Maternal glycated haemoglobin, pre-gestational weight, pregnancy weight gain and risk of large-for-gestational-age babies: a Danish cohort study of 209 singleton Type 1 diabetic pregnancies.

AIMS: To examine the association between maternal glycated haemoglobin in the second half of diabetic pregnancies and the relative risk of delivering large-for-gestational-age (LGA) babies, controlling for maternal body mass index (BMI) before pregnancy, weight gain, age, White class and smoking habits. METHODS: We identified all pregnant diabetic women in North Jutland County, Denmark from 1985 to 2003. Data on HbA(1c) values from the 20th gestational week to term were collected from medical records and the babies were classified as large, normal or small for gestational age. The association between glycated haemoglobin (HbA(1c)) and relative risk of delivering an LGA baby was quantified based on logistic regression models and stratified analysis controlling for the five covariates. RESULTS: We included 209 singleton pregnancies with assessable HbA(1c) values of which 59%[95% confidence interval (CI) 52-65%] terminated with an LGA baby. Increasing levels of HbA(1c), BMI and weight gain were all associated with increasing risk of delivering an LGA baby. Analyses stratified according to maternal BMI showed that the association between HbA(1c) and risk of delivering an LGA baby was restricted to pregnancies with pre-pregnancy BMI > 23 kg/m(2). We found no association between HbA(1c) and risk of delivering an LGA baby in pregnancies with lower BMI. CONCLUSION: The positive association between glycated haemoglobin and birth of an LGA baby seems to be restricted to women with BMI > 23 kg/m(2).     

Treatment of age-related macular degeneration by laser photocoagulation. Visual results 2-8 weeks and 2-4 years after initial laser treatment

Laser treatment with blue-green argon, green argon and/or krypton red was performed on 578 eyes in 443 patients with neovascular age-related macular degeneration (AMD). The visual acuity was examined in all eyes 2 to 8 weeks after initial treatment and in 204 eyes in 167 patients 2 to 4 years after initial treatment. The short term results were as follow: 91/578 eyes (16%) had improved (greater than or equal to 2 lines on Snellen's charge or equivalent steps), 445/578 eyes (77%) remained unchanged and 42/578 eyes (7%) had deteriorated visual acuity (greater than or equal to 2 lines on Snellen's chart or equivalent steps). The reduction in visual acuity, may in about half of the 42 eyes be caused by too intensive laser application in the beginning of this study in 1983 and 1984 where treatment was applied with blue-green argon, which has now been abandoned. In the group with an observation time of 2 to 4 years, 42/204 eyes (21%) had improved, 119/204 eyes (58%) remained unchanged and 43/204 eyes (21%) had a deteriorated visual acuity. In the 204 eyes the subretinal neovascular lesion(s) were located extrafoveally in 52 eyes, juxtafoveally in 114 eyes and subfoveally in 38 eyes. It is to be pointed out, that even patients with a pre-laser visual acuity of 6/60 or worse obtained an improvement of visual acuity in 12/27 eyes. About 40% of the eyes needed re-treatment from 1 to 8 times. It is unknown whether the obtained results are to be considered marginal or more substantial.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anal sphincter size measured by endosonography in healthy volunteers. Effect of age, sex, and parity.

The anal sphincter muscles consist of the circular internal and external sphincters together with the sling-shaped associated puborectalis muscle. Ten men, 10 women with no vaginal deliveries, and 10 women with one or more vaginal deliveries were studied with anal endosonography using a 7 MHz multiplanar endoprobe. The thickness of the internal sphincter and the thickness, length, and cross-sectional area of the external sphincter were measured and related to age, sex, and parity. Reproducibility was assessed by similar measurements on different days in 10 volunteers. Anal sphincter size was the same in men and women and was not affected by the number of child births. Internal sphincter muscle thickness increased with age. Anal manometry and electromyography with an anal sponge were performed in all volunteers but the results did not correlate to any of the anal sphincter dimensions. Our conclusion is that although there are some limitations, endosonography can be used to determine the size of the anal sphincter muscles.     

Angiotensin-II contracts isolated human posterior ciliary arteries

The effect of angiotensin-II (A-II) was studied on ring segments of the terminal extraocular branches of the posterior ciliary artery isolated from human enucleated eyes. It induced a potent concentration-dependent contraction on top of the spontaneous myogenic tone of all arteries studied from five patients with the concentration required to give half-maximal response equal to 51 nM. The spontaneous tone and maximal increase in vessel wall tension induced by A-II was equal to 51% of Emax. The relative response and sensitivity to A-II was unchanged in three endothelial denuded vessels, but the spontaneous tone increased. The arteries became completely insensitive to A-II after one exposure. These results show an immediate direct contractile effect of A-II on human posterior ciliary arteries, but the development of pronounced tachyphylaxis indicates that A-II is probably not an important factor in reducing blood flow to the optic nerve head.     

Computer-assisted three-dimensional reconstruction of the hippocampal region based on serial sections

A large series of rabbit hippocampal Neo-Timm stained sections were manually aligned, digitized, and by a modified median filtration noise reduced and reconstructed into a three-dimensional object. From the presented simulated grey tone cuts of this object, the reader may assemble a rabbit hippocampal model, that spatially illustrates its anatomy.     

Pinacidil uptake and effects in the isolated rabbit heart

The myocardial accumulation of pinacidil showed one-compartment characteristics with a half-time of 1.11 min., whereas the disposition followed three-compartment kinetics with half-times for the relevant two redistributory and the terminal phases of 0.39, 1.51 and 5.44 min., respectively. At a steady-state drug concentration in the perfusate of 6.12 nmol ml-1, the average concentration of pinacidil in the myocardium was 20.6 nmol g-1. The accumulated amount could predictically be referred with 57% to a central and 31 and 12% to two peripheral (deeper) drug pools. The pharmacodynamic effects of pinacidil in the isolated perfused rabbit heart were studied at stepwise increasing concentrations from 0.15 to 100 microM. Coronary flowrate increased initially up to 24.5% at 1.5 microM pinacidil and then gradually decreased. Amplitude and velocity of contraction were both inhibited in a biphasic way up to 92.7 and 94.1%, respectively. Apparent dynamic steady states developed within 13-15 min. The computer-derived inhibitory Em-values related to the first phase were 49.2 and 52.4% and those related to the second phase were 111.7 and 108.3%, respectively. Heart frequency decreased monophasically and exhibited an inhibitory Em-value of 19.6%. Oxygen consumption decreased at pinacidil concentrations higher than 15 microM and the Em-value was 69.7%. The frequency-corrected QT-interval decreased biphasically and the related inhibitory Em-values were 8.6 and 58.7%. The QRS-interval did not change and the PQ-interval only showed a minor increase at the highest pinacidil concentration. Our findings are compatible with the concept of pinacidil being a potassium channel opener.