ET-1 Infusion Increases Systemic Vascular Resistance and Depresses Cardiac Output in Patients with Chronic Hypoxaemia and Pulmonary Hypertension

The pulmonary vascular effects of the endothelium-derived peptide endothelin (ET) vary depending on the existing vascular tone, modes of administration and species studied; ET can cause both pulmonary vasodilatation and vasoconstriction. Increased plasma levels of ET have been reported in hypoxic pulmonary hypertension, although it is unclear whether ET is a mediator or a marker of hypoxia-induced increase in pulmonary vascular resistance (PVR). In our study, the plasma levels of ET-1 and the functional effects of ET-1 infusion in patients (n     

A tissue velocity ultrasound imaging investigation of the dorsal neck muscles during resisted isometric extension

Persons with neck pain exhibit altered patterns of muscle patterning, but limited investigations have been carried out on these alterations or muscle patterning in healthy volunteers. This study investigated the tissue motion of the dorsal neck muscles at the C4 segmental level in 15 healthy subjects during manually resisted head extension. Doppler-based tissue velocity ultrasound imaging (TVI) was used to detect regional tissue deformation, providing indirect evidence of inter-muscular movement patterning. The deep muscles, multifidus and semispinalis, had different muscular movement patterning than the superficial muscles, especially the trapezius muscle. The semispinalis cervicis (SSCerv) was the first deformed upon exercise initiation, followed by multifidus and semispinalis capitis (SSCap). The semispinalis muscles, notably capitis, exhibited a high rate of deformation during the exercise. The trapezius muscle exhibited the least and lowest deformation rate. In conclusion, TVI provided detailed information on regional tissue activity and muscle movement patterning among the dorsal neck muscles. In future studies, data from patients with neck disorders will have to be matched to data from healthy volunteers in a variety of situations and activities.     

Total hip replacement with or without trochanteric osteotomy

Summary In a consecutive series of primary total hip replacements (THR) 54 patients were operated upon with and 78 patients without trochanteric osteotomy. Follow-up at least 2.5 years postoperatively failed to disclose any differences between the two groups in bleeding during operation, the incidence of early complications or the infection rate. A longer operation time was noted for the osteotomized group. Mechanical failure was more frequent in the non-osteotomized group. The clinical end result was similar in both groups. In complicated cases or when accessibility to the operation site is poor a trochanteric osteotomy is recommended.

---

Zusammenfassung In einer konsekutiven Studie von primären totalen Hüftgelenksendoprothesen wurden 54 Patienten mit und 78 Patienten ohne Osteotomie des Trochanter majors operiert. Die Nachuntersuchungsdauer betrug mindestens 2,5 Jahre. Es wurden keine Unterschiede bezüglich peroperativer Blutung, früher postoperative Komplikationen oder Infektionen zwischen den beiden Gruppen notiert. Die Operationszeit war bei denjenigen Patienten länger, bei welchen eine Trochanterosteotomie durchgeführt wurde. Eine Lockerung kam häufiger bei den Patienten vor, welche ohne Trochanterosteotomie operiert wurden. Das klinische Endergebnis war für beide Patientengruppen gleichartig. Bei komplizierten Fällen, oder wenn der Zugang zum Operationssitus schlecht ist, ist die Osteotomie des Trochanter majors zu empfehlen.

     

Effects of neonatal sympathetic denervation on amylase secretion in the adult rat parotid gland: Difference in β1- and β2-adrenoceptor response

Changes in amylase secretion and cyclic AMP accumulation in response to various secretagogues were studied in parotid glands of adult rats subjected to neonatal sympathetic denervation by unilateral excision of the superior cervical ganglion. Denervation decreased the gland content of amylase and both basal and the stimulated levels of cyclic AMP were elevated. The secretory cells of neonatally devervated glands exhibited enhanced maximal enzyme discharge in response to β-adrenoceptor agonists. However, the selective β₁-agonist, prenalterol, was not effective in this respect whereas an enhanced maximal secretory response to the β₂-selective agonist, terbutaline, was particularly prominent. DBcAMP was also more efficient in inducing amylase release from the denervated gland. The results of the present study demonstrate that the usual dominance of the β₁-adrenoceptor subtype in eliciting amylase 3elease is lost, implying that the differentiation of the β-adrenoceptor into its subtypes is altered by neonatal sympathetic denervation.     

