Treatment of long-term sterility by intra-tubal gamete transfer

It is reported about a first successful program of gamete intra fallopian transfer (GIFT) as a supplement to intrauterine insemination and to in vitro fertilization (IVF). In 29 patients after HMG stimulation of the ovaries and laparoscopic aspiration of follicles recovered oocytes have been introduced together with prepared sperm via a special catheter directly into the ampulla of the oviduct. In 21 patients with different causes of infertility optimal stimulation conditions could be achieved. A pregnancy rate of 41.4% is the result of 29 GIFT events and 3 of them resulted in spontaneous term deliveries (10.3%).     

Vocal fold vibration irregularities caused by different types of laryngeal asymmetry

The common symptom of hoarseness is regarded to be caused by (1) turbulences and air loss due to incomplete glottic closure and (2) irregular vibrations of the vocal folds. With real time resolution, the latter can only be observed using high-speed recording techniques (> or =2,000 images/s). In this paper an actual recording method is described, called high-speed glottography (HGG), which quantifies vibration irregularities. It combines imaging and image processing techniques with a functional endoscopy of the disordered voice and delivers motion curves separately for each vocal fold. They are fitted with a computer simulation in order to identify the underlying driving parameters of the vibration. A vocal fold is assumed to vibrate as a system of two coupled oscillators ("two-mass model"). From the model fit to bilateral motion curves, the subglottal pressure, muscular tension and oscillating masses of the vocal folds can be computed with reasonable accuracy. Besides normal voices, HGG has been applied to selected clinical cases of voice disorders. Two types of irregularities have been measured: there is a frequency difference either between left and right vocal folds (horizontal asymmetry) or on one side between the ventral and dorsal third (vertical asymmetry). By modeling, both categories of irregular motion curves can be explained in detail. It is presumed that laryngeal asymmetry (either in mass or tension) causes irregular vibrations.     

Coping strategies in laryngectomy patients

BACKGROUND: Over the last few years, paradigms for judging the results of treatment of tumor patients have shifted. In addition to characteristics such as the complete excision of the tumor and the duration of patient survival, restoring the quality of life has become an equally important aim. There is still a lack of systematic (and sufficient) research on coping strategies as a means of dealing with malignant tumors of the head and neck. PATIENTS AND METHOD: In a cross-sectional study, 25 laryngectomees, whose voices had been successfully restored with a Provox voice prosthesis,were examined for their coping strategies and the effects of the illness on their lives. The standardized Trier Scales of Coping Strategies and a custom-made questionnaire, which helped to structure the anamnesis of disease specific functional restrictions and the state of rehabilitation, were used as the means of inquiry. RESULTS: A high percentage of patients were content despite objective and subjective restrictions.Voice replacement was mainly experienced as unproblematic,with psychosocial restraints more commonly being felt in connection with pain and difficulties ingesting food. A correlation between the patients' evaluation of physical,psychological and social experiences and the coping strategies applied could not be verified. The way laryngectomees deal with their illness does not differ from the strategies of patients suffering from malignant or chronic diseases of other organ systems. CONCLUSION: The Trier Scales of Coping Strategies is a suitable means for determining the coping strategies of laryngectomees who have been successfully rehabilitated with the help of voice prostheses.The patients examined here did not apply different coping strategies from groups of patients with other severe illnesses. Obviously, the limitations on communication do not constitute a determining factor in coping with the disease. This finding is useful when planning psychological and social rehabilitation, e.g. by psychosomatic interventions.     

Mammary intraepithelial neoplasia outgrowths (MINO): MINO and human ductal carcinoma <Emphasis Type="Italic">in situ</Emphasis>

Germ-line mutations in the BRCA1 tumour suppressor gene contribute to familial breast tumour formation, but there is no evidence for direct mutation of the BRCA1 gene in the sporadic form of the disease. In contrast, decreased expression of the BRCA1 gene has been shown to be common in sporadic tumours, and the magnitude of the decrease correlates with disease progression. BRCA1 expression is also tightly regulated during normal breast development. Determining how these developmental regulators of BRCA1 expression are co-opted during breast tumourigenesis could lead to a better understanding of sporadic breast cancer aetiology and the generation of novel therapeutic strategies aimed at preventing sporadic breast tumour progression.     

