International quit and win 1996: standardized evaluation in selected campaign countries

BACKGROUND: Quit and Win '96 recruited 70,000 smokers in 25 countries. The participants tried to abstain from smoking for at least 4 weeks. All participating countries followed the jointly agreed rules. Half of the countries implemented the campaign nationally and half, regionally. METHODS: A 1-year follow-up study was conducted in the participating countries. The aim of this study was to provide a standardized evaluation based on data from eight European campaign sites. Three measures were used to evaluate the effectiveness of the campaigns. The first measure was the participation rate, which is the proportion of participants among the smoking population targeted in each site. The second measure was a cautious estimate for the continuous 1-year abstinence rate, which is the proportion of abstainers among the follow-up sample regarding all non-respondents as relapsed. Third was the measure of the population impact, which is the efficacy of the intervention multiplied by its reach, where the efficacy equals the abstinence rate and the reach equals the participation rate. RESULTS: The participation rates varied from 0.1 to 2%, being highest in North Karelia, Finland, and Pitka;auranta, Russia. The abstinence rates varied from 12 to 35%, being highest in Hungary, Ukraine, and Russia, where the prevalence of smoking is also relatively high. The population impacts varied from 0.02 to 0.5%, being highest in Pitka;auranta, where both the reach and the efficacy of the Quit and Win were relatively high. CONCLUSIONS: There was great variation in effectiveness, with population impact being affected more by participation rate than abstinence rate. Quit and Win contests are feasible interventions in diverse European populations. To improve the effectiveness, future campaigns should increase the reach of the intervention.     

Beta-endorphin in maternal and umbilical cord plasma at elective cesarean section and in spontaneous labor

Concentration of beta-endorphin in relation to the mode of delivery and anesthesia was studied in maternal and umbilical cord plasma in 30 healthy women at term pregnancy. At elective cesarean section under epidural anesthesia, the mean maternal beta-endorphin level rose from 9.8 +/- 2.7 pmol/L (SE) before induction to 15.5 +/- 3.7 pmol/L at the time of delivery (P less than .02). Under general anesthesia the mean beta-endorphin level increased more, from 14.6 +/- 7.2 to 34.4 +/- 7.8 pmol/L (P less than .02), reaching the mean beta-endorphin value of the second stage of normal labor, 39.4 +/- 7.0 pmol/L. In the cord arterial and venous plasma, the mean beta-endorphin value was significantly higher after spontaneous labor (40.9 +/- 11 and 40.1 +/- 9.2 pmol/L, respectively) than at elective cesarean section under epidural (14.3 +/- 1.9 and 12.4 +/- 3.6 pmol/L, respectively) or general anesthesia (11.9 +/- 2.2 and 13.4 +/- 2.2 pmol/L, respectively). Thus cesarean section under general anesthesia proved to be more stressful for the mother than that under epidural anesthesia, when beta-endorphin release is used as the measure of stress. The mode of anesthesia did not seem to influence the plasma beta-endorphin level in the newborn infant. Normal delivery by vaginal route increased the release of beta-endorphin both to the maternal and the fetoplacental circulation.     

Corticotrophin-releasing factor in human placenta: localization, concentration and release in vitro

Corticotrophin-releasing factor (CRF) immunoreactivity was demonstrated by immunohistochemical staining in the cytotrophoblast of the early pregnancy placenta, in the decidua and in the amnion. This localization is different from that of adrenocorticotrophic hormone (ACTH) and beta-endorphin, which are present in the syncytiotrophoblast. The release of immunoreactive CRF was demonstrated from both early and term placental tissues in vitro. The mean amounts of CRF in the early and term pregnancy placental/decidual extracts were 0.99 +/- 0.5 ng/g and 19.7 +/- 3.1 ng/g, respectively. A slightly greater amount of CRF was found in extracts from term placentae and in cord venous plasma collected after spontaneous vaginal delivery than in those collected at elective caesarean section performed before the beginning of labour.     

Current and future genetic screening for male infertility

Although much of male infertility is currently unexplained, it is likely that underlying defects in critical genes or entire gene pathways are responsible. Because powerful technologies exist to bypass severe male-factor infertility, improving the diagnosis of genetic infertility is important for the infertile couple, not only to explain the problem but also to inform them of conditions potentially transmissible to offspring.     

