Histologically intact neurons in the CA3 and dentate gyrus also had marked modulation in glutamatergic neurotransmission after ischemia. |
8041509 | Stressor-specific increase of vasopressin mRNA in paraventricular hypophysiotrophic neurons. | Cellular levels of vasopressin (VP) and corticotropin-releasing factor (CRF) RNA transcripts were determined in hypophysiotrophic neurons after open-field and immobilization stress using quantitative in situ hybridization. We found that 8 min open-field stress is sufficient to produce a significant up-regulation of CRF mRNA, without any concomitant changes in the level of VP mRNA. In contrast, 8 min immobilization stress resulted in an increased labeling density of both CRF and VP mRNAs. These results suggest that the level of CRF and VP transcripts in parvicellular hypophysiotrophic neurons is differentially regulated in a stressor-specific manner. |
8041507 | Activities of monoamine oxidase-A and -B are altered in the brains of congenitally hyperammonemic sparse-fur (spf) mice. | Activities of monoamine oxidases, MAOA and MAOB, were measured using radiometric assays in different brain regions of the sparse-fur (spf/Y) mouse, a model of congenital hyperammonemia resulting from an X-chromosomal defect of ornithine transcarbamylase. MAOA activities were decreased in cerebellum (by 23%, P < 0.05) and brainstem (by 16%, P < 0.05) of spf mice; activities of MAOB were concomitantly increased in cerebellum (by 22%, P < 0.05), brainstem (by 20%, P < 0.05) and cerebral cortex (by 22%, P < 0.05). These findings offer a rational explanation for previous findings of increased acidic metabolites of monoamines in the brain of spf mice. Altered monoaminergic function could be a key factor in the pathogenesis of neurological dysfunction in congenital hyperammonemias. |
8041506 | Methylcobalamin (methyl-B12) promotes regeneration of motor nerve terminals degenerating in anterior gracile muscle of gracile axonal dystrophy (GAD) mutant mouse. | We examined the effects of methylcobalamin (methyl-B12, mecobalamin) on degeneration of motor nerve terminals in the anterior gracile muscle of gracile axonal dystrophy (GAD) mutant mice. GAD mice received orally methyl-B12 (1 mg/kg body wt/day) from the 40th day after birth for 25 days. In the distal endplate zone of the muscle, although most terminals were degenerated in both the untreated and methyl-B12-treated GAD mice, sprouts were more frequently observed in the latter. In the proximal endplate zone, where few degenerated terminals were seen in both groups of the mice, the perimeter of the terminals was increased and the area of the terminals was decreased significantly in the methyl-B12-treated GAD mice. These findings indicate that methyl-B12 promotes regeneration of degenerating nerve terminals in GAD mice. |
8041505 | Apoptosis is induced by 1-methyl-4-phenylpyridinium ion (MPP+) in ventral mesencephalic-striatal co-culture in rat. | Apoptosis may be an important mechanism of cell death in some experimental cell death models as well as in human neurodegenerative disorders. We report evidence to indicate that 1-methyl-4-phenylpyridinium ion (MPP+) induces apoptotic cell death using ventral mesencephalic and striatal co-culture; Apoptosis was defined by characteristic changes in nuclear morphology as revealed by hematoxylin-staining and DNA breaks in situ, which were demonstrated histochemically by labeling 3'-OH ends with biotinylated deoxyuridine through the action of terminal deoxynucleotidyltransferase, and DNA fragmentation, which was shown by agarose-gel electrophoresis. Apoptosis may be an important mechanism of cell death in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism. |
8041504 | Neurofibrillary tangles in the cerebral cortex of sheep. | Neurofibrillary degeneration, including neurofibrillary tangles (NFTs) and neuritic plaques, is an important pathological hallmark of Alzheimer's disease (AD). Unfortunately, no practical animal model of neurofibrillary degeneration has been described. We report here the presence of structures in the cerebral cortex of sheep, Ovis aries, that resemble Alzheimer NFTs and neuritic plaques. NFT-like structures and clusters of degenerating neurites are stained by silver impregnation and thioflavin-S, and are immunoreactive with antibodies against tau microtubule-associated proteins. Viewed under the electron microscope, tau-immunoreactive tangles consist of paired helical filaments. Naturally occurring neurofibrillary structures in sheep cortex provide a model for studying the pathobiology of Alzheimer's disease. |
8041503 | Circadian rhythms in the release of vasoactive intestinal polypeptide and arginine-vasopressin in organotypic slice culture of rat suprachiasmatic nucleus. | Temporal profiles of the amount of vasoactive intestinal polypeptide (VIP) were examined in the medium of organotypic suprachiasmatic nucleus (SCN) slice cultures over a 2-day period. Arginine-vasopressin (AVP) level was also measured in the same medium. The slices of the SCN were obtained from 7-8-day-old rats and cultured individually in tubes on a roller drum for 14 days. The VIP amount in the medium of SCN culture showed a circadian rhythm with a approximately 22-h period. Circadian rhythms with identical periods were also observed in AVP amount of the same culture. However, the peak time of the VIP rhythm was slightly ahead of that of the AVP rhythm. Furthermore, the total VIP amount in the medium over a 24-h period was six times as large as that of AVP. These results suggest that there is a circadian rhythm of VIP which is released from the ventrolateral SCN. |
8041502 | Unique change of pancreastatin-like immunoreactivity in cerebrospinal fluid by aging. | Using a specific antiserum for the C-terminal glycine amide region of human pancreastatin (PST), pancreastatin-like immunoreactivity (PST-LI) was measured in cerebrospinal fluid (CSF) from 447 subjects (368 +/- 10.8 pmol/l, mean +/- S.E.M.) free from endocrine diseases. The CSF contents of PST-LI showed a mountain-shape type change which peaked at 40 years of age. The highest concentration was found in the group of ages 40-49 years old (412 +/- 22.9 pmol/l) and the lowest concentration was found in the group of ages 80-89 years old (293.2 +/- 45.2 pmol/l) among various age groups. Gel chromatographic examination revealed the presence of two major forms (MW 13,500 and 5,400) of PST-LI in CSF. Because of the character of this antibody, the large molecular form is possibly an N-terminally elongated PST and the other may be PST-52. This may be the first report on the unique age-related change of PST concentration in CSF. |
