The effect of smear layer upon the coronal leakage of gutta-percha fillings and a glass ionomer sealer.

The effect of the removal of the smear layer on coronal leakage of root fillings was studied using two sealer cements. Sixty single-rooted teeth with mature apices were prepared chemomechanically using a modified double-flared technique with non-cutting tipped files and copious irrigation with 2% sodium hypochlorite. The teeth were randomly allocated to four groups of 15 teeth each. Two groups were treated with 40% citric acid to remove the smear layer. Two groups of teeth, one with and one without smear layer, were filled by lateral condensation of gutta-percha with either Tubliseal or a resin-based glass ionomer, Vitrebond. The teeth were stored for 1 week, thermocycled, and the extent of coronal leakage determined for each group after immersion in Indian ink for 90 h. The teeth were demineralized, dehydrated and immersed in methyl salicylate which rendered them transparent. Linear measurement of dye penetration was recorded. The mean depth (+/- SD) of leakage for the groups in which the smear layer was left intact was 4.26 +/- 1.53 mm and 6.83 +/- 1.65 mm for the Vitrebond and Tubliseal, respectively. When the smear layer had been removed, the mean depth of leakage for the Vitrebond group was 1.13 +/- 0.29 mm, and 3.72 +/- 1.23 mm for the Tubliseal group. There was a statistically significant difference in leakage between the groups (P < 0.001). With both sealers, those teeth in which the smear layer had been removed showed less leakage than the specimens in which the smear layer was left intact (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)


Human pulpectomy: incidence of postoperative pain using two different intracanal dressings.

A clinical study using vital maxillary central incisors was performed to evaluate the incidence of postoperative pain after pulpectomy and dressing with a corticosteroid-antibiotic preparation or a calcium-hydroxide paste. Sixty teeth from 45 patients were prepared and dressed on the first visit and re-evaluated 7 days later. No difference was observed in the incidence of postoperative pain between the two groups.


Mandibular premolar with three root canals--two case reports.

The presence of three root canals in the mandibular premolar may sometimes be recognized when there is persistent postoperative discomfort following root canal therapy. This paper presents two cases of root canal treatment of mandibular premolars with three root canals including one mandibular first premolar and one mandibular second premolar. The possibility that there is more than one root canal in lower premolar teeth must be considered in the radiographic and clinical examination during root canal treatment.


[Work absenteeism of the nursing personnel of Valencia hospitals].

A survey was carried out on a sample of 973 nurses from hospitals in the Valencian Region. The objective was to study work absenteeism due to health reasons depending on socio-demographic factors, work organization and self perception of health status. Information was collected by means of a self-administered questionnaire. Duration and frequency of absenteeism was analysed over the previous twelve months. A 34.4% of female nurses and 35.4% of male nurses reported at least one episode, with an average length of 21 and 26 days respectively. There is a relation between absenteeism and self-perception of health status. We did not find man/woman differences with regards to absenteeism.


[The association between regular alcohol consumption and accidents].

The traffic accidents prevention in the direction of attempting to limit drinking-driving behaviour is difficult to implement. However, if there was a relationship between these accidents and the regular consumption of alcohol, the reduction of alcohol use should be promoted. Likely, this strategy would be useful to other accidents. This study evaluates the association between regular consumption of alcohol and the occurrence of any type of accidents, a traffic accident, a home accident and an occupational accident. The information source has been interviews carried out to persons 16 years and older in National Health Interview Survey. In occupational accidents only interviews of men between 16 and 64 years of age have been used. The odds ratio (OR) calculated by logistic regression was the measure of association used. Except for home accidents, the results show statistically significant OR for the 16 to 24 and 25 to 44 age groups. For the occurrence of any type of accident, the ORs for the 16 to 24 years age group were: 1.37 for moderate drinkers, 1.87 for great drinkers and 2.55 for heavy drinkers, and the ORs for the 25 to 44 years age group were 1.28, 1.65 and 2.11 for the same levels of consumption. Similar magnitude of association showed the traffic and occupational accidents. In all cases interaction between regular consumption of alcohol and age was found. Our results suggest that a new direction in the health policy of accidents should be developed.


[Mortality from cancer of the breast and the female genitalia in Aragón, 1975-1984].

One out of four cancer deaths in women are due to breast cancer and female genital cancer. Mortality data are a basic information source to study disease characteristics in the population. A descriptive study on breast and female genital cancer mortality was carried out in Aragón covering the period 1975-84. Geographical differences and variations on mortality rates between the periods 1980-84 and 1975-79 have been studied. A mortality rate of 40.2 per 100,000 women per year has been observed for these tumours. Breast cancer accounted for 55% of these deaths. Reduction of mortality rate was seen for uterus non-specified between the periods 1980-84 and 1975-79, probably due to an improvement in quality of death certificates for uterus cancer. Higher mortality rates have been observed in the town of Zaragoza than in other parts of Aragón. This suggests the town of Zaragoza as priority in strategies of prevention and control programs.


[The knowledge of the obligatory reporting of diseases among health professionals].

In order to assess what different health care workers (mainly physicians and nursing staff) know about the reporting of communicable diseases, with special emphasis on diseases that must be urgently reported, four groups were interviewed about this health information system (91 persons, who took part in different Public Health Seminars during the periods 1989-90 and 1990-91). The total mean score was 16.6 +/- 5.2, in a quantitative scale ranging from 0 to 27 points. Cholera was the communicable disease with the highest percentage of correct answers concerning the knowledge of its reporting (100% in two groups), while typhus was the disease with the lowest percentage (23%). The diversity of the results within the study groups suggests that it is necessary to insist on a continuous training on epidemiological surveillance and communicable diseases within Public Health activities in Catalonia.


Assessment of vitamin A deficiency in a rural area in Mali. Estimation of sample size for the impression cytology test.

The prevalence of vitamin A deficiency among two to ten years old children in a rural area of Mali was assessed by ophthalmic examination, determination of plasma retinol levels and impression cytology with transfer tests. A Public Health problem of vitamin A deficiency was identified in this rural area by: the prevalence of nightblindness significantly (p < 0.001) above the cut-off (1%) defined by the World Health Organization (WHO); the prevalence of corneal scarring significantly (p < 0.001) above the WHO's cut-off (0.05%); the percentage of subjects with plasma retinol levels below 0.35 mumol/l (10 micrograms/dl) significantly (p < 0.001) higher than the WHO's threshold (5%); and 52.8 +/- 8.2% children with "Abnormal" impression cytology as determined by the impression cytology test (IC). This preliminary survey confirmed widespread vitamin A deficiency in Mali. The minimum sample size required for a study using the impression cytology test to determinate a Public Health problem in a population was calculated for different situations. Ophthalmic examination indicated a very high rate of active trachoma (29.6 +/- 7.0%), and a relationship between active trachoma and impression cytology results was identified.


[Physical exercise and health promotion in childhood and youth].

The "new health consciousness" that emerged in the developing countries in the 70s and 80s, has contributed to consider exercise as an element of health promotion. But it can establish simplistic relationships between exercise and health, particularly critical for professionals who develop promotion programmes. In this paper, five problematic aspects linked, to exercise and health relationships both in children and youngsters, are discussed and should be taken into account when promoting health programmes. We refer to: 1) the problematic role of exercise in health promotion and in physical education curriculum as an area of privileged action in children and youngsters; 2) the automatic relationship between fitness and health, when the former addresses to high levels of performance and the later is linked to moderate, regular and frequent exercise; 3) problems of fitness tests as a measure of health-related physical activity; 4) the assumption that any kind of physical activity is health-related; and 5) the quantity of exercise necessary for health as a practical problem. From the discussion different proposals are offered in order to develop health-related exercise promotion programmes such as to consider the risks of doing physical activity as a criteria to select exercises; to emphasize the qualitative instead of quantitative aspects of practice; to reconceptualize fitness and sport towards a health focus; to include a broad range of activities which offer the opportunity to every child and youngster to participate; to reduce the importance of testing in evaluation programmes; and other educational considerations which can help to maintain exercise practice beyond the schooling period.


Chemical synthesis, growth-promoting activity, and metabolism of all-trans retinyl beta-glucose in the rat.

Reaction of all-trans retinol with alpha-D-glucopyranosyl bromide tetrabenzoate in the presence of silver carbonate gave all-trans retinyl beta-glucose in good yield. Depending on the mode of administration, retinyl beta-glucose, which is soluble in water, showed 67-100% of the growth-promoting activity of retinyl acetate in vitamin A-deficient rats. In metabolic studies on vitamin A-deficient rats, retinyl beta-glucose was rapidly hydrolyzed to retinol. The possible therapeutic uses of retinyl glucose are discussed.


[Primary health care: an analysis of the transition in Anadalucía].

The article develops an analysis of the process of transformation of primary health care in Andalucía (Spain), related to two fundamental aspects. On the one hand, the strategic aspects of reform are analysed, inspiring principles, as well as legislation and administration. So called "central" changes, that is, those that really suppose transformations in the services: geographic distribution, donation, organisation, human resources, etc., are also analyzed. The second aspect approached is an analysis of the situation of the system related to the limitations and malfunctions, important conditioners of the present functioning and immediate future of primary care.


The influence of dietary intake and sunlight exposure on the vitamin D status in an elderly Spanish group.

Traditional dietary habits and the living style in Spain should theoretically be enough to assure a healthy vitamin D status: a very high fish intake and one of the highest sun exposure rates of all countries in Europe. However, in spite of this, there is a high percentage in the elderly showing low vitamin D serum values. This paper is part of the Euronut-SENECA study, a major multicentre survey assessing the nutritional status in the elderly from 19 centres over 12 countries in Europe. In it, the vitamin D status in 55 healthy individuals from Spain has been studied and assessed by measuring dietary and supplemental vitamin D intakes; the influence of sunlight exposure such as physical activity, permanence in the sun, clothing, etc.; and 25-hydroxyvitamin D [25 (OH)D] serum concentration. The mean dietary intake was 1.3 +/- 1.5 micrograms/day, being fish, and specially fatty fish, the main source (62%). Of the total, 85% of the elderly did not reach the Spanish recommended dietary intake (2.5 micrograms/day). The mean 25(OH)D serum level was 25 +/- 14.7 nmol/l and there was a high percentage with deficit (13%) (8.4 +/- 1.9 nmol/l) and marginal (62%) (19.8 +/- 4.2 nmol/l) levels. People who usually walked 1.9 +/- 1.3 hours/day or stayed in the sun "every day" or "as much as possible", had higher (p < 0.05) serum 25 (OH)D concentrations (27.7 +/- 2.4 nmol/l and 31.3 +/- 3.7 nmol/l, respectively) than people who did not (16.6 +/- 1.2 nmol/l and 21.3 +/- 2.1 nmol/l, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)


Possible roles of vitamin E in immune response of calves.