Changes in visual acuity of patients undergoing cataract surgery during the last two decades

PURPOSE: To compare preoperative visual acuities in patients who underwent cataract surgery between 1982 and 2000. METHODS: Information on visual acuity (VA), ocular disease and general disease was obtained from records relating to samples of consecutive cataract operations in 1982, 1985, 1990, 1995 and 2000 in two hospitals in the Vaasa region of Finland. RESULTS: Between 1982 and 2000, the average preoperative VA in the operated eye increased by 0.85 logMAR units (from logMAR 1.56 to logMAR 0.71) or 8.5 log lines. Corresponding decimal values are 0.03 and 0.2, respectively. In the better eye, VA increased from logMAR 0.64 to logMAR 0.37. Corresponding decimal values are 0.23 and 0.43, respectively. The incidence of cataract surgery increased from 1.0 to 7.2 operations per 1000 of the population per year over the period. For an annual increase of one operation per 1000 inhabitants, the increase in average VA before surgery is 1.3 log lines in the operated eye and 0.4 log lines in the better eye. The number of patients with visual impairment (WHO definition: VA < 0.3) before surgery fell from 47% to 15%, and the number of patients with profound visual handicaps (VA < 0.1) before surgery fell from 15% to 4%. CONCLUSION: The preoperative vision of patients undergoing cataract surgery during the last two decades has improved significantly. Preoperative VA has increased linearly in line with the incidence of surgery. Only a small proportion of the increase in incidence of cataract surgery can be explained by the increasing average age of the population.     

Long-term effect of pharyngeal flap surgery on craniofacial and nasopharyngeal morphology in patients with cleft palate

The craniofacial morphology of 48 consecutive adult males with isolated cleft palate was studied by means of lateral cephalograms at the mean age of 18.8 years. Twelve of the patients had received pharyngeal flap surgery between 4 and 12 years of age (mean age 6 years) to improve speech. No significant differences were noticed in craniofacial cephalometric relations between the patients who had not had velopharyngeal flap surgery (VPF-) and those who had (VPF+), although the latter showed a tendency toward a more vertical growth direction. In the pharynx, the VPF+ group showed larger sagittal depths of nasopharyngeal airway but smaller depths of oropharyngeal airway. The differences were significant at the levels of the upper nasopharynx and lower oropharynx. According to the hospital records, none of the patients demonstrated persistent airway obstruction. Cephalometry may be useful in evaluating the changes in pharyngeal airway dimensions that may be related to velopharyngeal flap surgery.     

Vitamins A1 and A2 in hepatic tissue and subcellular fractions in mink feeding on fish-based diets and exposed to Aroclor 1242

Two-month-old female mink were fed diets based on either Baltic herring (Clupea harengus membras) or freshwater smelt (Osmerus eperlanus) for 21 weeks. A portion of the smelt-fed mink were exposed orally to polychlorinated biphenyls (PCBs), Aroclor 1242 (1 mg/d). Retinol (vitamin A1), 3,4-didehydroretinol (vitamin A2), and their different fatty acyl esters were studied in hepatic tissue, microsomes, and cytosol by argentated reversed-phase high-performance liquid chromatography. As a result of Aroclor exposure, concentrations of the fatty acyl esters of vitamins A1 and A2 were about one-tenth and those of unesterified A2 one-fourth those of the control levels. In the fatty acyl esters, percentages of stearates (A1--18:0 and A2--18:0) increased at the expense of the other fatty acyl esters. The Aroclor exposure decreased concentrations of alcoholic and esterified forms of the A2 analog more than those of the corresponding A1 analog. In microsomes. Aroclor decreased the alcoholic and esterified vitamin analogs to the same extent (to 9-17%). In the cytosol compared to the control, the concentrations of the vitamin esters fell below 10%, but the alcoholic analogs remained at 30 to 40%. Despite equal dietary supply, in mink fed on Baltic herring, the hepatic levels of vitamin A, were only about one-third of the values found in the smelt-fed mink. The organochlorines also altered hepatic lipid composition and impaired breeding and kit growth. In the kits of the females fed on Baltic herring, blood hemoglobin was decreased.     