8041501 | Power spectral analysis of electroencephalographic desynchronization induced by cocaine in the rat. | Whereas it is well-known that cocaine induces EEG desynchronization and behavioral excitation in animals and human subjects, the detailed effect of cocaine on EEG activity remains to be fully elucidated. This communication reports our attempts in quantifying the effect of cocaine on EEG signals recorded from the somatosensory cortex of adult male Sprague-Dawley rats under chloral hydrate anesthesia (400 mg/kg i.p.). Continuous, on-line and real-time power spectral analysis revealed that i.v. administration of two doses of cocaine (1.5 or 3.0 mg/kg) dose-dependently induced EEG desynchronization, as indicated by a decrease in the root mean square and an increase in the mean power frequency values. More interestingly, whereas both doses of cocaine promoted a reduction in the alpha (8-13 Hz), theta (4-8 Hz) and delta (1-4 Hz) spectral components, the beta band (13-32 Hz) underwent differential alterations. The lower dose of cocaine elicited a transient increase, followed by a decrease in the power of the beta band. A prolonged increase in the power of the beta band, on the other hand, was observed after the higher dose of cocaine. These results suggest that subtle changes in the individual EEG spectral components, which are dose-dependent, may underlie the EEG desynchronization induced by cocaine. |
8041500 | Carbamazepine-induced blockade of induction of long-term potentiation in the perforant path-dentate gyrus pathway in chronically prepared rabbits. | We investigated the effects of a representative anti-epileptic or anti-psychotic drug, carbamazepine (CBZ), on the induction of long-term potentiation (LTP) in the perforant path-dentate gyrus pathway in 15 chronically prepared rabbits. Pharmacokinetically injected low-dose CBZ, which produced steady serum levels of 2.2-3.3 micrograms/ml (mean +/- S.D. 2.85 +/- 0.40), variably affected the induction of LTP, blocking it or showing almost no effect. The high-dose CBZ, which produced steady serum levels of 6.5-8.6 micrograms/ml (8.01 +/- 0.87), always blocked the induction of LTP. These results indicate that CBZ dose-dependently blocks the induction of LTP. The possible mechanisms underlying this blockade are discussed, especially in association with the possible inhibitory action of CBZ on N-methyl-D-aspartate (NMDA) receptors. |
8041499 | (RS)-alpha-methyl-4-carboxyphenylglycine (MCPG) does not block theta burst-induced long-term potentiation in area CA1 of rat hippocampal slices. | We have used the selective metabotropic glutamate receptor antagonist (RS)-alpha-methyl-4-carboxyphenylglycine (MCPG) to investigate in the CA1 hippocampal subregion in vitro whether coactivation of N-methyl-D-aspartate (NMDA) and metabotropic glutamate receptors is necessary for the induction of long-term potentiation (LTP) when LTP is induced by theta burst stimulation (TBS). When MCPG (500 microM) was bath applied 14-30 min prior to a triple high-frequency tetanization (100 Hz, 1 s) and washed out immediately afterwards the potentiation of the extracellularly recorded field potentials decayed gradually to baseline (P < 0.05) over 2-3 h. However, when MCPG was applied in the same manner before a triple TBS (10 bursts at 5 Hz, 100 Hz within the bursts) the resulting potentiation remained stable for at least 4 h. MCPG had no effect on baseline synaptic transmission or post-tetanic potentiation. These results demonstrate a clear difference in the mechanisms underlying these two different forms of LTP. |
8041498 | Mechanisms of respiratory rhythm generation change profoundly during early life in mice and rats. | To study the ontogenesis of central respiratory rhythm generation, a novel brainstem slice preparation was developed that generates respiratory rhythmic activity spontaneously in mice and rats at all post-natal ages. The slice was made by tilting the brainstem to include both the ventrolateral and dorsomedial medulla. This 'tilted-sagittal' slice contained the nucleus ambiguus, the hypoglossal motor nucleus (XII) and the nucleus of the solitary tract which were preserved intact throughout their rostro-caudal extent. Using this rhythmic preparation it has been possible for the first time to directly compare the significance of glycinergic mechanisms for respiratory rhythmogenesis between newborns and mature rodents in vitro. Our findings demonstrate that during the first two weeks of life there are profound changes in both the motor pattern of rhythmic XII neurons and sensitivity of the respiratory rhythm to strychnine blockade of glycine receptors. Thus, developmental changes in strychnine-sensitive receptors are vital for the maturation of the respiratory network and it is suggested that any disturbance in their development may be lethal. |
8041497 | Modulation of calcitonin gene-related peptide release evoked by bradykinin and electrical field stimulation in guinea-pig atria. | Electrical field stimulation (EFS) and bradykinin (BK) are able to activate capsaicin-sensitive sensory neurons of guinea-pig atria in a omega-conotoxin (CTX)-sensitive and Ruthenium Red (RR)-insensitive manner. The aim of this work was to study EFS and BK-induced release of calcitonin gene-related peptide (CGRP) from guinea-pig atria and in particular the action of morphine and neuropeptide Y (NPY) on this release. EFS-induced CGRP release was frequency-dependent and tetrodotoxin (TTX)-sensitive, while BK-evoked CGRP release was TTX-insensitive. On the other hand, CGRP outflow induced by either EFS or BK was similarly reduced in the presence of morphine and NPY. It is therefore hypothesized that NPY and opioids exert their inhibitory action by acting on the very terminal region of the nerve fibre. Moreover, our results show that dermorphine but not dynorphin reduced BK-evoked CGRP release, suggesting that mu opioid receptors are responsible for morphine action. Studying the action of peptide YY and NPY(16-36) on BK-evoked CGRP release, we demonstrated that both had similar inhibitory effects, supporting the presence of Y2 receptors on the nerve terminal region. |