Multi-rooted mandibular premolars: report of case

Differential growth of the epithelial diaphragm is needed for the formation of multiple roots in the primary and permanent dentitions. In most instances, the mandibular premolars possess a single root. It is a very unusual event to find a case of bilateral multi-rooted first and second mandibular premolars. This paper presents such a case.     

Whole body protein metabolism in children with cancer

Whole body protein synthesis and catabolism were measured using the [ring-2H5]phenylalanine and [1-13C]leucine primed constant infusion technique in 32 paediatric patients with cancer at different stages of treatment. Rates of synthesis (S) and catabolism (C) derived from the [ring-2H5]phenylalanine and [1-13C]leucine models were 4.7 (SD 1.3) (S) and 6.0 (1.5) (C) g/d/kg, and 5.5 (0.8) (S) and 6.8 (1.2) (C) g/d/kg, respectively. These results show that these two tracer techniques give similar results in this study population. Comparison of these values with results previously reported for groups of control children using the [ring-2H5]phenylalanine model (S = 3.69 and 3.93; C = 4.09 and 4.28 g/d/kg) and the [1-13C]leucine model (S = 4.32; C = 4.85 g/d/kg) show that rates of synthesis and catabolism were higher in cancer patients than in controls. Thus whole body protein turnover is increased in children under treatment for cancer. Other indices of metabolism such as plasma amino acids and intermediary metabolites were also measured and showed that, although subjects were in isotopic steady state, there were significant metabolic changes during the course of the primed constant infusions used to measure protein turnover.     

Natural rubber latex allergy: prevalence and risk factors in patients with spina bifida compared with atopic children and controls

Type 1 allergy against natural rubber latex is an increasing problem in health care workers and children with spina bifida or urogenital malformations. The aim of our study was to evaluate the prevalence of latex IgE antibodies and cross-reacting fruit antibodies in patients with spina bifida compared with atopic and non-atopic controls. Risk factors for sensitization should be determined. Sera of 148 patients with spina bifida and 98 controls (44 with atopy) were screened for IgE antibodies against latex, banana and kiwi by fluorescence enzyme immunoassay (CAP system). Atopies, allergic symptoms after latex contacts and the number of operations were compiled by a questionnaire. Patients with spina bifida developed latex IgE antibodies (≥0.7 kU/l) more frequently (40.5%) than atopic children (11.4%) or healthy controls (1.9%). All 18 symptomatic patients belonged to the spina bifida group and had high values of latex antibodies. The risk for developing latex antibodies increases with the number of operations. There was no difference in the history of atopic diseases and in a screening test of IgE antibodies against inhalative allergens between latex sensitized and not sensitized children with spina bifida. Antibodies against banana were more frequent in the latex sensitized children with spina bifida. (18.3% vs 3.4%, P = 0.002). Conclusion The high prevalence of latex antibodies in children with spina bifida justifies a primary prophylaxis by avoiding latex contacts, especially during anaesthesia and surgery, a correlation between the number of operations and the development of latex antibodies exists. Received: 30 March 1996 and in revised form: 19 March 1997 / Accepted: 20 March 1997     

Should the guidelines for monitoring serum cholesterol levels in the elderly be re-evaluated?

Elevated circulating cholesterol can have profound effects on the health of an individual. Such excess cholesterol can promote coronary artery disease, production and accumulation of β-amyloid in the brain, and possibly Alzheimer’s disease (AD). In a clinical trial evaluating the benefit of a cholesterol-lowering drug in the treatment of AD, mean cholesterol levels at baseline among individuals participating in the trial were found to be relatively high. Based on this observation we suggest that cholesterol levels should be actively monitored in the elderly, as many individuals with AD are over 65 years of age and therefore excluded by currently accepted guidelines.