Haemoglobin A1 and congenital malformation

Two hundred and thirty pregnancies were studied in 196 diabetic women. Seven women with babies found to have major malformations had a higher median first trimester haemoglobin A1 (12.9%) than the median HbA1 (10.8%) in those with normal babies (p = 0.06). No relationship was found between the occurrence of minor malformations and first trimester maternal haemoglobin A1. Two of the seven congenital malformations were diagnosed antenatally at a time when therapeutic abortion could be offered. Expert antenatal ultrasound scanning should be offered to all pregnant diabetic women as poor glycaemic control at the time of conception and organogenesis, as evidenced by raised first trimester HbA1, predisposes to congenital malformation.     

Self-mutilation and self-blame in incest victims

A case is made for self-blame as the psychic link between children's experiences of incestuous sexual abuse and their self-mutilating behavior later in life. Representative case histories and the results of a small pilot study are presented to illustrate the author's theoretical formulation.     

Computed tomographic investigation of serosal and intramural gastrointestinal pathology

Various cases are presented demonstrating the role of computed tomography (CT) in the assessment of serosal and bowel wall pathology. Reference is made to the morphology of the lesions. Illustrative examples of tumors, secondary malignant dissemination, irradiation injury to the gut, and intramural gas associated with ulcerative colitis, are all illustrated.     

Effect of thiamine on auditory evoked potentials of the guinea pig

Application of thiamine (1 X 10(-11)-1 X 10(-3) mol/l) on the membrane of cochlear round window increased the amplitude and decreased the latency of the auditory nerve action potential, waves I and II of brainstem auditory-evoked electrical potentials in response to acoustic clicks of different intensity. The mechanism of thiamine action on auditory-evoked electric potentials is discussed.     

Minor Burns: A Review

Two million burns occur annually in the USA, of which 95% aretreated in an out-patient setting. The treatment of burns iscontroversial. There are few data from controlled studies toprovide rational guidelines for the frequency of both dressingchanges and patient visits for the physician. Conclusions concerninginfection drawn from studies on major burns are misleading whenapplied to the management of minor burns. Trauma to regeneratingepithelium caused by frequent dressing change is of relativelyless importance in treating major burns, because the controlof infection is of overriding importance. In the treatment ofminor burns, the traumatic consequences of too frequent changesof dressing may assume greater importance. There is a clearneed to study the variables in the treatment of minor burnsand to generate criteria for their clinical management thatare distinct from those of major burn management. Collaborativestudies of out-patient populations by providers of primary healthcare are suggested as a useful approach to such investigation.The effects of several additional therapies are reviewed, includinginitial cold therapy, debridement of blisters and antibiotics.     

Estimation of the potential digestibility and rate of degradation of water-insoluble dietary fiber in the pig cecum with a modified nylon bag technique

Potential digestibility and rate of degradation of water-insoluble material (WIM) prepared from rutabaga, wheat bran and digesta recovered from the terminal ileum of pigs fed bran- or rutabaga-based diets were measured in the cecum of surgically modified pigs. WIM samples recovered from the cecum after fixed incubation times were analyzed and the rate of total disappearance of organic matter, cellulose, uronic acid and noncellulosic neutral sugars was calculated. Maximum degradation of each WIM occurred within 48 h after incubation and was for rutabaga and its ileal digesta 90 and 70%, respectively, and for bran and bran ileal digesta 55 and 45%, respectively. Cellulose and uronic acid in bran samples did not appear to be degraded, material disappearance being attributable to the loss of noncellulosic neutral sugars. Estimation of potential organic matter digestibility showed rutabaga to be 93%, rutabaga digesta 79%, bran 56% and bran digesta 43% digestible. Fractional rates of digestion in rutabaga samples were significantly faster than in corresponding bran samples. When related to the role of fiber in nutrition the results obtained suggest that cereal fiber would be only slightly modified during gut transit, unlike vegetable fiber in which microbial digestion would probably result in the total destruction of the fiber cell wall matrix.