8041496 | Barium-induced bistability in rat ocular motoneurones in vitro. | Intracellular recordings were obtained from adult rat oculomotor neurones in an in vitro brainstem slice preparation. In motoneurones hyperpolarized to levels below -90 mV, depolarizing current injections induced voltage-dependent low-threshold plateau potentials. These potentials were triggered at rest when charge transfer through Ca2+ channels was increased by Ba2+ substitution. In such conditions, the membrane displayed voltage-dependent bistable properties similar to those described in other preparations and shown in vivo to be under neurotransmitter control. These results show that increasing inward currents in adult oculomotor neurones of the rat induce functionally different responses to slight shifts of membrane potential. |
8041495 | Anti-nociceptive effects of oxytocin in rats and mice. | The existence of neural opioid-mediated networks that are specific for the modulation of nociception is well established. Parallel non-opioid pathways exist, but their underlying physiology is little known. We now report that oxytocin administered intraperitoneally to rats, and intraperitoneally or intracisternally to mice has an anti-nociceptive effect, which is related to the activation of descending anti-nociceptive pathways. This anti-nociceptive effect can be reversed by an oxytocin antagonist but not by the opioid antagonist naloxone. The anti-nociceptive effect of oxytocin is not directly dependent on the activation of serotonergic pathways or to changes in temperature. Our data indicate that the oxytocinergic system has a modulatory function on nociception. |
8041494 | Vibration-induced presynaptic inhibition of the soleus H reflex is temporarily reduced by cortical magnetic stimulation in human subjects. | We have examined the effects of a transcranial magnetic stimulus (TMS) on the H reflex of the soleus muscle during vibration-induced presynaptic inhibition of the reflex, in seven normal volunteers. Without vibration, the H reflex was facilitated at interstimulus time intervals of > or = 5 ms after TMS. With vibration, the H reflex was markedly reduced or completely inhibited in control trials, but facilitation by TMS was noticed at intervals as short as -2.5 ms. These findings indicate an effect of TMS on the spinal interneurons mediating presynaptic vibratory inhibition of the H reflex. |
8041493 | Nuclear factor-kappa B in rat brain: enhanced DNA-binding activity following convulsant-induced seizures. | The DNA-binding protein nuclear factor-kappa B (NF-kappa B) is a pleiotropic transcription factor which regulates the transcription of specific target genes such as cytokines. The existence of NF-kappa B has not been reported in brain tissue. This is the first report demonstrating the expression of NF-kappa B in the rat brain. After pentylene tetrazole (s.c.)-induced clonic-tonic seizures at an LD50 dose of 85 mg/kg, we have shown a gradual increase in NF-kappa B expression reaching a maximum at 24 h, a decrease at 48 h and again increased at 96 and 120 h. A similar time-dependent pattern was observed for the NF-kappa B subunit p50 expression. The NF-kappa B subunit p65 was not expressed at all. These data suggest a possible underlying mechanism of signal transduction and transcriptional regulation of late-response genes after perturbations in the CNS milieu. |
8041492 | Prenatal cocaine decreases the trophic factor S-100 beta and induced microcephaly: reversal by postnatal 5-HT1A receptor agonist. | In utero exposure to cocaine results in neurobehavioral abnormalities in both clinical and laboratory studies. Cocaine administration from embryonic day 13 to parturition disrupts the distribution of S-100-positive astrocytes in the hippocampus and subplate region of the cortex in cocaine-exposed animals. Postnatal treatment with ipsapirone, a 5-HT1A agonist, shown to stimulate glial release of S-100, alleviated the cellular disruptions and growth retardation caused by prenatal cocaine exposure. |
8041491 | Dopamine induces apoptosis-like cell death in cultured chick sympathetic neurons--a possible novel pathogenetic mechanism in Parkinson's disease. | We report that exposure of cultured, postmitotic chick-embryo sympathetic neurons, to physiological concentrations of dopamine (0.1-1 mM) for 24 h initiates a cellular death process characteristic of apoptosis (= programmed-cell-death, PCD). Dopamine caused marked morphological alterations, mainly axonal disintegration and severe shrinkage and condensation of cell bodies. Flow-cytometric analysis of propidium-iodide-stained cell nuclei revealed the characteristic apoptotic nuclear fragmentation: increase in nuclear granularity and emergence of a large, distinct population of nuclei with reduced DNA content (subdiploid, apoptotic peak). These alterations were similar to changes induced by nerve growth factor (NGF) deprivation, a model of sympathetic neuronal PCD. Alterations were inhibited by the anti-oxidative agent DTT. Inappropriate, dopamine-induced activation of PCD might have a role in nigral neuronal degeneration in Parkinson's disease. |
8041490 | Mortality in gerbils with repetitive ischemia: CGSGS-19755/hypothermia therapy. | Repetitive ischemia causes more severe damage than a single insult of comparable duration. Gerbils were followed for 1 month postrepetitive ischemia and 100% mortality was demonstrated in the unprotected ischemia group by 12 days postischemia. Significant protection against mortality due to repetitive ischemia was offered by both CGS-19755 and combination CGS-19755-hypothermia treatments. Current practices of sacrificing repetitive ischemia subjects shortly postischemia may lead to an underestimation of the effects of ischemia and/or an overestimation of the protective effects of experimental treatments. |