Relationship between radiological and clinical variables in spondylolysis

Summary A clinical and radiological follow-up investigation with at least 20 years observation time was made of 255 persons with lumbar spondylolysis with or without spondylolisthesis. The main purposes were to study the relationship between clinical and radiological features and to look for radiological and other variables of prognostic value. There was a clear positive correlation of symptoms and functional impairment during the observation period to disc degeneration and vertebral slipping at follow-up, as well as to a decrease in lumbar index at the time of diagnosis. Individual factors and radiological signs at the time of diagnosis were shown to have prognostic value for the course of the disease. The risk factors for severe symptoms and need for treatment were more than 10 mm of vertebral slipping, low lumbar index, increased lumbar lordosis, lysis in the fourth lumbar vertebra and early onset of symptoms.

---

Résumé Un bilan clinique et radiologique a été effectué après un délai d'observation d'au moins 20 ans chez 255 sujets porteurs d'une spondylolyse lombaire, avec ou sans spondylolisthésis. Le but de cette étude était d'évaleur les relations entre les données cliniques et radiologiques et de rechercher quels éléments, radiologiques ou autres, pouvaient avoir une valeur pronostique dès le début de l'affection. On a pu mettre en évidence une corrélation significative entre d'une part la symptomatologie et le handicap fonctionnel durant la période d'observation et, d'autre part, l'importance du glissement et de la dégénérescence discale au moment de la révision, de même que la diminution de l'index lombaire au moment du diagnostic initial. Les facteurs individuels et les signes radiologiques notés à ce moment permettent également d'établir un pronostic. Les facteurs qui sont en faveur d'une symptomatologie sévère et de la nécessité d'un traitement sont les suivants: un glissement de plus de 10 mm, un faible index lombaire, une hyperlordose lombaire, une lyse de la 4ème vertèbre lombaire et un début précoce des symptômes.

     

Unreported births and deaths,a severe obstacle for improved neonatal survival in low-income countries; a population based study

Background  

In order to improve child survival there is a need to target neonatal mortality. In this pursuit, valid local and national statistics on child health are essential. We analyze to what extent births and neonatal deaths are unreported in a low-income country and discuss the consequences at local and international levels for efforts to save newborn lives.     

Evidence for multiple species within the endoparasitic dinoflagellate Amoebophrya ceratii as based on 18S rRNA gene-sequence analysis

Parasitism within the group of dinoflagellates is a widespread phenomenon. Whether the parasitic dinoflagellates exhibit specificity in their infection is not well known, but this possibility has become an important issue in the development of biological control of harmful algal blooms. The 18S rDNA sequences from the parasite Amoebophrya sp. and its dinoflagellate host Dinophysis norvegica were determined and compared with the published sequence of Amoebophrya sp. infecting Gymnodinium sanguineum and other dinoflagellates. The results showed that the sequence from the parasite within D. norvegica was clustered with that of the one from G. sanguineum with 100% bootstrap support in a maximum-likelihood analysis. The observed identity between these two sequences was 93%, which indicates that they are not identical species. The two sequences from Amoebophrya sp. were deeply branched within the group of dinoflagellate sequences and represent the earliest diverging dinoflagellates. The sequence from the parasite Parvilucifera infectans, also infecting D. norvegica, was not closely related to the Amoebophrya sp. sequences. The sequence from D. norvegica appeared as a sister group to a cluster containing Prorocentrum lima and Alexandrium spp. without significant bootstrap support. The data presented herein support the hypothesis that A. ceratii comprises more than one species, and this opens the possibility that infections of harmful algal species might involve more than one Amoebophrya species. Received: 29 March 2000 / Accepted: 6 June 2000     