The effect of vitamin E injections on immune responses of calves was investigated. Treatments were: 0, 900, 1800 and 2700 IU of D-alpha-tocopherol given by injection starting at birth and then a 3 wk interval until the age of 12 wk. Plasma vitamin E levels were significantly higher for supplemented calves than control calves at any of the sampling times. There were no significant differences in the concentrations of immunoglobulin IgG1, IgG2 and titre to Keyhole Limpet Haemocyanin among treatments. However, the general trend was to have higher concentrations of IgG1 and IgG2 with an increase in the levels of vitamin E. Immunoglobulin IgM was significantly higher for calves supplemented with 2700 IU of vitamin E than control calves.


Determination of vitamins A and E in liver tissue.

A simple, efficient and robust method for the simultaneous determination of the two vitamins A and E in liver tissue has been developed and evaluated. The assay consists of a saponification step followed by a single extraction of the resulting solution with a mixture of n-hexane/toluene. The vitamins are quantified in the extract using two separate HPLC lines running on straight phase mode. The eluted compounds were detected with a fluorescence detector. Recoveries of spiked samples were found to be 92.4% for vitamin A and 95.2% for alpha-tocopherol. The coefficient of variation was found to be +/- 4.27% for retinol and +/- 4.64% for alpha-tocopherol. The described analytical method has proven to be very effective and fast, enabling the processing of a large number of samples within a short period of time. It is highly specific and sensitive covering a wide range of different concentrations in the samples. It may be applied therefore in routine assays of samples with great variability concerning the vitamin concentrations in the tissue.


Evaluation of ascorbic acid 2-O-alpha-glucoside as vitamin C source: mode of intestinal hydrolysis and absorption following oral administration.

Ascorbic acid 2-O-alpha-glucoside (AA-2G) has been reported to have antiscorbutic activity in guinea pigs. The present experiments examined the metabolic fate of AA-2G following ingestion. Oral administration of AA-2G (96 mg) to guinea pigs resulted in a remarkable increase of ascorbic acid in various tissues as well as plasma, but intact AA-2G was detected only in plasma, but intact AA-2G was detected only in plasma and urine in small amounts. The absorption efficiency of AA-2G and ascorbic acid was further determined by using everted gut sacs of rats. Ascorbic acid released from AA-2G on the mucosal side was effectively taken up across intestinal membranes into the serosal side, whereas AA-2G poorly permeated via a passive transport system. The hydrolysis of AA-2G on the mucosal surface of everted gut was completely inhibited by an alpha-glucosidase inhibitor and the hydrolytic activity of a crude membrane extract diminished to one-forth after immunoprecipitation with the antibody specific to maltase. From these results, it is concluded that ingested AA-2G serves as a vitamin C source through the hydrolysis by intestinal membrane-bound alpha-glucosidase, mainly maltase, and the subsequent absorption of released ascorbic acid.


Lipid profile, anthropometry and dietary intake of 132 Thai vegetarians.

The anthropometric measurements, lipid pattern and dietary intake of 64 male and 68 female Thai vegetarians (mostly lacto-vegetarians) were investigated. 32 males and 36 females on an ordinary Thai diet served as controls. Nutritional anthropometric variables and serum lipid concentrations, which the exception of triglycerides, were found to be lower in the vegetarian group than in the control group. The vegetarians consumed more energy than the controls. No difference in the protein intake was observed in both groups. Fat intake was, however, lower and carbohydrate intake higher in the vegetarian group. Also in the vegetarian group, HDL-cholesterol fraction correlated negatively with anthropometric measurements. Other fractions show only a weak correlation, if at all, in this group. A good correlation to all serum lipid variables determined to anthropometric measurement was observed in the control group.


Change in cholesterol levels and in lipid fatty acid composition in safflower oil fed lambs.

The influence of safflower oil supplemented (5%) diet both on cholesterol level and on lipid fatty acid composition was investigated in serum, liver and muscle (Longissimus dorsi) of lambs. The fatty acid pattern varied similarly in all the three tissues. An increase in linoleic acid and in some other polyunsaturated fatty acids, and a simultaneous reduction of the saturated fatty acids (mostly palmitic and stearic acid) were observed. On the contrary, cholesterol content decreased notably (44%) in the liver, with a much less evident decrease in serum and muscle of treated animals.


Influence of a natural-ingredient diet containing Phaseolus vulgaris on the colonization by segmented, filamentous bacteria of the small bowel of mice.

The appearance of segmented, filamentous bacteria (SFBs) in the small bowel of mice is influenced by the composition of the diet, but the dietary components responsible are not known. The addition of ground, whole Phaseolus vulgaris to a natural-ingredient diet at the expense of part of the skim milk powder, ground barley and wheat middlings components, caused an increase of the colonization of the mouse small bowel by SFBs. This effect was not seen when whole Phaseolus was added to a purified diet at the expense of part of the casein, corn oil, coconut fat, corn starch, dextrose and cellulose components. In an attempt to identify the fraction of Phaseolus that might contain SFB-inducing substances, the skin and kernel fraction of the bean were added to the natural-ingredient diet. The skin and kernel fraction were found to be as effective in inducing SFB appearance as was whole Phaseolus.


A psychoanalytic study of eating disorders: I. A developmental profile of 67 index cases.

Much has been written in both the professional literature and lay press regarding the sociocultural basis for the current increase in eating disorders. The typical victims of these afflictions appear to be intelligent adolescent girls from middle and upper class families (Garfinkel and Garner, 1982). Although the general pressure for thinness, mastery, and achievement among women in our culture undoubtedly help shape the course of illness, these social mores do not appear to be its root causes. The data presented here suggest strongly that the truly eating-disordered individual has a history of disturbances in early relationships, leading to a lack of security and pronounced difficulties in trusting others, and in simply being an authentic individual in the presence of others. As such these individuals share many characteristics of others with severe personality disorders such as inner emptiness, problems with identity, fear of abandonment, and peer relationships (Clarkin et al., in press), but differ in the expression of these basic defects or in solutions found to compensate pathologically for these core deficiencies. Therefore, although contemporary cultural ideals and values may supply the shape of the disorder, these individuals would have fared badly in any social climate although their presentation of illness may have differed (Bemporad et al., 1988). It is this profound underlying personality pathology that necessitates prolonged treatment for any hope of amelioration. Later reports will address this indication with a description of the results of therapy.


Psychoanalysis and cognitive science: contrasting models of the mind.

Although the relationship between psychoanalysis and cognitive science has begun to be addressed, theorists have not constructed a unifying conceptual framework from which to compare and contrast these disciplines. This paper begins by considering the models of mind of cognitive science, and of classical and contemporary psychoanalysis. It is argued that it is useful to reformulate psychoanalytic constructs in terms of cognitive science models. Psychoanalysts have therefore become, and will continue to be, more cognitivist in their work. Nevertheless, psychoanalytic theory and practice is so fundamental that it constitutes the only starting point for clinical cognitivists. The reformulation of psychoanalysis in cognitivist terms is beneficial for both psychoanalysis and cognitive science. The explanatory power of the cognitivist remodelling of psychoanalysis can, of course, be fully assessed only once it has taken place. This paper encourages that theoretical work to proceed.


The selfobject function of weapons: a self psychology examination.

Weapons serve a variety of functions, both for individuals and for society. One such function is that of a selfobject for narcissistically vulnerable persons. This selfobject function allows the damaged self to maintain cohesion and to offset feelings of vulnerability and powerlessness. Because the weapon allows the personality to feel in control and to exert dominance over others, it may come to be viewed in an idealized manner. This is very similar to the idealizing selfobject transference described by Kohut. Weapons are more likely to become selfobjects for those personalities suffering from some degree of self pathology. The selfobject function of weapons, however, may have significance beyond individual psychopathology. Groups of individuals, societies, and even nations may utilize weapons to counter feelings of vulnerability and to diminish fragmentation of the group's collective self. Their destructive potential may be unleashed in response to an intense narcissistic injury and narcissistic rage. The importance of weapons can thus be better understood by examining them within the context of self psychology.


Accelerated disappearance of ovarian follicles in mid-life: implications for forecasting menopause.

Menopause is triggered by the number of ovarian follicles falling below a threshold number and is irreversible because oogonial stem cells disappear after birth. Since it is the result of programmed disappearance of a limited store of follicles, menopause can be predicted using mathematical models based on total follicle counts at different ages. Our model shows follicle numbers decline bi-exponentially rather than as a simple exponential function of age, as had been assumed, with a first exponential rate parameter of -0.097 and a second of -0.237. The change occurred when numbers had fallen to the critical figure of 25,000 at age 37.5 years. The unexpectedly faster rate of ovarian ageing afterwards lowers the follicle population to 1000 at approximately 51 years, and was adopted as the menopausal threshold because it corresponds to the median age of menopause in the general population. Had the earlier rate persisted menopause would not be expected until 71 years. The impact of step reductions of follicle numbers on the prospective span of menstrual life was predicted by the model. A reduction by 50% before age 30 years resulted in the threshold being reached at 44 years and 0.6 year later for every subsequent year until age 37.5 years after which it is reached at 48 years. A reduction of 90% in childhood before age 14 years could result in menopause as early as 27 years, with increments of 0.6 year per year afterwards until after 37.5 years when it is expected at age 41 years.(ABSTRACT TRUNCATED AT 250 WORDS)


Controlled preparation of the endometrium with exogenous oestradiol and progesterone: a novel regimen not using a gonadotrophin-releasing hormone agonist.