8041489 | Expression of chromogranin A in lesions in the central nervous system from patients with neurological diseases. | Expression of chromogranin A in various neurological diseases was examined immunohistochemically using purified anti-human chromogranin A antiserum. The antibody stained dystrophic neurites in senile plaques in Alzheimer disease brain, Pick bodies and ballooned neurons in Pick's disease brain, some Lewy bodies in the substantia nigra of Parkinson's disease, and axonal swellings in various neurological conditions including Parkinson's disease, striatonigral degeneration, Shy-Drager syndrome, amyotrophic lateral sclerosis and cerebral infarction. The present study shows that expression of chromogranin A is not an exclusive feature of Alzheimer disease or Pick's disease, and indicates that it could be a useful marker for various neurological diseases. |
8041488 | Interleukin-6 (IL-6) production and cell growth of cultured human ameningiomas:-interactions with interleukin-1 beta (IL-1 beta) and interleukin-4 (IL-4) in vitro. | We examined the production of interleukin (IL)-6 by human meningioma cells in vitro, and the effects of IL-1 beta and IL-4 on IL-6 production and meningioma cell growth. The histological classification of the tumours studied included transitional, syncytial, fibroblastic and atypical. All 10 meningiomas studied produced IL-6 (range 0.22-7.6 ng/ml/10(6) cells/24 h). Separate addition of IL-1 beta or IL-4 to cultures increased IL-6 production up to ten fold, and two to three fold, respectively. Growth studies with IL-6 indicated that this cytokine significantly increased terminal cell density at a concentration greater than 1 ng/ml in 60% of the meningioma cultures studied. IL-1 beta caused a significant decrease in the terminal cell density in 25% of the meningioma cultures studied whereas IL-4 had a tendency to significantly inhibit growth in 16.6% of the cultures. These data suggest that IL-6 production by meningiomas can be modified by other cytokines and secondly, that IL-6, IL-1 beta and IL-4 can modify growth in vitro and may act as autocrine factors in vivo. By further determining the cytokine profiles within meningiomas and their effects, a better understanding of meningioma growth characteristics may be obtained. |
8041487 | Involvement of the nucleus accumbens in the myorelaxant effect of baclofen in rats. | The study was designed to search for brain structures responsible for the myorelaxant action of baclofen. Rats were chronically implanted with cannulae in the medial nucleus accumbens (NAS). The muscle tone was increased by reserpine (10 mg/kg i.p.) and measured as a resistance of the hind foot, developed in response to successive passive bendings and straightenings in the ankle joint. (+/-)Baclofen (1 or 2.5 mg/0.5 microliter), injected bilaterally into the NAS 1.5 h after pretreatment with reserpine, decreased the muscle tone of flexors and extensors enhanced by that compound. It is suggested that GABAB receptors of the NAS are involved in the myorelaxant action of baclofen. |
8041486 | Age-related changes in glutathione and lipid peroxide content in mouse synaptic mitochondria: relationship to cytochrome c oxidase decline. | To elucidate the contribution of lipid peroxides and glutathione to brain aging, we have carried out a comparative study of their contents in synaptic mitochondria from young (10-week-old), adult (24-week-old), and senescent (72-week-old) mice. In synaptic mitochondria, there is a significant decline in lipid peroxide content (P < 0.01) and cytochrome c oxidase activity (P < 0.001) in senescent as compared to adult and young mice. By contrast, glutathione concentration showed an increase in senescent (P < 0.05) in comparison to the other age groups. Moreover, there was a significant inverse correlation between age and lipid peroxide content (r = -0.5, P < 0.001) or cytochrome c oxidase-specific activity (r = -0.58, P < 0.001). We suggest that this age-dependent decrease in lipid peroxide content in synaptic mitochondria may be the result of an age-related decline in the activity of the electron transport chain, with concomitant decrease in oxyradical production, in the senescent organelles. |
8041485 | Nerve growth factor increases extracellular acetylcholine levels in the parietal cortex and hippocampus of aged rats and restores object recognition. | Male Wistar rats (3- and 20-month-old) were perfused i.c.v. with 1.5 micrograms of either nerve growth factor (NGF) or cytochrome C daily for 14 days. At the end of the infusion, the object-recognition test was carried out and extracellular acetylcholine levels (ACh) were measured in the cortex and hippocampus by transversal microdialysis technique. In 20-month-old control rats, the cortical and hippocampal ACh levels were 35 and 45% lower, respectively, than in 3-month-old rats and the ability to discriminate between a familiar and new object was impared. In the old rats treated with NGF, the ACh release as well as the behavioral performance showed no difference from those of young rats. These findings indicate that both ACh levels and memory impairment are improved in aged rats by NGF treatment and suggest that there is a relationship between object recognition and the activity of the forebrain cholinergic system. |
8041484 | Distribution and morphological features of nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) activity in intrinsic neurons of the Oddi sphincter of the cat. | To clarify the role of nitric oxide (NO) in the sphincter of Oddi, we histochemically investigated the distribution of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d), a marker for NO synthase, in the cat. NADPH-diaphorase activity was localized in two neuronal subtypes: large neurons with many dendrites and smaller with one process. Most of the nerve cell bodies (99%) in the wall of the sphincter of Oddi showed strong activity for this enzyme. The nerve fibers with NADPH-d activity were observed in all layers, chiefly in the muscle layers. These results suggest that NO may play a very important role in the neuronal regulation of sphincter of Oddi. |
8041483 | Pentobarbital sodium inhibits the release of noradrenaline in the medial preoptic area in the rat. | The effect of pentobarbital sodium (PB) on noradrenaline (NA) release in the medial preoptic area was studied in ovariectomized rats by a microdialysis method coupled to HPLC. Dialyzates were collected at 6-min intervals before and after the injection in freely moving rats. PB injected i.p. at a dose of 35 mg/kg caused a marked, approximately 40-50% decrease in NA release, which became evident 50 min after the injection and lasted for another 60 min during which the observation was performed. The results suggest that the anesthetic effect of barbiturates is related to the reduction in NA release in the brain. |