The risk of stroke following coronary revascularization -- a population-based long-term follow-up study

OBJECTIVE: To study the incidence and risk factors of stroke after coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA). DESIGN: During 1983-1992, coronary revascularization procedures (n = 2160) were recorded in patients aged 35-64 years as part of the population-based FINMONICA Myocardial Infarction Register. The FINMONICA Stroke Register and National Hospital Discharge Register were used to ascertain subsequent stroke events in such patients. RESULTS: During the average follow-up of 5.83 years, 155 patients (7.2%) had a stroke. The cumulative incidence of stroke was 1.55% in the first year after revascularization and varied between 0.8 and 1.4% during subsequent years. In Cox proportional hazard models the relative risk of stroke was 3.01 (p = 0.0007) for a previous stroke, 2.61 (p = 0.0001) for diabetes mellitus, 2.15 (p = 0.007) for low income (compared with high income), 2.06 (p = 0.03) for male sex, and 1.43 (p = 0.02) for a 10-year increment in age. CONCLUSION: The incidence of stroke during the first year after revascularization was five times higher than among the age- and sex-matched general population. Patients with a previous stroke, diabetes mellitus, advanced age, male sex and low socioeconomic status need special attention because of increased risk of stroke after CABG or PTCA.     

Evaluation of PAP and PSA gene expression in prostatic hyperplasia and prostatic carcinoma using northern-blot analyses,in situ hybridization and immunohistochemical stainings with monoclonal and bispecific antibodies

In this report we have investigated levels of prostatic acid phosphatase (PAP) and prostate-specific antigen (PSA) gene expression in prostatic carcinoma (Ca) and benign prostatic hyperplasia (BPH) specimens. Northern-blot analyses of total prostatic mRNA indicated that there was a tendency towards lower amounts of PAP mRNA and PSA mRNA in the Ca specimens than in the BPH specimens, although, because of the great variation in the expression levels of both mRNAs, these differences were not statistically significant. In situ hybridization analyses clearly showed that both PAP and PSA mRNAs were confined to the columnar epithelial cells and that stromal cells were devoid of these mRNAs. In addition, PAP and PSA mRNAs were more abundant in BPH tissue than in adjacent Ca tissue within the same specimen. The levels of PAP and PSA enzymes were analyzed immunohistochemically using a bispecific antibody having high affinity for both PAP and PSA, and the results were compared with those obtained using monoclonal anti-PAP and anti-PSA antibodies. All 3 antibodies stained only epithelial cells and BPH tissue consistently gave more intense staining than Ca tissue. Furthermore, the anti-PSA and the bispecific anti-PAP-PSA antibodies stained well or moderately differentiated Ca tissues more strongly than poorly differentiated Ca tissues. No PSA staining was detected in 3 and no PAP staining in 5 of the moderately or poorly differentiated carcinomas (grades II or III). Our results show that, in comparison with BPH tissue, prostatic Ca tissue is associated with significantly lower levels of mRNAs coding for the prostatic marker enzymes PAP and PSA, as well as with lower concentrations of these enzymes. Furthermore, dedifferentiation of prostate Ca is associated with a decrease in the level of intraprostatic PSA.     

Second Derivative of Developed Tension in Classifying Cardiotonics with Respect to Their Mechanisms of Action: Drugs Affecting cAMP Metabolism

Abstract: The second derivative of developed tension (T”, d²T/dt²) has not come into common use in the analysis of cardiac contractility, although it has been shown to give additional information on the myocardial contraction-relaxation cycle (CRC). In the present study a new way to use T”in the analysis of myocardial mechanics, including the time course of T”, is described. Profiles of the T”of the some drugs with established cardiotonic effects are presented. Experiments were carried out in spontaneously beating whole rat atria preparations. The effects of changing contraction frequency on the measured parameters were studied with electrically paced left atria. Qualitative inotropic effects of 1-methyl-3-isobutylxanthine (MIX), theophylline, caffeine, milrinone, isoprenaline and forskolin were studied. Concentrations equief-fective with respect to the force of contraction were tested. Inotropic profiles were evaluated at the time of maximal force of contraction. We found that methylxanthines have a mechanical behaviour quite distinct from other inotropic agents acting via cAMP. The effects of MIX were similar to those of theophylline in all respects. A tendency to increase the active relaxation phase of T”was a property common to methylxanthines. Caffeine also prolonged the phases of contraction, whereas MIX and theophylline have opposite effects. Milrinone in turn mimics the effects of isoprenaline and forskolin; abbreviation of the relaxation phase of T”was the feature most typical of them. Caffeine was the only agent which did not shorten the duration of CRC. The method proved valuable in basic research on drug effects on cardiac contractility.