In women having inactive ovaries, controlled preparation of the endometrium has been achieved with exogenous oestradiol and progesterone. We report on the feasibility and practicality of using a similar regimen for timing transfers of cryopreserved embryos in women whose ovaries have not been suppressed. A total of 91 women having cryopreserved embryos from previous in-vitro fertilization (IVF) attempts received 4 mg/day of oestradiol valerate, starting on cycle day 1 of spontaneous (n = 85) or induced (n = 6) menstruation. A single blood sample was obtained on cycle day 14 for the measurement of plasma progesterone, oestradiol and luteinizing hormone (LH). Vaginal administration of micronized progesterone (300 mg/day) was started on day 15. Cryopreserved embryos were transferred on day 17 or 18 provided that day 14 plasma progesterone remained < or = 0.5 ng/ml, thereby confirming the absence of spontaneous ovulation prior to the administration of exogenous progesterone. Out of 91 cycles studied, plasma progesterone was found to be elevated (> 1 ng/ml) in only three (3.2%). Of the 88 scheduled transfers, 31 did not take place because no embryo survived thawing. In the remaining 57 cycles, 116 embryos were transferred resulting in 10 pregnancies, giving pregnancy and embryo implantation rates of 17.5 and 8.6% respectively. When a positive beta human chorionic gonadotrophin (HCG) titre was obtained, supplementation with oral oestradiol and vaginal progesterone was continued until placental autonomy was achieved. Of the 10 pregnancies, five (50%) were lost during the first trimester (biochemical, n = 1; miscarriage, n = 3; ectopic, n = 1).(ABSTRACT TRUNCATED AT 250 WORDS)


Interactions between interferon gamma, tumour necrosis factor alpha, and interleukin-1 in modulating progesterone and oestradiol production by human luteinized granulosa cells in culture.

We have reported that the cytokines, interleukin-1 (IL-1), tumour necrosis factor alpha (TNF alpha), and interferon (IFN) alpha, beta, and gamma modulate the steroidogenic function of human luteinized granulosa cells in culture. In the present study we examined the interactions between these cytokines in modulating progesterone and oestradiol production by these cells. Neither IL-1 nor TNF alpha had significant effects on human chorionic gonadotrophin (HCG)-stimulated progesterone production, whereas IFN gamma (1-10 ng/ml) significantly reduced HCG-stimulated progesterone production by 26-37%. Concomitant treatment with IL-1 (1 ng/ml) did not further enhance the inhibitory effect of IFN gamma on HCG-stimulated progesterone production. In contrast, the combination of TNF alpha (1 ng/ml) and IFN gamma (10 ng/ml) acted synergistically to markedly inhibit HCG-stimulated progesterone production by 81%. In addition, IL-1 and TNF alpha, neither of which was effective alone, acted synergistically to reduce significantly HCG-stimulated progesterone production by 30%. The combination of TNF alpha and IFN gamma also markedly inhibited follicle stimulating hormone (FSH)-stimulated oestradiol production by 97%, a significantly greater inhibition than that obtained with either cytokine alone. These results suggest that the cytokines may interact to modulate the steroidogenic function of luteal cells in the developing corpus luteum.


Serum levels of free androstenedione, testosterone and oestradiol are lower in the follicular phase of conceptional than of non-conceptional cycles after ovarian stimulation with a gonadotrophin-releasing hormone agonist protocol.

Serum concentrations of total and free androstenedione, testosterone and oestradiol were followed during the follicular phase in women undergoing ovarian stimulation for treatment by in-vitro fertilization and embryo transfer (IVF-ET) and compared to those in natural unstimulated cycles. In addition, 10 conceptional and 18 non-conceptional cycles were compared in an attempt to understand the background for successful IVF cycles. The ultra-short gonadotrophin-releasing hormone agonist protocol was used for ovarian stimulation. Throughout the follicular phase, levels of total and free androstenedione and oestradiol were significantly lower in conceptional than in non-conceptional IVF cycles. In addition, levels of free testosterone during the follicular phase were significantly lower in women who conceived compared to non-conceptional IVF cycles, whereas levels of total testosterone were similar. Levels of both free and total androstenedione increased significantly from the second day of the menstrual cycle until oocyte retrieval in non-conceptional IVF cycles, whereas levels in conceptional IVF cycles and unstimulated cycles showed no increase. On the day of oocyte retrieval levels of free and total androstenedione were significantly higher in non-conceptional IVF cycles than in conceptional IVF cycles and unstimulated cycles, which were similar. This study suggests that appropriate levels of free biologically active androgens and oestradiol are important parameters for successful conception.(ABSTRACT TRUNCATED AT 250 WORDS)


Biological characterization of the isoforms of urinary human follicle-stimulating hormone contained in a purified commercial preparation.

The main physicochemical and biological properties of the several isoforms of urinary follicle-stimulating hormone (uFSH) present in a commercially available uFSH preparation were analysed. Purified urinary FSH was submitted to chromatofocusing and several immunoactive forms of uFSH with isoelectric points (pI) ranging from 5.5 to 3.8 were identified. An additional isoform was detected after passing through the chromatofocusing column a 1.0 M NaCl solution (salt peak). Each uFSH isoform or pool of neighbouring isoforms (pI value 5.5-5.1, pool I, 3.8 +/- 1.0% of total immunoactivity recovered; pI value 5.0-4.6, pool II, 18.4 +/- 3.6% of total; pI value 4.5-4.3, pool III, 14.9 +/- 1.5% of total; pI value 4.1, pool IV, 8.2 +/- 1.4% of total; salt peak, pool V, 51.1 +/- 6.4% of total) eluted as single FSH peaks after Sephadex G-100 exclusion chromatography (apparent M(r) 60,000). Even though FSH present within each pool was recognized by a receptor preparation, the receptor binding activity expressed as the radioreceptor assay/radioimmunoassay (RRA/RIA) activity ratio varied with the pI value of the particular uFSH isoform tested; starting from a pI value of 5.5, the receptor binding activity of FSH decreased from 5.9 +/- 0.39 to 2.4 +/- 0.19, as the pI value of the corresponding isoform declined. A similar trend was observed when the potency of each isoform was assessed by an in-vitro bioassay.(ABSTRACT TRUNCATED AT 250 WORDS)


The clinical significance of antisperm antibodies in infertile couples.

Sera from 150 women and 162 men with unexplained infertility were examined using a commercial enzyme-linked immunosorbent assay (ELISA) kit for antisperm antibodies. The results were compared to those of the Friberg agglutination test, the post-coital test, the sperm-cervical mucus contact (SCMC) test and the pregnancy rate. We also tested follicular fluids obtained from 38 women who underwent in-vitro fertilization (IVF). These data were compared with those obtained in serum, post-coital test data and with the later development of the oocyte in IVF. Antibodies in follicular fluid were found only in women with antibodies circulating in serum. The correlation coefficient between these was 0.88 (P < 0.001). There was no correlation between antisperm antibodies in serum found with the ELISA test, and with the agglutination test, the post-coital test or the SCMC test. Neither was there any correlation between antibodies in follicular fluid and the post-coital test, the pregnancy rate or successful IVF.


Prognostic factors in assessment and management of male infertility.

Evaluation of 304 infertile couples with at least one abnormal semen analysis (sperm density < 20 x 10(6)/ml and/or motility < 50%) and no apparent female factors was performed in a multicentre prospective cohort study. In 73 cases therapeutic donor insemination was performed (TDI group) with a resulting pregnancy rate of 48%. The remaining 231 couples (non-TDI group) had an overall pregnancy rate of 25%. The TDI group had a shorter duration of infertility. The ages of both partners were comparable in TDI and non-TDI groups. In the non-TDI group, univariate analysis resulted in identification of six clinical variables associated with a change in pregnancy rates. The strongest association was noted for length of infertility. There was a weaker association for semen volume, concentration of leukocytes in semen, history of pregnancy in the female partner and laparoscopy. Multiple variable analysis of data from the non-TDI group revealed that independent predictors of pregnancy were 'duration of infertility' and 'history of pregnancy in the female partner'. The multiple variable modelling suggested that (i) an increase in the length of infertility by 1 month prolongs the time to pregnancy by an additional 1.6% (95% confidence interval: 1.5-1.7%); and (ii) a history of past pregnancy in the female partner reduces the time of pregnancy by 51% (95% confidence interval: 47-56%).


Chromosome anomalies in mouse zygotes treated by growth hormone-releasing factor.

The incidence of chromosome anomalies was studied in fertilized oocytes in two groups of hybrid mice in which superovulation was induced by gonadotrophins and growth hormone-releasing factor (GRF) supplementation or gonadotrophins alone (controls). The rate of fertilization was significantly higher among GRF-treated females than among controls (74.1 versus 84.7%; P < 0.013). Cytogenetic data were obtained in 262 fertilized oocytes (89 from control females and 173 from GRF-treated females). The frequency of aneuploidy, calculated as twice the frequency of hyperhaploidy was 2.31% in GRF-treated females and 2.24% in controls (NS). The use of GRF to treat female mice did not adversely affect the maturation process of oocytes nor did it induce an increased frequency of aneuploidy.


The incidence of chromosomal aneuploidy in stimulated and unstimulated (natural) uninseminated human oocytes.

The incidence of chromosomal aneuploidy in human oocytes is higher than for various animal species. Since this estimate for aneuploidies is based on data obtained from in-vitro fertilization (IVF) patients, it is possible that superovulation could be contributing to this phenomenon. In this study we determine the incidence of chromosomal aneuploidy in nonstimulated uninseminated human oocytes donated by IVF patients. Furthermore, we compare this incidence of aneuploidy to that obtained after superovulation using two different protocols for induction of multiple follicular growth. The rate of aneuploidy in non-stimulated oocytes was 20% (4/20). This is not significantly different from the rate of aneuploidy in oocytes obtained after superovulation with clomiphene/human menopausal gonadotrophin (HMG)/(HCG) (15/43 = 35%, chi 2 = 1.11; P > 0.20), buserelin-flare (8/25 = 32%; chi 2 = 0.32; P > 0.05), and the rate of aneuploidy in the total number of superovulated oocytes (23/68 = 34%; chi 2 = 82; P < 0.30). Furthermore, the incidence of chromosome aneuploidy in non-stimulated uninseminated oocytes (20%) was well within the range and not significantly different from that reported in the literature for both superovulated uninseminated oocytes (range, 21-57%; total aneuploidy rate, 67/216 = 31%; P < 0.30) and superovulated inseminated oocytes (range, 3-56%; total aneuploidy, 339/1480 = 23%; P < 0.95). Consequently, the data provide evidence that superovulation protocols used in IVF may not be responsible for the higher rate of aneuploidy in human oocytes. These results are discussed in relation to hypotheses on the occurrence of meiotic non-disjunction.