8041482 | Activated human platelets in plasma excite nociceptors in rat skin, in vitro. | Extravascular activation of thrombocytes may contribute to nociceptor excitation and pain, since platelets store and, upon stimulation, release potential algogenic substances such as serotonin, histamine and precursor molecules of bradykinin. To test this hypothesis, a skin-nerve preparation of rat hairy skin, in vitro, was used that allows to record and characterize single afferent nerve fibers. In a first protocol, receptive fields of nociceptive C-fibers, at the corium side of the skin patch, were exposed to adenosine diphosphate (ADP), to heparinized human platelet-rich plasma (PRP) and to PRP activated by ADP. Such activated platelets excited 9/11 units characterized as mechano-heat responsive C-nociceptors (CMH); peak discharges of more than 10 spikes/s were observed. After application of activated PRP, 4/5 high threshold mechanosensitive C-units and 4/5 mechano-cold sensitive C-units became responsive to heat stimulation but only few of these fibers were excited (1/5 in each group). In a second series of experiments the exposure to native PRP was prolonged to test for the effect of spontaneous platelet activation resulting from cutaneous collagen. Prolonged exposure did, but not significantly, enhance fiber discharge. During subsequent exposure to activated PRP, the discharge commenced, on average, after a significant delay of about three minutes. With this protocol 5/7 CMH units were driven by activated platelets. Following both protocols, mechanical (v.Frey) and thermal thresholds of the CMH units were not significantly altered. The findings demonstrate that nociceptors can indeed be driven and sensitized by activated platelets. This pain inducing mechanism may be relevant to certain clinical conditions, and it appears promising to scrutinize the chemical factors involved. |
8041481 | Lack of task-related motor unit activity in human triceps brachii muscle during elbow movements. | Surface electromyographic (EMG) recordings have been associated with the acceleration and deceleration characteristics of single joint elbow movements [J. Neurophysiol., 63 (1990) 465-472]. To explore further the neural control of single joint movements, we investigated the behavior of motor units in triceps brachii muscle during elbow flexion and extension movements. In this communication, we provide evidence that individual motor units can contribute to each of the surface EMG bursts. This finding suggests that the nervous system can use the same motor units during movement regardless of whether the muscle is acting as an agonist or antagonist or functioning to initiate or terminate the movement. |
8041480 | A case of Pott's disease in a 20-year-old military dependent. | Tuberculous spondylitis (Pott's disease) is an uncommon complication of Mycobacterium tuberculosis infection that may have serious consequences if the diagnosis is missed or delayed. A case of tuberculous spondylitis in a military dependent is presented. Clinical presentation, radiologic findings, laboratory findings, and treatment are discussed. |
8041477 | Recurrence of Treacher Collins' syndrome with sonographic findings. | Treacher Collins' syndrome, or mandibulofacial dysostosis, is a rare, autosomal-dominant disorder. We describe the recurrence of this anomaly in the fetus of a patient who previously had delivered a severely affected infant. The ultrasonographic findings of hydramnios, absence of fetal swallowing movements, and poor growth of the biparietal diameter and head circumference permitted us to suggest the diagnosis antenatally of another affected child. |
8041476 | Splenic rupture due to extraperitoneal gunshot wound: use of peritoneal lavage in the low-tech environment. | The upsurge in armed conflicts and civil unrest around the world will result in the need to treat gunshot wounds in austere conditions. This report details a splenic injury that resulted from a gunshot of the torso that did not penetrate the peritoneum. The author made the diagnosis using peritoneal lavage, which can be adapted to field conditions. |
8041475 | Desert Shield deployment and social problems on a U.S. Army combat support post. | We undertook a study of selected mental health-related services at a combat support post to determine if stress levels surrounding Operations Desert Shield/Desert Storm had an effect on the utilization of these services. Our measure was the problem rate formed by adding the visits to the alcohol and drug service and the social work service. The findings (not all of which reached statistical significance in our small study) were that the problem rates were higher in those units which deployed, both before and after deployment. The pre-deployment differences in age, rank, and race between those soldiers deployed and not deployed is a finding which may help to account for the difference between units. There was a transient, but not sustained, problem rate increase immediately following return home for those units which deployed. Implications for mental health-related services staffing and directions for further research are discussed. |
8041474 | An analysis of duty restrictions of aviation personnel in the Republic of Korea. | Aviation medical records were reviewed from four U.S. Army medical clinics in the Republic of Korea for flying duty restrictions over a 1-year time period. Duty restrictions were catalogued into 1 of 15 different diagnostic categories and compared by parameters of duration, time of year, crew status, age, and sex. Four hundred twenty-eight records were reviewed. Respiratory illnesses were the most common cause of flight restriction, followed by gastrointestinal and musculoskeletal problems. Flight personnel averaged 12.8 days a year on restrictions. Non-crewmembers were frequently not restricted for treatments that should have required restriction, but when restricted, averaged a significantly longer period of time than crewmembers. Females averaged significantly fewer days out for restrictions, and there were large differences in the number of days out by age for certain restrictions, but the numbers were small. There were some seasonal variation noted in patient visits with fewer visits in the spring and summer. |
