CLOSED CHAMBER SYSTEM FOR DELIVERY OF ETHANOL TO CELL CULTURES

The accuracy and consistency of the delivery of ethanol to culturedcells is important to determine effects on morphologic, biochemicaland physiologic alterations. Open and closed chamber systemswere evaluated to determine cytotoxic vs sublethal, potentiallyteratogenic effects on neonatal rat cardiac myocytes. The open system employed a variety of cell culture vessels.Cardiac cells were exposed directly to ethanol in the growthmedia at concentrations of 5–50 mM in Petri dishes, multiwellslides and multiwell chambers. Ethanol concentrations in themedia in these open vessels decreased over 60% in a 24 hr incubationperiod. A closed system consisted of tightly sealed plastic containersin which the same vessels were used. The vessels were placedon a platform over a bath of ethanol-water. Cells were acclimatedfor 24 hr with ethanol in the bath at 200% of the final desiredmedia concentration. Ethanol gradually diffused into the mediato reach peak levels of 5, 10,25 or 50 mM at 24 hr. After the24 hr period, ethanol was added to both the media and bath atthe desired concentration. Cells exposed gradually to ethanol in the closed chambers remainedviable, but showed slower division and growth. A period of gradualacclimation is required to induce sublethal cellular effectsrather than lethal effects. The diversity of cell systems andmanipulations of cultures to study the potential teratogeniceffects of ethanol are improved using such a closed chambersystem.     

Intensive Hypnotherapy for Smoking Cessation:A Prospective Study 1

This study reports on a prospective pilot trial of intensive hypnotherapy for smoking cessation. The hypnotherapy involved multiple individual sessions (8 visits) over approximately 2 months, individualization of hypnotic suggestions, and a supportive therapeutic relationship. Twenty subjects were randomly assigned to either an intensive hypnotherapy condition or to a wait-list control condition. The target quitting date was 1 week after beginning treatment. Patients were evaluated for smoking cessation at the end of treatment and at Weeks 12 and 26. Self-reported abstinence was confirmed by a carbon-monoxide concentration in expired air of 8 ppm or less. The rates of point prevalence smoking cessation, as confirmed by carbon-monoxide measurements for the intensive hypnotherapy group, was 40% at the end of treatment; 60% at 12 weeks, and 40% at 26 weeks (p < .05).     

Pharmacotherapy of obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a chronic and often incapacitating disorder that is frequently complicated by mood and additional anxiety diagnoses. Although appropriate pharmacotherapy is often of great benefit, full remission is rare. Separate multi-center, placebo-controlled trials of clomipramine, paroxetine, fluoxetine, sertraline and fluvoxamine, respectively, have established the unparalleled efficacy and safety of the serotonin reuptake inhibitors (SRIs) in the treatment of OCD. Direct comparisons of SRIs suggest similar efficacy, but reduced tolerability for clomipramine in comparison to fluoxetine, fluvoxamine, sertraline and paroxetine in patients with OCD. Although 60-80% of OCD patients will respond to SRI treatment, partial symptom reduction (mean improvement, 25-40% from baseline) remains the rule. Controlled trials of adjuvant lithium, buspirone, thyroid hormone or clonazepam added to ongoing SRI therapy have failed to demonstrate substantial further antiobsessive effects. The presence of comorbid conditions, specific OCD symptom content and various other clinical features have been investigated as potential predictors of medication response in patients with OCD, but consistent factors have not yet been identified. Clinical experience and preliminary data does suggest that a lack of response to one or more SRIs does not preclude response to another SRI. An overview of the pharmacotherapy of OCD, including first-line medication(s) and the comparative efficacy and pharmacological features of the different SRIs will be presented in this review, as well as potential strategies for OCD patients who fail to respond to conventional pharmacotherapeutic interventions.     