Effect of human cervical mucus on human sperm motion and hyperactivation in vitro.

The aim of our experiment was to examine the effect of exposure to human cervical mucus on quantitative sperm motility with specific reference to hyperactivated sperm motility. Human spermatozoa were allowed to penetrate cervical mucus for 20 min before swimming into Earle's balanced salt solution tissue culture medium for 25 min. The sperm motion characteristics were compared to those which had been obtained from a direct swim-up for 45 min. Spermatozoa treated with mucus were more 'active' than the control group. Multivariate statistical analysis indicated that cervical mucus promotes hyperactivated motility and that sperm sub-populations exposed to cervical mucus are very heterogeneous, as indicated by the numbers and motility characteristics of spermatozoa.


Influence of sperm parameters on outcome of subzonal insemination in the case of previous IVF failure. off.

Subzonal insemination (SUZI) has been proposed for patients with sperm male factor infertility, and in cases of in-vitro fertilization (IVF) failures. However despite SUZI, there still remain couples with very low fertilization rates and even with fertilization failures. Since sperm parameters are known to influence the IVF fertilization rate, we investigated the relation between sperm parameters and the SUZI issue in cases of previous IVF failures with normal or subnormal sperm. Twenty-seven couples were included in the study and were split into two groups according to whether they had normal or subnormal sperm. In the first part of the study a randomized prospective trial comparing SUZI to classic IVF insemination was carried out (11 cycles). In the second part, all the oocytes had SUZI (35 cycles). None of the control inseminated oocytes fertilized. Including all the cases, the fertilization rate after SUZI was 29.8% with a pregnancy rate of 15.2% per cycle. We concluded that: (i) SUZI is efficient for achieving fertilization in cases of IVF failures; (ii) the post SUZI fertilization rate is inversely correlated to the percentage of acrosome defects in the semen (P < 0.001); and (iii) when the sperm is normal, the oocyte quality might be responsible for the previous IVF failures. In spite of a good fertilization rate for this indication, it seems that the chance of having a baby is low.


Effects of chamber depth on the motion pattern of human spermatozoa in semen or in capacitating medium.

The computer-aided sperm analysis system (CASA) permits precise calculation of the trajectory characteristics of human spermatozoa. Comparison between different chamber depths (10, 20 and 100 microns) revealed variations in the results, which were more evident as the magnitude of the spermatozoon flagellar beat increased. In seminal spermatozoa, the reduced amplitude of movement, linked to the relatively short flagellum and high viscosity of seminal plasma, indicates that the 10 microns-deep chamber can be used for motion analysis without involving extensive modifications. On the other hand, analysis of quicker movement, such as in capacitated spermatozoa, revealed large variations; in particular the proportion of non-progressive hyperactivated spermatozoa was higher in the 20 microns than in the 10 microns chamber (17.9 +/- 14% and 6.9 +/- 4.5% respectively, P < 0.01). In fact the distribution of non-progressive and progressive hyperactivated spermatozoa is depth-dependent. It is therefore necessary to use a chamber of at least 20 microns in depth for sperm analysis in capacitated medium.


Propofol anaesthesia for ultrasound guided oocyte retrieval: accumulation of the anaesthetic agent in follicular fluid.

Propofol (2,6-diisopropylphenol, Diprivan, ICI-Pharmaceuticals, Manchester, UK) is widely used either as an adjunct in general anaesthesia or as sole anaesthetic agent by the continuous intravenous route and intermittent bolus injections for minor surgical interventions. For several years, we have been using this kind of anaesthesia in transvaginal oocyte retrieval for in-vitro fertilization (IVF), allowing a completely painless puncture on an out-patient basis. From in-vitro studies on mouse oocytes, it appeared that propofol could be deleterious for fertilization in a dose- and time-dependent manner. We therefore investigated the concentrations of propofol in follicular fluid during oocyte retrieval in women. We measured propofol levels in serum and follicular fluid of nine patients at fixed intervals during ultrasound guided oocyte retrieval. Serum levels fluctuated randomly, due to interference from top-off doses of propofol. In follicular fluid, however, we found a steady increase of propofol levels, which was proportional to the total dose of propofol administered. These data indicate that propofol accumulates in follicular fluid. Although it seems unlikely that propofol as used in the present protocol exerts a clinically significant unfavourable effect on IVF, we suggest that the oocyte retrieval procedure should be kept as short as possible, in order to limit the accumulation of the anaesthetic in follicular fluid.


Fallopian tube recanalization by selective salpingography: an alternative to more invasive techniques?

Selective salpingography was used in a total of 64 patients, engaged in evaluation for infertility and in whom standard hysterograms showed no tubal passage of contrast medium. Fallopian tube catheterization was successful in 92% of the cases; a peritoneal spill of contrast medium was obtained in 74% of the cases by manual injection. Recanalization of an obstructed oviduct was successful in 61% of the cases. Thus, after the procedure, 82% of the patients had at least one patent tube. We conclude that selective tubal catheterization, and recanalization when needed, should be included in the therapeutic procedures for tubal infertility, prior to in-vitro fertilization or tubal microsurgery.


Laparoscopic removal of benign mature teratoma.

Laparoscopic removal of benign mature teratoma is safe and effective in pre-menopausal patients. Fourteen patients underwent laparoscopic removal of such tumours. There were no operative complications. Post-operative hospitalization was short (average: 2 days). All patients undergoing a second-look laparoscopy had mild adhesions around the operated ovary. Two spontaneous and one in-vitro fertilization pregnancy occurred. If a teratoma is diagnosed during laparoscopy or oocyte retrieval, it should be promptly removed as malignant transformation is not excluded. In this case, the embryos should be frozen for later transfer.


Diagnostic hysteroscopy: its value in an in-vitro fertilization/embryo transfer unit.

A total of 324 patients participating in our in-vitro fertilization/embryo transfer (IVF) programme underwent a diagnostic hysteroscopy. Of these, 152 women were referred before their first IVF attempt, because of some hysterosalpingographic suspicion of an intra-uterine abnormality; the other 172 patients had failed to conceive after IVF and transfer of good quality embryos. An intra-uterine pathology (mainly intra-uterine adhesions) was diagnosed in 50% of the patients in each group. Hysterosalpingography, although very sensitive, had low specificity (23%), a false positive rate of 44% and false negative rate of 10%. The main risk factor for intra-uterine pathology was a previous abortion. Conception rates were 22% after surgical treatment and 38% after the diagnostic procedure. We think that hysteroscopy should be performed in every patient failing to conceive after replacement of good quality embryos. It is also recommended whenever a suspicious finding is revealed by hysterosalpingography, before IVF. Routine hysteroscopy before entering an IVF programme should be seriously considered.


Platelet activating factor in culture media as an indicator of human embryonic development after in-vitro fertilization.

Although human chorionic gonadotrophin can detect trophoblast after implantation of the conceptus, there is a need to detect the conceptus before implantation. We have investigated whether human embryo-derived platelet activating factor is formed during embryonic development after in-vitro fertilization. A total of 99 ova from 12 patients were cultured and the 54 media were analysed. Platelet activating factor was also measured by radioimmunoassay after extraction. Fertilization increased the amount of platelet activating factor 4-fold over non-fertilized ova to a level of 4 ng/ml. This increase was also dependent on the degree of embryonic development with a maximum level of platelet activating factor of 7 ng/ml at the 2-cell stage. The follicular inducing agent used to treat the patient also had an effect on platelet activating factor; buserelin treatment gave embryos with a higher level than did clomiphene citrate treatment. These results indicate that platelet activating factor may have a role in embryonic development before implantation and may serve as a useful marker for fertilization and the developmental stage of the embryo.


In vitro maturation of mouse germinal vesicle-stage oocytes following cooling, exposure to cryoprotectants and ultrarapid freezing: limited effect on the morphology of the second meiotic spindle.

Cryopreservation of germinal vesicle (GV)-stage mouse oocytes results in a developmental block. As an approach to explain the failure in development, we have investigated the morphology of the second meiotic spindle after in-vitro maturation. Fully grown GV-stage mouse oocytes were collected from the ovaries of primed mice and kept in meiotic arrest with dibutyryl cyclic AMP. These oocytes were submitted to different variables of cryopreservation: (i) cooling to 22 degrees C or 0 degrees C; (ii) exposure to 1.5 M 1,2-propanediol at 22 degrees C or 0 degrees C; (iii) exposure to 1.5 M dimethylsulphoxide (DMSO) at 22 degrees C or 0 degrees C; (iv) ultrarapid freezing with 3.5 M DMSO/0.5 M sucrose; (v) exposure to a sucrose dehydration series according to the ultrarapid freezing protocol. The morphology of the second meiotic spindle was evaluated 16 h after release from meiotic arrest. We were able to demonstrate that following cooling, exposure to cryoprotectants or ultrarapid freezing of GV-stage mouse oocytes, a normal barrel-shaped spindle with the chromosomes in midplane position is found in 79-94% of oocytes except for two conditions with great exposure to dehydration stress. Exposure to DMSO at 0 degrees C or exposure to a sucrose dehydration series resulted in significantly lower percentages of barrel-shaped spindles, respectively 64% and 62%. The effect on spindle morphology has to be put into perspective, however, since the observed abnormalities were changes of spindle shape, such as elongation or reduction, which are assumed to be restorable, and since no polar organizational defects were found.(ABSTRACT TRUNCATED AT 250 WORDS)


Fertilization and embryonic development of human oocytes after cooling.

Injury to living cells resulting from rapid cooling to temperatures at or near 0 degrees C has long been recognized, and the phenomenon, which is termed 'cold shock', has been known to occur in some mammalian gametes. Although human embryos have been successfully stored at low temperatures, cryopreservation of the human oocyte is proving to be more difficult. Whether or not this lack of success is a direct result of cellular injury brought about by 'cold shock' is the purpose of the current investigation. Human oocytes were cooled, in the absence of cryoprotectants, at two different cooling rates (-3 degrees C/min and -1000+ degrees C/min) to a temperature of 0 degrees C and rewarmed prior to insemination. In both cases fertilization after cooling was similar to the rates achieved in a routine in-vitro fertilization and embryo transfer procedure. After cooling at -3 degrees C/min, the rate of fertilization was 19/22 (86%) and after cooling at -1000+ degrees C/min, 9/9 (100%), with non-cooled control rates of 62/87 (71%) and 35/50 (70%) respectively. Fertilized oocytes from both groups were successfully cultured for a further 24 h before termination of the experiment.