8041473 | Management of orthotopic heart transplant recipients at Brooke Army Medical Center. | Advances in heart transplantation and post-operative rejection therapy have given new hope to patients with end-stage congestive heart failure and cardiomyopathies. The growing numbers of pre- and post-transplant patients and the complexity of their care underscore the need for a multispecialty approach to patient management. This study examines the success of a multi-service program at Brooke Army Medical Center which offers pre- and post-transplant care to active duty, dependent, and retired military personnel. |
8041472 | Prevalence of periodontal disease in an active duty military population as indicated by an experimental periodontal index. | An experimental periodontal screening examination and index was used to measure the prevalence of gingivitis and periodontitis among 1,334 soldiers at Fort Knox, Kentucky. Although 12.1% of the subjects demonstrated no disease, 40.3% were found to have gingivitis. In this sample group, the occurrence of gingivitis decreased with increasing age. Early periodontitis (probing depths of 3-5 mm) was detected in 35.7% of the subjects, and subjects with moderate to advanced periodontitis (probing depths greater than 5 mm) comprised 11.9% of the sample. The screening exam used is suggested for use as part of each soldier's annual dental examination. |
8041471 | Patients' perspectives: subjective responses in a primary care setting. | To determine patients' responses to the evaluation and treatment of primary care outpatient medical complaints, 103 consecutive patient encounters are analyzed. Diagnostic certainty is classified as either high or low and the patients' subjective responses categorized as improved, unchanged, or worse. The overall patient response rates are: 69% improved; 27% unchanged; and 4% worse. Subgroup analysis identify patients with low diagnostic certainty and chronic medical conditions as having reduced subjective improvement rates. |
8041470 | Early discharge of mothers and infants following vaginal childbirth at the United States Air Force Academy: A three-year study. | Since opening the Air Force's first in-hospital birth center, the United States Air Force Academy Hospital has followed a policy of 24-hour discharge of mothers and babies--a major paradigm shift in traditional military treatment facility practice. This study was conducted to evaluate this change. Records were reviewed of all vaginal births in the first 3 years of operation. Factors considered included demographic data, parity, gestational age, and complicating factors, both mother and infant. Postpartum bed days were reduced by 48%, the maternal readmission rate was 0.59%, and the infant readmission rate was 0.29%. It is the opinion of this author that 24-hour discharge is safe, cost effective, promotes access to care, and is desirable for patient satisfaction. With 1,340 subjects evaluated, the results of this study are provided to encourage and support a change in traditional practice patterns in military treatment facilities. |
8041468 | Evaluation of health, sanitation, and nutrition in Forces Command Child Development Centers. | In 1992, Forces Command had 42 Child Development Centers on 22 installations. We evaluated program compliance in the areas of health, sanitation, and nutrition using inspection findings from April 1991 through June 1992. Each program was rated on 20 items, using inspection checklists developed for this evaluation. We also surveyed Haemophilus influenza type b (Hib) vaccination records among enrolled children. Most programs and facilities were fully or partially compliant in most areas. By quantifying the inspection findings, we were able to identify compliance items that needed further attention. The most frequent problem area across all programs was documentation of child immunization and health records. For children between 13 and 60 months of age, 77.7% had records indicating appropriate vaccination against Hib. Comparisons with the prior year's findings indicated a trend toward improvement. |
8041467 | An eclectic inpatient treatment model for Vietnam and Desert Storm veterans suffering from posttraumatic stress disorder. | This paper describes the therapeutic components of an eclectic, intensive inpatient treatment strategy for Vietnam and Desert Storm veterans with posttraumatic stress disorder. A specific treatment model was devised by this author. The procedure was a collaborative effort: the staff and the patients participated in this preparatory phase treatment program at the Tripler Posttraumatic Stress Unit, Tripler Army Medical Center, Honolulu, Hawaii. The basic treatment is based on group therapy, utilizing educational, cognitive-behavioral therapy, gestalt therapy, and individualized psychotherapy, and eye movement desensitization strategies. The timing and sequencing of these treatments are a critical part of the model, and we have come to refer to it as the layered model because the treatments are layered, much like the delicious parfait dessert. |
8041466 | Health claims on food labels. | Food and drug law requires that the ingredients in most foods be disclosed on their labels, but until recently there was no requirement that nutrition information be provided. The Nutrition Labeling and Education Act of 1990 (NLEA), passed on November 8, 1990, mandated the Food and Drug Administration to establish regulations requiring most foods to have a uniform nutrition label showing the amount of calories, calories from fat, total fat, saturated fatty acids, cholesterol, total carbohydrates, complex carbohydrates, sugars, fiber, protein, and sodium. The Act also establishes the circumstances under which content claims and disease claims may be made about nutrients in food. This paper briefly discusses recent changes in the food label brought about by the NLEA and focuses on health claims on food labels. |