Long-Lasting Catch-up Growth under Bio-Methionyl Growth Hormone Treatment in an Infant with Isolated Growth Hormone Deficiency Type 1A1

ABSTRACT. This case report concerns a 7-month-old infant with severe height retardation (–5.0 SD), typical growth hormone (GH)-deficient phenotype, and undetectable GH serum levels in response to three pharmacological stimuli. Diagnosis of isolated GH deficiency type 1A was confirmed by restriction endonuclease analysis of genomic DNA which pointed out GH-N gene deletion. The introduction of bio-methionyl-GH therapy in this patient was followed by a transient and clinically irrelevant appearance of low binding capacity GH antibodies as well as by a long-lasting catch-up growth (42.2 cm) which is continuing 44 months after beginning of treatment. This atypical pattern confirms that immune and growth response to exogenous GH in isolated GH deficiency 1A may be very heterogeneous.     

The use of distraction and imagery with children during painful procedures

The effectiveness of a paediatric pain management programme was examined using a multiple case study design. This study examined both the children's pain experience during cancer treatment, as well as their parents'anxiety and behavioural stress. Fourteen people were videotaped while receiving lumbar punctures during an 8–12 month period. Baseline data were obtained at the first of three visits prior to the introduction of relaxation, imagery and distraction exercises. Self-ratings of child fear and parent anxiety, videotaped observations of child and parent behaviour and child pain ratings were obtained at all three visits. The children's behavioural responses to the procedure varied considerably, but their fear scores were stable and their reports of pain decreased over time. Parents reported high-trait, low-state anxiety scores that were stable over time. They were observed to be very supportive during the procedures. Implications for further research in this area and recommendations for practice are presented.     

Family Mental Health Care in the Neonatal Intensive Care Unit

The potential role of the neonatal intensive care nurse in mental health promotion is explored. The focus is upon assessment and intervention of families who are at risk for child abuse and future dysfunction. The importance of support systems during a crisis period is emphasized.     

The cells of the rabbit meniscus: their arrangement, interrelationship, morphological variations and cytoarchitecture

Four major morphologically distinct classes of cells were identified within the adult rabbit meniscus using antibodies to cytoskeletal proteins. Two classes of cell were present in the fibrocartilage region of the meniscus. These meniscal cells exhibited long cellular processes that extended from the cell body. A third cell type found in the inner hyaline-like region of the meniscus had a rounded form and lacked projections. A fourth cell type with a fusiform shape and no cytoplasmic projections was found along the superficial regions of the meniscus. Using a monoclonal antibody to connexin 43, numerous gap junctions were observed in the fibrocartilage region, whereas none were seen in cells either from the hyaline-like or the superficial zones of the meniscus. The majority of the cells within the meniscus exhibited other specific features such as primary cilia and 2 centrosomes. The placement of the meniscal cell subtypes as well as their morphology and architecture support the supposition that their specific characteristics underlie the ability of the meniscus to respond to different types of environmental mechanical loads.     

Testicular function in eight patients with seminoma after unilateral orchidectomy and radiotherapy

Testicular function was monitored in eight patients with low stage seminoma who were treated with radiotherapy following unilateral orchidectomy. The absorbed gonadal radiation dose ranged from 15 to 157.5 rad. At 10-24 months after radiotherapy, serum hormone levels, sperm analysis, sperm penetration into zona-free hamster ova (HOP-test) and lymphocyte chromosome abnormalities were evaluated. Two patients were azoospermic with elevated serum levels of LH and FSH. The remaining six patients had slightly decreased (n = 3) or normal (n = 3) seminal parameters. Their HOP rates were within the normal range. A low incidence of polyspermy (i.e. only one penetrating sperm per ovum) was found in the patients, suggesting low penetrability of motile sperm. A highly significant correlation was found between sperm count or sperm penetrability and time post-irradiation. The results indicate that restitution of testicular function is time-dependent.     

A Permanently Implanted Endocardial Electrode Complicating Ventricular Tachycardia with A Second VT

A VVI pacemalter was permanently implanted for the purpose of suppressing recurrent ventricular tachycardia (VT). Not only did the device fail to suppress the VT, but also the permanent endocardial electrode caused a second VT which was more rapid and clinically more severe. When a new VT occurs in the presence of a permanently implanted ventricular pacing system, the implanted electrode should he considered as one of the possible etiologic causes for the VT.