Effects of cryopreservation on survival and development of interphase- and mitotic-stage 1-cell mouse embryos.

The effects of cryopreservation with 1,2-propanediol on two groups of 1-cell mouse embryos were studied in terms of survival after thawing, growth in vitro until the blastocyst stage and development in vivo assessed by the number of implantations and living fetuses. The two groups were divided according to different stages in the cell cycle: cells in (i) interphase with two distinct pronuclei or (ii) mitosis just prior to the first cleavage division. Zygotes in the interphase stage proved to be more resistant to freezing and thawing procedures, showing a significantly higher survival rate after thawing than zygotes in mitosis (78.5 versus 61.3%, P < 0.05). Blastocyst formation was similar in the two experimental groups: 72.7% for interphase and 60.8% for mitosis (P = 0.06), but for both groups fewer blastocysts formed when compared with the control group (86.7%) (P < or = 0.01). The implantation rates were not statistically different: 54.2% for the interphase cells and 47.4% for the control group and 44.0% for the mitotic cells and 49.4% for the control group. The formation of living fetuses was similar between the experimental and control groups: 36.5% for the interphase group (40.0% for its control group) and 22.6% for the mitotic group (38.8% for its control group). We conclude that freezing embryos during nuclear division is detrimental for their survival after thawing.


Transvaginal intratubal insemination, ectopic pregnancy and treatment by single-dose parenteral methotrexate.

We report a case of a woman with ectopic pregnancy with fetal cardiac activity after ovulation induction and transvaginal intratubal insemination by tactile sensation. The patient was successfully treated by single-dose methotrexate (MTX) (77 mg or 50 mg/m2 given intramuscularly). Control hysterosalpingograms showed no tubal patency on the involved side. Potential advantages and hazards of transvaginal intratubal insemination and single-dose MTX for ectopic pregnancy are discussed.


Immunohistochemical localization of androgen receptor in the human endometrium, decidua, placenta and pathological conditions of the endometrium.

The immunohistochemical localization of the androgen receptor in the human endometrium at various stages of the menstrual cycle and post-menopausal period, in decidua and placenta of early pregnancy, and in several pathological conditions of the endometrium has been investigated. At any phase of the menstrual cycle, both endometrial glandular cells and endometrial stromal cells showed positive nuclear staining. Endometrial stromal cells of the functional layer showed stronger staining than those of the basal layer, but endometrial glandular cells of both layers showed the same staining intensity. There was little staining in myometrium. Even after menopause, endometrial glandular and stromal cells showed the same staining pattern as the basal layer of pre-menopausal endometrium and the staining intensity of endometrial stromal cells was weak. In decidua and placenta of early pregnancy, decidual and trophoblastic cells showed positive staining and there was no staining in the stromal cells of placenta. The expression of the androgen receptor was also detected in adenomyosis, endometriosis and endometrial carcinoma. Although the proliferation and differentiation of endometrium are mediated mainly by oestrogen and progesterone receptors, the androgen receptor may play some role in modulating these changes. These results suggest that it may be involved in both physiological and pathological changes of the endometrium.


Influence of human chorionic gonadotrophin, oestradiol and progesterone on uteroplacental and corpus luteum blood flow in normal early pregnancy.

A transvaginal colour and pulsed Doppler study was performed on 44 women with normal pregnancies between 5 and 16 weeks of gestation. Maternal levels of human chorionic gonadotrophin (HCG), free alpha-HCG subunit, free beta-HCG subunit, 17 beta-oestradiol and progesterone were determined in sera obtained at the time of Doppler examination. Uterine peak systolic velocity (PSV) and alpha-HCG and 17 beta-oestradiol levels increased significantly (P < 0.001) from the second to the fourth month of gestation, whereas uterine and spiral resistance index (RI) decreased significantly (P < 0.005 and P < 0.001, respectively) with gestational age. Levels of HCG and beta-HCG peaked significantly (P < 0.01) during the third month of gestation. Corpus luteum PSV and RI and progesterone levels did not vary significantly with gestational age. Multiple regression analysis showed that gestational age was the only significant (P < 0.05) contributor to uterine PSV and spiral RI variability. In addition to gestational age, 17 beta-oestradiol had a significant (P < 0.001) influence on uterine RI. Both corpus luteum PSV and RI were significantly (P < 0.01 and P < 0.05, respectively) related to progesterone levels. Corpus luteum PSV was also significantly (P < 0.05) related to 17 beta-oestradiol levels and RI to HCG levels.(ABSTRACT TRUNCATED AT 250 WORDS)


Expression of human chorionic gonadotrophin alpha and beta subunits is depressed in trophoblast from pregnancies with early embryonic failure.

The expression of the placental proteins human chorionic gonadotrophin alpha (HCG alpha), beta (HCG beta) and human placental lactogen (HPL) was examined in trophoblast from human normal pregnancy and early embryonic failure (EEF) using Northern blot analysis. Trophoblast from EEF expressed significantly depressed levels of HCG alpha (P < 0.05) and HCG beta (P < 0.01) when compared to normal pregnancy. Levels of expression of HPL in EEF were not significantly different to those from normal pregnancy. The gestational ages of the two groups were not significantly different. Immunocytochemistry on paraffin-fixed tissue sections supported these data and showed that mRNA levels reflected protein production of HCG within the tissue. It appears from these data that the depressed level of HCG found in the serum of women with early pregnancy failure is not solely a consequence of diminished placentation in these pregnancies, or placental necrosis, but that the genes of the alpha and beta HCG subunits are down-regulated. This study further suggests that there are two subsets of women with early pregnancy failure; those with apparently normal levels of placental proteins, and those with severely depressed levels. It would seem likely that these two groups have different aetiologies.


Critical differences of clinical chemical components in blood from Red Danish dairy cows based on weekly measurements.

The critical difference, which may help to judge whether the difference between two consecutive analytical results may be safely ascribed to natural variation or not, was calculated for 12 clinical chemical components determined in blood samples collected once a week for 5 consecutive weeks from 19 clinically healthy Red Danish dairy cows. For each clinical chemical component, the total variance of the analytical results was divided into the component of variance between cows (S2Inter), the component of variance for weeks within cows (S2Intra) and the component of variance for measurements (S2Anal) using nested analysis of variance. The critical difference calculated in absolute values from S2Intra and S2Anal was 0.15 mu kat per 1 for alanine aminotransferase, 0.55 mu kat per 1 for aspartate aminotransferase, 0.57 mu kat per 1 for alkaline phosphatase, 0.14 mu kat per 1 for gamma-glutamyltransferase, 1.95 mu kat per 1 for creatine kinase, 2.23 mmol per 1 for urea, 22 mu mol per 1 for creatinine, 2.4 g per 1 for albumin, 10.0 g per 1 for serum protein Total, 0.71 mmol per 1 for glucose, 0.54 mmol per 1 for calcium and 0.25 mmol per 1 for magnesium. These critical differences may be used as guidelines to evaluate the difference between two consecutive analytical results in cows. However, the analytical results should not be assessed by the critical differences alone, but should also be compared with the corresponding reference intervals.


Lenticular lesions in harbour seals (Phoca vitulina).

Lenticular lesions were found in 21 of 44 mainly younger harbour seals investigated during the epidemic caused by phocine distemper virus (PDV) in 1988/89. Malformations and cataracts varied in quality and degree and were histologically characterized by proliferative and/or degenerative lenticular alterations. Except for two animals, both eyes were affected symmetrically. For that reason, local exogenous causes are improbable. There was very little evidence for infectious agents isolated from the seals investigated (viruses, in particular PDV, bacteria, mycoplasma, parasites). Environmental, dietary and hereditary aspects were also considered, but no final conclusions could be made as to the involvement of these factors in the genesis of lens lesions in harbour seals.


Vacuolar neuronal degeneration in the ventral horns of SCID mice in naturally occurring Theiler's encephalomyelitis.

During a spontaneous outbreak of Theiler's encephalomyelitis severe combined immunodeficient mice developed high morbidity and high mortality. Histological lesions were localized in the ventral horns of the spinal cord and brain stem. The salient features were the severe vacuolar degeneration of neurones and glial cells and the absence of inflammatory cellular infiltrates. The clinical and pathological features of this outbreak indicate that the SCID mouse would be a much improved model for studying the mechanism of poliovirus infection and of virus-induced demyelinating diseases.


Comparison of four erythrocyte fragility tests as indicators of vitamin E status in adult dogs.

Plasma alpha-tocopherol (alpha-T) concentrations, erythrocyte osmotic fragility and detergent sensitivity were measured at 8 week intervals in two 1-year-old male beagle dogs fed a vitamin E-deficient diet (< 0.08 mg per kg alpha-T) and in two control beagles fed the same diet supplemented with vitamin E (> 90 mg per kg alpha-T). Beginning at 24 weeks, dialuric acid haemolysis and spontaneous haemolysis were evaluated also. In the vitamin E-deficient dogs, plasma alpha-T concentrations declined progressively from baseline values of 20.5 and 31.3 micrograms per ml to 0.11 and 0.07 micrograms per ml, respectively, by 90 weeks. The supplemented dogs maintained alpha-T concentrations between 18.3 and 38.4 micrograms per ml. Both dialuric acid haemolysis (R = -0.89) and spontaneous haemolysis (R = -0.91) increased with declining plasma alpha-T concentration. In the dialuric acid haemolysis assay, 50 per cent haemolysis occurred when plasma alpha-T declined to 1.7 micrograms per ml, compared with spontaneous haemolysis in which 50 per cent haemolysis occurred when plasma alpha-T declined to 0.5 micrograms per ml. Osmotic fragility and detergent sensitivity remained unchanged in the vitamin E-deficient dogs throughout the study. Of the four tests, dialuric acid haemolysis was the most sensitive in-vitro assay for vitamin E deficiency in adult dogs.


Feline non-suppurative meningoencephalomyelitis. A clinical and pathological study.