8041465 | Quantitative applications: forecasting and costing nursing service at an Army community hospital. | The utilization of a quantitative method of forecasting, coupled with an existing patient classification system (the Army's Workload Management System for Nursing), provides a creative costing tool for managing nursing resources at military medical facilities. Although the nursing management options discussed in this article are focused on a downsizing situation at an Army Community Hospital, they are applicable throughout military medical facilities. |
8041464 | Mental health services in Army primary care: the need for a collaborative health care agenda. | Epidemiologic studies have shown that more than half of mentally ill patients in the United States receive their psychiatric care exclusively in primary care settings. This fraction may be even higher in the military due to concern over possible occupational repercussions resulting from use of specialty psychiatric care and specialist shortages. Collaboration between generalists and mental health care specialists could potentially improve mental health care delivery and reduce psychiatric disability for a large segment of the Army population who have a psychiatric disorder but may not seek specialty care. Collaborative efforts can reinforce military generalists' essential gate-keeping function, thereby decreasing unnecessary medical utilization and health care costs. The authors review the problems associated with mental health care delivery in primary care and provide examples of collaborative models previously studied or currently being explored. A four-part Army Primary Care-Mental Health Services Agenda is proposed, consisting of: (1) coordinated research including primary care-mental health services research and community-based epidemiologic studies; (2) formation of a primary care-mental health services advisory committee for aiding with policy and program development; (3) graduate and continuing medical education in primary care-mental health services emphasizing interdisciplinary collaborative skills; and (4) clinical implementation of feasible collaborative interdisciplinary mental health care models adapted to the range of unique Army primary care settings. The main goal of the Army Primary Care-Mental Health Services Agenda is to improve access to Army mental health care in the most efficacious and cost-effective way and to help minimize the organizational impact of disability related to psychosocial distress. |
8041463 | Routine 36-week hemoglobin and hematocrits: are they necessary? | Different schedules for hemoglobin and hematocrit (H&H) screening of pregnant women exist at various hospitals in the Air Force. Charts of women delivering between November 1990 through February 1991 were reviewed for 28-week, 36-week, and labor admission H&H; 111 were included in the study. Statistical analysis of the data obtained showed that 28-week values were significantly lower (p > 0.01) than the 36-week values, which were lower (p > 0.01) than those on admission. This study indicates that screening at 36 weeks does not improve prenatal care and increases both discomfort for the patient and the workload for the laboratory. |
8041462 | Austere military medical care: a graded response. | In war, there has always been a dichotomy between health care needs and resources, and until the mid 18th century, this was an accepted fact of military medicine. However, since then, health care has made remarkable progress based on a belief that a linear periodic deterministic approach will provide solutions to problems. The dichotomy between needs and resources has been recognized or accepted only in disaster or mass casualty medicine, and then only to a limited degree. While degradation to dyssymmetry or chaos and unpredictability is accepted in other scientific disciplines, it has been ignored in medicine. The unpredictability and dissonance inherent in providing military medical care exists, and requires an acceptance of chaos as normal and inevitable. Accordingly, graded responses or austere levels of treatment care plans should be developed that will provide for improved care, particularly in austere military situations. |
8041461 | Substance abuse and sexual activity in an overseas population of adolescent military dependents. | To determine the incidence of high-risk behaviors, such as substance abuse and sexual activity, in an overseas population of adolescents, and how these rates compared to the general population in the United States, a survey of high school-aged military dependents residing overseas was undertaken. A questionnaire was designed and distributed to all 8th through 12th graders at the Department of Defense Dependent's School in Seoul, Korea. Use of tobacco products and a history of illicit drug use was similar to that of referant groups in the United States. Present use of illicit drugs was decreased. Use of alcohol was increased over that of similar age groups in America. The authors discuss these findings in light of the environmental differences in the overseas military community. |
8041460 | Joint Task Force Andrew: the 44th Medical Brigade mental health staff officer's after action review. | The massive Department of Defense deployment in support of Hurricane Andrew relief cast the military medical departments in a new role. Military medical personnel were challenged to apply the traditional principles of combat medicine to a noncombat environment, within the continental United States, within an existing health care infrastructure, in a role subordinate to local civilian health care agencies. As a medical "subject matter expert" assigned to the Joint Task Force Andrew Surgeon's staff, the author worked at the civil-military interface. The lessons learned in his role as a special staff officer should benefit any health care provider involved in disaster relief. They focus on problem areas peculiar to the disaster relief scenario. |
8041459 | Designing a standardized oral health survey for the tri-services. | To address a Congressional directive for a comprehensive study of the military medical care system (including dental care), the Tri-Service Dental Chiefs convened a panel of dental epidemiologists to develop a standardized protocol for assessing the oral health of soldiers, sailors, and airmen. This paper discusses previous military and civilian oral health surveys and outlines key design features of the common military protocol that evolved from this critical review of the literature. |