To live with a wagging tailed assistant – Service and hearing dog ownership from the perspective of Swedish owners

Individuals who have a functional or health impairment, are often in great need of conventional healthcare, social care and support, as well as help from family and friends. The use of dogs may be an important assistive support for this population. Assistance dogs are trained to assist with their owners’ specific needs. The aim of this study is to explore service and hearing dog ownership from the owner´s perspective, by examining the owner's expectations before training a dog, and experiences after having a certified dog. This study was designed as a longitudinal intervention study with pre-post design. The participants included in the study trained their own dogs to become service or hearing dogs. A number of open-ended questions were answered by the participants before the training of the dog started, three months after the dog was certified, and 1–3 years after the first follow-up. Data were analysed using thematic content analysis. The participants’ expectations of what the dog would contribute after being certified was high. Their perceived experiences in many ways reflected their expectations. For example, they perceived that the dog contributed to improved health status, a more active lifestyle, improved ability to feel secure, and that they had become more independent. They also felt that the dog had strengthened their social relationships. Negative experiences were also identified. Not being allowed to bring their dog into public places and negative attitudes from other people were examples of this. This study shows that individuals being supported by an assistance dog experience the dog as an invaluable help in their everyday life. By improving the owners’ lives in many ways, a certified service or hearing dog is a novel and important assistive support for people with a functional or health impairment.     

Body Composition of Bangladeshi Children: Comparison and Development of Leg-to-Leg Bioelectrical Impedance Equation

The aim of this study was to investigate the validity of the Tanita TBF 300A leg-to-leg bioimpedance analyzer for estimating fat-free mass (FFM) in Bangladeshi children aged 4-10 years and to develop novel prediction equations for use in this population, using deuterium dilution as the reference method. Two hundred Bangladeshi children were enrolled. The isotope dilution technique with deuterium oxide was used for estimation of total body water (TBW). FFM estimated by Tanita was compared with results of deuterium oxide dilution technique. Novel prediction equations were created for estimating FFM, using linear regression models, fitting child''s height and impedance as predictors. There was a significant difference in FFM and percentage of body fat (BF%) between methods (p<0.01), Tanita underestimating TBW in boys (p=0.001) and underestimating BF% in girls (p<0.001). A basic linear regression model with height and impedance explained 83% of the variance in FFM estimated by deuterium oxide dilution technique. The best-fit equation to predict FFM from linear regression modelling was achieved by adding weight, sex, and age to the basic model, bringing the adjusted R² to 89% (standard error=0.90, p<0.001). These data suggest Tanita analyzer may be a valid field-assessment technique in Bangladeshi children when using population-specific prediction equations, such as the ones developed here.Key words: Bioelectrical impedance, Body composition, Children, Deuterium oxide dilution, Bangladesh     

Echocardiographic functional images based on tissue velocity information

Tissue velocity information (TVI) is acquired by sampling of tissue Doppler velocity values at discrete points. The information is stored in an interfoiled format with gray scale imaging during one or several cardiac cycle at a high temporal resolution, > 60 Hz, giving signals that tolerate mathematical processing as derivation, integration and Fourier analysis of velocity profiles without distortions. The software enables the possibility to analyze multiple velocity profiles from any localization within the acquired scanned sector. The myocardial tissue velocity direction and color-coded numerical value can be computed along any chosen curve form (C-line) and be presented as a spatial function of velocities against time (C-mode). The velocity curves can also be presented in several new functional modes as color-coded running cineloops: phase imaging, time delay imaging, amplitude imaging, acceleration imaging, instantaneous phase imaging, wrapped phase imaging. The software also allows color or C-mode presentation of tissue contraction and expansion. This facilitates the differentiation between active and passive myocardial tissue movements, thus improving the ability to differentiate between healthy and diseased myocardial tissue. This article presents several applications of the software in normals and in cardiac patients.