A spontaneous neurological disease in cats characterized by behavioural and motor disturbances was investigated by clinical, morphological and immunological methods. Neuropathological examination showed a marked inflammatory reaction in the cerebral leptomeninges and the grey matter of the brain. In the white matter, the reaction was moderate. The changes consisted of perivascular cuffing by mononuclear cells and neuronal damage. The brain stem (thalamus, mesencephalon, caudal colliculus) was most severely affected. The spinal cord and its leptomeninges were involved to a lesser degree. The histopathological picture as well as the laboratory findings suggests a viral cause of the disease. The morphology of the disease and serological as well as immunohistochemical results indicate that this disorder is different from previously known feline viral encephalitides.


An orderly approach to the study of odontogenic tumours in animals.

In this paper odontogenic tumours in animals are discussed with the aim of developing a sound basis for further work in this relatively poorly understood field. The following recommendations are made: (1) Odontogenic tumours should be classified according to whether they are of epithelial, mesenchymal or of mixed epithelial and mesenchymal origin, rather than based on inductive changes. (2) The clinical behaviour implied by ameloblastoma, ameloblastic fibroma and odontoma should be carefully considered before these terms are incorporated into the diagnosis of any odontogenic tumour. (3) Caution should be exercised in designating specific odontogenic tumours in animals as being the counterpart of human tumours until their histopathological features and clinical behaviour have been proved to be equivalent. (4) Only tumours that exhibit the typical features of the basal cell layer of ameloblastomas should be designated as ameloblastomas. (5) Ameloblastic epithelium should not be used when odontogenic epithelium is intended. (6) These recommendations should be substantiated by reviewing odontogenic tumours in animals, although doing so will be difficult because of their rarity.


Canine distemper virus infection in a masked palm civet (Paguma larvata).

A free-living masked palm civet (Paguma larvata) died after exhibiting signs of canine distemper (CD). The microscopic lesions consisted of cytoplasmic and intranuclear eosinophilic inclusion bodies, bronchointerstitial pneumonia, non-purulent encephalitis accompanied by demyelination and lymphocytic depletion in various lymphoid tissues. CD virus-specific antigens were demonstrated immunohistochemically in intracellular eosinophilic inclusions, which were ultrastructurally confirmed to be viral nucleocapsids. From these findings, the present case was diagnosed as CD virus infection in a masked palm civet.


Bone histomorphometry in Cushing's syndrome.

Bone involvement is a common finding in Cushing's syndrome. The actions of corticosteroids on bone have been studied quite intensively but only a few studies of bone histomorphometry in this syndrome have been published. In this paper we present histomorphometric measurements of bone activity in 7 patients with a postoperative reevaluation in two. The results show irregular alterations on histomorphometric parameters with an increased bone resorption and decreased bone formation rate. After surgery the abnormalities changed towards normal.


Double-blind controlled trial of progesterone vaginal cream treatment for cyclical mastodynia in women with benign breast disease.

The clinical effectiveness and safety of vaginal micronized progesterone treatment in mastodynia were evaluated in a double-blind placebo controlled study. Eighty regularly menstruating women affected by severe cyclical mastodynia were randomly assigned to two groups of 40 patients. One group was treated for 6 cycles from the 19th to the 25th day of the cycle with 4 g of vaginal cream containing 2.5% natural progesterone. The other group was similarly treated with placebo. The treatment was preceded by a control cycle. All patients reported every day their breast pain on a 100 mm visual linear analogue scale (VAS). The response of breast tenderness and nodularity to treatment was assessed by clinical examination. Vaginal progesterone resulted significantly more efficacious than placebo in reducing mean ratings of breast pain on VAS and mean scores of breast tenderness to touch. Success of treatment, defined as reduction greater than 50% of basal mean score of breast pain on VAS, was achieved in the 64.9% of patients treated with progesterone and in the 22.2% of patients receiving placebo (p < 0.01). Conversely, at the end of treatment, the improvement in breast nodularity showed a not statistically significant difference between the two groups. No major side-effects were detected.


The value of visual evoked potentials in optic neuropathy of Graves' disease.

Visual evoked potentials (VEP) were tested in patients with ophthalmopathy (OP) of Graves' disease (GD) before treatment and half-a-year and 5-7 yr after orbital decompression (7 patients) or retrobulbar irradiation (3 patients). Five patients not requiring treatment for OP and 16 healthy subjects served as controls. Treatment of OP was given on clinical grounds including decreased visual acuity (VA) indicating optic neuropathy. Before treatment VA was decreased in 5 out of 19 eyes whereas VEP were abnormal in all. The mean latency at N60 both in the operated (83.1 +/- 21.6 ms) and in the irradiated groups (80.9 +/- 7.0 ms) was significantly different from that in the untreated group (62.6 +/- 8.2 ms; p < 0.001) and the healthy subjects (58.9 +/- 6.3; p < 0.001). At P120 only the latency of the operated group differed significantly from that of the other groups (p < 0.001). There was a relationship between the eye muscle changes seen on CT scans and the ophthalmopathy score (according to the classification of the American Thyroid Association) and the latency both at N60 and P120. A change from a V-shape to a W-shape of the waves occurred more often in the treated patients before therapy than in the other groups. Two patients had multiphase VEP in both eyes which improved after treatment. After adequate clinical response the visual acuity improved in one of the 5 patients with initially depressed VA. VEP, initially abnormal in all, improved in 7 of the 19 eyes (37%) but further deterioration was observed in 8 (42%).(ABSTRACT TRUNCATED AT 250 WORDS)


Time related bias in longitudinal studies using dual photon absorptiometry.

Examining the bone mineral density (BMD's) slope of patients regularly followed in our department, we observed recently that the group of patients who had their last BMD during the last 6 months of 1989, had a different slope than patients who had their last BMD during the following 6 months. In order to investigate if a small time-related bias of measurement, unsuspected by the former quality control investigations, could exist, we performed the following analyses. A regression equation between BMD and time was calculated and a slope was obtained for 95 women who had been followed for at least 3 yr and had had at least 3 BMD measurements during that time. The women were divided in 3 groups according to when the last BMD measurement had been performed (July-December 1989, January-June 1990 or July-December 1990). The slopes of the 3 groups of patients were compared. For each value of BMD of every patient, a predicted BMD (BMDp) was calculated using the regression equation and the relative difference (RD) between BMDp and BMD was calculated and analysed in relation to time. There was a significant difference (p < 0.05) between the slopes of patients in relation to the time when the last BMD had been measured. Significant fluctuations (p < 0.001) in RD were observed in relation to time. These RD variations suggested the existence of a time-related error. The presence of this error is also substantiated by the fact that a parallelism existed between the curve of the RD variations and the curve of the mean values of BMD of all patients referred to our department, calculated per period of 4 months. Although the fluctuation of the latter curve was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)


Effect of naltrexone treatment on the treadmill exercise-induced hormone release in amenorrheic women.

The effect of an acute physical stress on hormone secretions before and after a 10-day naltrexone treatment in untrained healthy and amenorrheic women was investigated. Plasma levels of pituitary (LH, FSH, prolactin, GH, ACTH, beta-endorphin) and adrenal (cortisol, androstenedione, testosterone) hormones were measured at rest and in response to 60 min of physical exercise. The test was done both before and after a 10-day naltrexone (50 mg/day) treatment. Graded levels of treadmill exercise (50, 70 and 90% of maximal oxygen uptake (VO2) every 20 min) was used as physical stressor. While mean +/- SE plasma LH levels in control women were higher than in amenorrheic patients and increased following the naltrexone treatment (p < 0.01), no significant differences of basal plasma hormonal levels were observed between amenorrheic and eumenorrheic women, both before and after naltrexone treatment. Physical exercise at 90% VO2 induced a significant increase in plasma GH, ACTH, beta-endorphin, cortisol, androstenedione and testosterone levels in controls before naltrexone treatment (p < 0.01). The mean increase in plasma androstenedione and testosterone levels in control women was significantly higher after naltrexone treatment (p < 0.01). In amenorrheic patients before naltrexone, physical exercise induced an increase in plasma prolactin and GH levels, but not in plasma ACTH, beta-endorphin, cortisol, testosterone and androstenedione. After naltrexone treatment, the exercise induced a significant plasma ACTH, beta-endorphin and cortisol levels, while the increase of plasma prolactin levels was significantly higher than before treatment (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


Hormonal and immunological pattern in a patient with acquired immunodeficiency syndrome related complex and Cushing's syndrome.

A case of Cushing's syndrome in a 24-yr-old homosexual with an AIDS-related complex is reported. In this patient certain symptoms common to both diseases, i.e. weakness, myalgia and muscle atrophy were accentuated, whereas other symptoms pathognomic of the human immunodeficiency virus (HIV) infection, i.e. lymphoadenopathies and weight loss, were less pronounced by the high levels of circulating adrenal steroids. Ketoconazole was administered po in order to block adrenal steroidogenesis, the drug caused a remarkable fall of cortisol serum concentrations, but was unable to modify significantly the immunological pattern of the patient. Our data suggest that changes of serum adrenal steroid levels have little effect on the immune network of patients with AIDS.


Subclinical hypothyroidism, overt thyrotoxicosis and subclinical hypothyroidism: the subsequent phases of thyroid function in a patient chronically treated with amiodarone.

In a patient chronically treated with amiodarone, subclinical iodine-induced hypothyroidism occurred as a result of excess iodine released from the amiodarone molecule. The patient was maintained on amiodarone and developed thyrotoxicosis as a result of a destructive process into the thyroid follicles. Amiodarone was withdrawn and methylprednisolone and methimazole treatment was started with resolution of the thyrotoxic phase. Months later, off therapy, the patient developed subclinical hypothyroidism. This is the first description of hypo- and hyperthyroidism in the same patient caused by amiodarone therapy. This unusual observation suggests that patients treated with amiodarone are at risk to develop hyperthyroidism even if they show laboratory findings consistent with hypothyroidism.


Caring as everydayness.

This article examines caring from an ontological perspective. Believing that the caring practices of nursing are often hidden from view because they constitute the everydayness of practice, it is proposed that one way to reveal caring practices is through storytelling. Brief stories from practice are shared and the author describes how caring practice is embedded within the experience of nursing.


Presence: discovering the artistry in relating.

Through the substantive practice experience of relating to patients, the author has identified provisional attributes associated with presence. Concept analysis was used to systematically illustrate the uses of presence identified by other authors and disciplines. A model case with the attributes of presence as described by the author is presented. The provisional attributes proposed by the author are (a) time with another (T), (b) unconditional positive regard (UPR), (c) transactional speaking with, being with, doing with (TR), (d) encounter that is valued (EV), (e) connectedness (essence linking) (C), and (f) sustaining memory (SM). The definition of presence as a nursing intervention is included.