8041458 | The prediction of fitness levels of United States Air Force officers: validation of cycle ergometry. | The purpose of this investigation was to evaluate the accuracy of the United States Air Force cycle ergometer test (CET) to predict maximal oxygen uptake (VO2max) of Air Force officers. The United States Air Force is currently evaluating cardiovascular fitness by cycle ergometry. In order to validate the accuracy of the CET, 50 male Air Force officers who were attending professional military education at Maxwell AFB were evaluated by a maximal treadmill Bruce test and open circuit spirometry. Characteristics of the subjects included the following mean values +/- SD: VO2max = 47.9 +/- 10.3 ml.kg-1.minute-1; age = 39.3 +/- 3.9 years; weight = 76.9 +/- 9.5 kg; height = 176.4 +/- 8.8 cm; percent fat = 20 +/- 9%; heart rate max = 174 +/- 10 beats.minute-1; and respiratory exchange ratio = 1.09 +/- 0.09. The predicted VO2max with the cycle ergometer test was 39.9 +/- 9.8 ml.kg-1.minute-1. The following product-moment correlation was derived between criterion VO2max (maximal treadmill test and the CET: r = 0.74 and standard error of estimate = 6.9 ml.kg-1.minute-1). A repeated measures analysis of variance between the CET and maximal treadmill test found a significant mean difference of 8.0 ml.kg-1.minute-1 (p < 0.0001). The CET significantly underpredicted fitness levels of Air Force officers. Based upon Air Force standards, the CET underpredicted oxygen uptake values by approximately one fitness category or 17%. |
8041454 | Early clinical and imaging (high-field MRI) diagnosis of Hallervorden-Spatz disease. | In a 10-year-old girl, with progressive motor disturbance since the age of seven years and dominant pyramidal signs, MRI revealed marked overall low signal from the globus pallidus on each side, with central zones of high signal. There was also strikingly low signal in the zona reticularis of the substantia nigra, indicative of Hallervorden-Spatz disease (HSD). |
8041453 | Acute bilateral striatal necrosis in an infant: CT and MRI. | We report a case of acute bilateral striatal necrosis in an infant. CT and MRI findings are described. |
8041452 | Transient bifrontal solitary periventricular cysts in term neonates. | We describe three children born at term investigated for neonatal seizures or transient apnoea. Cranial ultrasound and MRI unexpectedly revealed symmetrical periventricular cysts adjacent to the anterior horns. We found no evidence of prenatal viral infection, intraventricular or subependymal haemorrhage or hypoxic-ischaemic lesions. The lesions were not seen on MRI at 3 months of age, but there was no compensatory dilatation of the anterior horns nor secondary loss of white matter. The appearance and location of these transient cysts were different from those of the cystic changes which typically follow germinal matrix haemorrhage or periventricular leukomalacia. Their pathogenesis and clinical significance remain to be determined. |
8041451 | Hemiatrophy of the tongue due to hypoglossal schwannoma shown by MRI. | Schwannomas account for 8.5% of all intracranial tumours; more than 90% arise from the 8th cranial nerve. Only 42 cases of schwannoma of the hypoglossal nerve have been reported. A 59 year-old woman developed right hemiatrophy of the tongue, clearly demonstrated on MRI, as was a small hypoglossal schwannoma. High signal was seen in the atrophic side of the tongue on both T1- and T2-weighted images, as described in the literature. |
8041449 | A single focus of probable multiple sclerosis in the cervical spinal cord mimicking a tumour. | A case of probable multiple sclerosis (MS) in the cervical cord without brain involvement, mimicking a tumour is reported. The patient had a progressive left Brown-Séquard syndrome. The diagnosis was suggested by MRI. In spite of intensive corticotherapy, the neurological status worsened, in parallel with the radiological findings. Biopsy excluded an intramedullary tumour and supported the diagnosis of MS. |
8041450 | High resolution computed tomography of the inferior alveolar and lingual nerves. | Coronal and axial high resolution computed tomography of the mandible extends facilities in dentoalveolar surgery. Preoperatively the relationship between the mandibular canal and the roots of deeply displaced third molars can be determined precisely. After surgical removal of lower wisdom teeth iatrogenic defects of the lingual cortical bone can be detected. The additional information obtained when compared with conventional radiographs is demonstrated in case descriptions. Indications for this technique, radiation exposure and implications for surgery are discussed. |
8041447 | Primitive neuroectodermal tumour of the cauda equina. | Primary primitive neuroectodermal tumours of the cauda equina are rare. We report a case and review the literature. |
8041448 | Upper cervical spinal cord compression due to bony stenosis of the spinal canal. | Compression of the upper cervical spinal cord due to stenosis of the bony spinal canal is infrequent. In the first case reported here, stenosis was due to acquired extensive, unilateral osteophytes centered on the left apophyseal joints of C1-C2 in an elderly professional violinist. In the second case, stenosis was secondary to isolated congenital hypertrophy of the laminae of C1 and C2. |
8041444 | Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis. | A 9-year-old boy presented with a subacute history of optic neuritis followed by brainstem involvement, with fever and a lymphocytic pleocytosis in the cerebrospinal fluid. Gadolinium-enhancing ring lesions were demonstrated in the white matter of the cerebrum, brain-stem and cerebellum on day 17 of the illness, all appearing simultaneously as part of a monophasic illness. A parietal lesion exerted mass effect. Needling and biopsy yielded no evidence of a pyogenic lesion, tumour or tuberculosis and showed vasculitis. There was insufficient material for myelin staining. Dexamethasone therapy lead to rapid improvement of the radiological lesions: MRI and CT on day 34 of the illness showed complete clearing of the lesions except for residual abnormality at the biopsy site. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.