Energy balancing through touch for health.

Through reflection on other types of energy work, the basis is laid for Touch for Health (TFH) as an energetic, touch, body therapy. TFH offers an opportunity for increased awareness of the subtle messages that our bodies are communicating to us. This communication is enhanced through the biofeedback quality of muscle testing. By introducing us to the feeling of well-being that occurs through energy balance, TFH makes individuals more aware of the meaning of optimal-level wellness. It assists people to move to a higher level of self-care. This health maintenance technique can be used anytime, anywhere for ourselves and others. By putting us back in control of our own health and well-being, TFH can increase self-esteem. Applications for nursing practice are explored.


Analysis of nurse theorists' definition of health for congruence with holism.

This article analyzes the definitions of health of seven nurse theorists for congruence with the American Holistic Nurses' Association's (AHNA) definition of health. The two themes of wholeness and change in the AHNA definition reflect the Fawcett categorization of worldviews as organismic versus mechanistic and change versus persistence. The organismic view assumes the person to be a proactive integrated being; in the change worldview the person is viewed as always in a state of transition and progress in values. All seven theorists' definitions appear to be congruent with the organismic and change focus of the AHNA definition. Clinicians who are seeking a client-focused theory to guide their practice are encouraged to investigate one or more of the nursing theories for adoption. This can have the dual outcome of improving the quality of nursing care and building the knowledge of the discipline as the theories are tested in practice.


The development of a conceptual model for multicultural nursing.

Cultural diversity exists among all humans, and nurses and patients are no exception to this general phenomenon. The cultural backgrounds of individual nurses and patients are composed of learned norms, values, customs, and beliefs. If nurses are to be as effective as they might in providing holistic nursing care to patients of culturally diverse backgrounds, their technical expertise must be complemented by knowledge of and respect for the various cultures. This is particularly true in situations where nurses are from cultural and ethnic backgrounds different from the patients for whom they are caring. The development of a conceptual model for multicultural nursing practice, based on King's Theory of Goal Attainment, provides direction for both practice and research in nursing and is an essential initial step toward better preparing nurses to provide holistic care in a global society.


Standards of practice by Nightingale.

Although the American Holistic Nurses' Association (AHNA) has a relatively short history, the ideas and concepts it embodies are similar to those of Florence Nightingale. This article describes those similarities in Nightingales's writings and in the AHNA's philosophy and standards of practice.


A clinical research perspective: look to the obvious.

The solution to nursing problems can often be found by using a combination of a naturalistic approach and traditional scientific methods. To illustrate this link, the development of a pacifier for low birth weight infants is described. The observation of fetus' thumb sucking in utero led to a broadly based literature review that suggested the idea of the thumb as an appropriate model for nonnutritive sucking. An anthropometric study was conducted to determine if the size of the thumb correlated with the size of the mouth. The correlations between the mouth and thumb further strengthened the appropriateness of the thumb as a model for a low birth weight infant pacifier.


Stability of surgical maxillary expansion.

Stability after transverse expansion of the maxilla via Le Fort I osteotomy with segments was evaluated in 39 patients. The average expansion was 5.4 mm at the second molars, decreasing almost linearly to 2.8 mm at the first premolars. Postsurgical relapse also was greatest at the second molars, averaging 2.6 mm. The percentage of relapse was greatest posteriorly, decreasing from 49% at the second molars to 30% at the first premolars. Considerable variability in stability followed surgery: Three-fourths of the patients had some relapse at the first molars (greater than 3 mm in 28%), but one fourth were stable. Sixty-two percent of the patients had a net posttreatment gain in arch width at the first molars. No correlation was found between transverse relapse and the type of presurgical orthodontic tooth movement, the use of rigid fixation, or the use of an auxiliary stabilizing arch wire. The amount of postsurgical relapse was significantly greater in those who had concurrent mandibular surgery. To improve clinical results with surgical expansion, we recommend (1) moderate overexpansion at surgery for major transverse changes, (2) maintenance of the occlusal splint for at least 6 weeks, and (3) use of a lingual arch wire or auxiliary labial arch wire to maintain molar width during postsurgical orthodontics.


In vitro comparison of screw versus plate fixation in the sagittal split osteotomy.

This study evaluated the transverse strength (rigidity) of three groups of sagittal split osteotomies performed in vitro in fresh sheep mandibles. Fixation was accomplished utilizing two different position screw techniques and a monocortical plate technique. Osteotomies fixed with three 2.0-mm screws in an inverted-L pattern and those fixed with one monocortical miniplate were significantly more rigid than those fixed with two 2.7-mm screws placed in a linear pattern. No significant difference in rigidity was noted between the inverted-L group and the miniplate group.


Mandibular border movements and masticatory patterns before and after orthognathic surgery.

To study the effects of combined surgical-orthodontic treatment, recordings of functional and border movements were obtained before and after surgery for 16 patients with severe skeletal malocclusions. The tracings showed a clear difference in the functional adaptation to mandibular setback and mandibular advancement surgeries. Patients with a skeletal Class III malocclusion who had undergone mandibular setback surgery generally showed an increase in the range of border and masticatory movements postsurgically. Patients with a skeletal Class II malocclusion corrected by mandibular advancement showed a restricted range of motion immediately postoperatively. Even 12 months after surgery, their recordings did not completely approach presurgical values.


Temporomandibular joint internal derangements in an orthognathic surgery population.

Of a selected group of 39 patients referred for orthognathic surgery, 38 were found to have some stage of internal derangement of the temporomandibular joint prior to surgery, a much higher incidence than previously reported in either symptomatic patients or asymptomatic individuals. Fifteen of 30 patients with follow-up greater than 12 months developed a new arthrosis after orthognathic surgery. All arthroses occurred in previously deranged joints. None of these patients has required joint surgery, but three have experienced pain. Internal derangement may be a contributing factor in the development of dentofacial deformities, and new loading of deranged joints after orthognathic surgery may be a cause of a new arthrosis and skeletal relapse.


Harmonic analysis and clustering of facial profiles.

The profiles of 83 healthy young adults were traced from right-side photographs, and then digitized with an image analyzer; each profile thus consisted of a series of coordinates. A dedicated computer program using Fourier analysis resulted in an equation of a curve that interpolated all profile points. By means of cluster analysis, profile equations were divided; two clusters each were found for male and female subjects. A mean profile was calculated for each of the clusters, so that four mean profiles were obtained. These profiles were compared with esthetic parameters found in literature; the results showed that the conventional parameters could sometimes give misleading information for orthodontic and craniofacial orthopedic treatment plans.


Analysis of 300 dentofacial deformities in Hong Kong.

The records of 300 consecutive Chinese patients with a dentofacial deformity were reviewed to determine the spectrum and characteristics of deformities presenting to a university joint orthognathic clinic. Twenty-six percent of the patients had cleft lip and palate with maxillary hypoplasia; within this group, 26% had double jaw deformity and 5% had nasomaxillary hypoplasia. Of the noncleft group, 47% were Class III facial types, of which 59% were due to mandibular hyperplasia. Of the noncleft group, facial asymmetry accounted for 21%, long face for 18%, bimaxillary protrusion for 14%, Class II types for 11%, and short face for 4%. Overall, there was a high incidence of two-jaw deformity, suggesting that severity may be a major factor in the decision by patients to seek treatment. Findings from this study are thought to be generally applicable to overseas Chinese.


Psychological profiles and motives of adults seeking orthodontic treatment.

Personality profiles and the motivations for seeking orthodontic treatment were investigated in a sample of adult patients. An improvement in dental esthetics was found to be the prime motivating factor, and the decision to seek treatment was usually made by the adult patients themselves. Questionnaires to assess personality traits revealed an atypical group of patients demonstrating neurotic traits. These patients were found to have a significantly different perception of their malocclusion than did the "normal" group of adult patients. Patients with neurotic traits may pose problems for clinicians with regard to expectations both during and at the end of treatment.


[Effects of local anesthetics on healing process of extraction wound in rats with reference to effects of epinephrine].

Effects of local anesthetics on the healing processes of the extraction wound were investigated in the rats. The study was performed on 5 experimental groups: control group (GA), 2% lidocaine without a vasoconstrictor (LEO) and 2% lidocaine with epinephrine 1/20,000 (LE2), 1/80,000 (LE8) and 1/200,000 (LE20). Under general anesthesia (GA) the mandibular 2nd molars were extracted after the injection of each local anesthetic. The control group (GA) had the teeth extracted without a local anesthetic. The wounds were examined histopathologically at timed sequence from 1 day to 14 days after the operation. Postextraction wounds of all the groups healed uncomplicatedly and these 5 groups could be classified into 2 types of healing process: epinephrine-free group (GA and LEO) and epinephrine group (LE2, LE8 and LE20). The 14-day postextraction sockets of the epinephrine-free group were filled with callus, whereas those of the epinephrine group had progressed to the final stage of bony healing unexpectedly. There was no difference in the healing process of each wound in the same group. These results suggest that a local anesthetic without a vasoconstrictor do not modify the postextraction wound healing process, and epinephrine does not prolong but will promote the wound healing.


[Studies on reduction of repellent force of rare earth magnets--concerning tooth intrusion].

The purpose of this investigation was to evaluate the sealing effect of the repelling force of the magnets with ferromagnetic stainless steel and also to examine the reduction pattern along with the change of the relative position of the magnets. The Nd-Fe-B magnet as rare earth magnet, and SUSXM 27, YEP-3, SUS 416 as ferromagnetic stainless steel were used in this experiment. The findings were as follows: 1. There was a little decrease of the repelling force of the magnets sealed with ferromagnetic stainless steel. On the other hand, no significant differences in the repelling force sealed with any kind of ferromagnetic stainless steel were found. 2. Direct contact of the repelling force of the phi 4.0 x 1.5 mm magnets sealed with SUSXM 27 of 0.2 mm in thickness was 242 gf. According to relative horizontal 1.2 mm movement keeping direct contact, the vertical and horizontal components of the repelling force were of the same value. 3. The repelling force of the phi 10.0 x 1.8 mm magnets sealed with SUSXM 27 of 0.2 mm in thickness was 815 gf. It showed more than 300 gf of vertical component of the repelling force when the magnets shifted to 3.0 mm horizontally when in contact. 4. It is suggested that the repelling force of the Nd-Fe-B magnets will be clinically useful for the intrusion of molar teeth.


[Clinical, radiological and histopathological studies of squamous cell carcinoma of lower gingiva].

In order to improve the treatment results of the lower gingival carcinoma, the treatment results were analysed based on the X-ray views, histopathological findings and mode of treatment. A series of 152 cases of primary lower gingival carcinomas treated at the First Department of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, during the 25 years between 1964 and 1988 was surveyed. The lesions with the invasive type of bone resorption on the X-ray picture often had unclear tumor margin histopathologically and those of the pressure type had a smooth front, with a small number of exceptions. The five-year cumulative survival rate was 76.7% for the pressure type, 64.6% for those without bone resorption, 53.9% for the invasive type. The deeper the resorption was, the higher the death rate was in the invasive type. Grade II of WHO classification and Grade 3 of the mode of invasion had the least recurrence rate and the least frequency of delayed cervical metastases. Grade 4D showed the highest recurrence rate and Grade 4C a high frequency of cervical metastases. Five-year cumulative survival rate was 77.8% for the cases treated by surgery, 65.6% for those by the combination of surgery and radiation, 57.1% for those by chemotherapy and 29.5% for those by radiation.


[Mechanical response of temporomandibular joint induced by occlusal change].

The purpose of this research was to investigate the mechanical effects on the temporomandibular joint influenced by the occlusal variations: the inclination of the upper incisor and the change of occlusal contacted position on the lower occlusal surface. For this purpose a theoretical study and a model experiment were performed. In the theoretical study, the Rigid Body Spring Model was applied to the temporomandibular joint for analyzation of the stress distribution and movement of the condyle head under the various conditions of the joint. Furthermore, the model experiment could be performed to confirm three-dimensionally the findings attained by the theoretical study. The results were as follows: 1. In the phase of the decreasing upper incisor inclination excessively, the direction of the temporomandibular joint force was be rotated counterclockwise and the magnitude of the joint force was be increased. 2. The movement of the condyle head (distance and direction) and the stress distribution of the disk were influenced by the various shapes of the joint and the mechanical properties of the surrounding soft tissues.


Black nurses in the United States: 1879-1992.

In the fall of 1991, while attending the Annual Convention of the New York State Nurses Association, a group of students who had heard me speak at their school recognized me in the audience. One of them blurted out, "That's Dr. Carnegie, the first Black nurse!" I was flattered by the recognition, but not by the designation. True, I have been in this world a long time but not that long. If Mary Mahoney, America's first Black nurse, had been alive in 1991, she would have been nearly 150 years old. This article focuses on the progress made by Black nurses in the 114 years from the time Mary Mahoney graduated from the New England Hospital for Women and Children in Boston, Massachusetts in 1879 to 1992 in the areas of education, employment, and organized nursing.


Hypertension management with church-based education: a pilot study.

The aim of this pilot study was to evaluate the efficacy of an education intervention for people with hypertension who attended Black churches. The goal was achieved by preparing six registered nurses from six inner city Black churches as educational experts who successfully implemented the intervention at three churches. A sample of 32 subjects from three churches participated in an education intervention on the nature of and management strategies for hypertension. Data were collected before, immediately after, and three months following the intervention. Findings indicate there was a statistical difference in knowledge between pre and post #1 (p = < .001, n = 18) and post #2 (p = < .0001, n = 8) assessments. It was concluded that the educational intervention was effective in increasing knowledge. No significant changes were noted in blood pressure readings and sodium intake. It is questioned whether more than three months are needed to detect meaningful behavioral changes since behavior change is a complex and gradual process.


Type A/B behaviors in employed black women: comparison of blood pressures and cholesterol levels.

The purpose of this study was to examine the difference in mean blood pressure and mean cholesterol levels between Type A/B employed Black women. Data were collected on age (mean 38.76 years), weight (mean 179.28 pounds), cholesterol (mean 194.45 mg/dL), systolic blood pressures before (mean 130.68 mm Hg), during (mean 138.81 mm Hg), and after (mean 129.98 mm Hg), and diastolic blood pressure before (mean 77.11 mm Hg), during (mean 81.45 mm Hg), and after (mean 76.20 mm Hg) the Type A Structured Interview (SI) on 280 employed Black women. Audio tape analyses of the SI resulted in 136 Type A's and 144 Types B's. Each individual was screened for hypercholesteremia using a portable reflectance photometer. Blood pressure measurements were taken every minute during administration of the SI. The results indicated that Type A's had higher mean systolic blood pressures, higher diastolic blood pressures before, during and after a structured interview, and higher cholesterol levels than Types B's.


The recruitment and retention of African American nurses: an analysis of current data.

The Recruitment and Retention of African American Nurses: An Analysis of Current Data reviews data collected by the American Nurses Association. During the years 1984-85, 1987-88, and 1990-91, the American Association of Colleges of Nursing, and The National League for Nursing observed trends in minority participation in nursing. Trends regarding African American nurses are emphasized. Data categories analyzed include: (1) registered nurses in practice; (2) admissions, enrollments, and graduations from undergraduate programs of all types; and (3) masters and doctoral enrollment. Detail analysis is performed for African American participation in baccalaureate programs, with a particular focus on the role of nursing programs in historically Black colleges and universities (HBCU). The data demonstrate that there has been growth in the numbers of African American and other minority groups entering nursing and completing undergraduate nursing programs. However, representation is below parity for the minority group's membership in American society. One interesting finding is that HBCUs graduate approximately 25% of African American nurses yearly despite the fact that they enroll less than 3% of the students in baccalaureate programs. The data also suggest a severe underrepresentation of minorities enrolled in masters and doctoral programs [corrected].


Strengthening black and minority community coalitions for health policy action.

African Americans and other racial/ethnic minorities suffer greater disparities in health and quality of life than do nonminorities. Health professionals are challenged to improve the health of minority communities by mobilizing minority people to participate in the public policy process through coalition building. The purpose of this article is to examine the role of the nurse in community development and the policy making process. A case study analyzing one nurse's role in community activism for child care policy is presented. Recommendations are provided for strengthening the involvement of minority community coalitions in influencing policy initiatives.


Comparative molecular field analysis of CCK-A antagonists using field-fit as an alignment technique. A convenient guide to design new CCK-A ligands.

Comparative molecular field analysis (CoMFA) has been used as a three-dimensional quantitative structure-activity relationship (QSAR) method to correlate the affinities of several antagonists towards CCK-A receptors with their steric and electrostatic fields. In this publication, we describe, for the first time, a field-fit operation as an alignment technique. These results could serve as a guide for the design of new non-peptide antagonists.


A comparison of progestin and androgen receptor binding using the CoMFA technique.

A series of 48 steroids has been studied with the SYBYL QSAR module using Relative Binding Affinities (RBAs) to progesterone and androgen receptors obtained from the literature. Models for the progesterone and androgen data were developed. Both models show regions where sterics and electrostatics correlate to binding affinity but are different for androgen and progesterone which suggests differences possibly important for receptor selectivity. The progesterone model is more predictive than the androgen (predictive r2 of 0.725 vs. 0.545 for progesterone and androgen, respectively).


Attitudes of nurses toward culturally diverse patients: an examination of the social contact theory.

This investigation uses the Social Contact Theory to explore to what extent does level of exposure to culturally different patients affect White nurses attitudes toward these patients. Attitudes and biases of 346 hospital-based nurses toward culturally different patients were measured using a self-administered, Likert-type questionnaire titled the Ethnic Attitude Scale. The results of between group t-tests indicated that there were statistically significant differences in biases expressed by White nurses who worked with predominantly African American patients compared to their counterparts who work in a setting with a few African American patients. This study has implications for nursing in education, development, staffing and improvement of the overall quality of nursing care in a global society.


Surface comparisons of some odour molecules: conformational calculations on sandalwood odour V.

Molecular surface comparison seems to be a very suitable tool for the investigation of small differences between biologically active and inactive compounds of the same structural type. A fast method for such comparisons, based on volume matching followed by the estimation of comparable surface dots, is presented and applied on a few selected sandalwood odour molecules.


LUDI: rule-based automatic design of new substituents for enzyme inhibitor leads.

Recent advances in a new method for the de novo design of enzyme inhibitors are reported. A new set of rules to define the possible nonbonded contacts between protein and ligand is presented. This method was derived from published statistical analyses of nonbonded contacts in crystal packings of organic molecules and has been implemented in the recently described computer program LUDI. Moreover, LUDI can now append a new substituent onto an already existing ligand. Applications are reported for the design of inhibitors of HIV protease and dihydrofolate reductase. The results demonstrate that LUDI is indeed capable of designing new ligands with improved binding when compared to the reference compound.


A fast and efficient method for 2D and 3D molecular shape description.

A new formalism for molecular shape description is described. The formalism, based on considering each molecule as a collection of its 3-atom submolecules, is applied to both the graph theory and geometrical coordinate representations of molecules. The timing results for shape description of several databases indicate that this new method is applicable to large databases. Furthermore, results from clustering a small database show good agreement with clustering results obtained by a distance-matching algorithm.


AM1-SM2 and PM3-SM3 parameterized SCF solvation models for free energies in aqueous solution.

Two new continuum solvation models have been presented recently, and in this paper they are explained and reviewed in detail with further examples. Solvation Model 2 (AM1-SM2) is based on the Austin Model 1 and Solvation Model 3 (PM3-SM3) on the Parameterized Model 3 semiempirical Hamiltonian. In addition to the incorporation of phosphorus parameters, both of these new models address specific deficiencies in the original Solvation Model 1 (AM1-SM1), viz., (1) more accurate account is taken of the hydrophobic effect of hydrocarbons, (2) assignment of heavy-atom surface tensions is based on the presence or absence of bonded hydrogen atoms, and (3) the treatment of specific hydration-shell water molecules is more consistent. The new models offer considerably improved performance compared to AM1-SM1 for neutral molecules and essentially equivalent performance for ions. The solute charges within the Parameterized Model 3 Hamiltonian limit the utility of PM3-SM3 for compounds containing nitrogen and possibly phosphorus. For other systems both AM1-SM2 and PM3-SM3 give realistic results, but AM1-SM2 in general outperforms PM3-SM3. Key features of the models are discussed with respect to alternative approaches.