What do we know about maternal-fetal attachment?

A review of the literature suggests that there are three critical attributes related to the concept of maternal-fetal attachment, including cognitive, affective, and altruistic attachment. Cognitive attachment is the desire to know the baby. Affective attachment is the pleasure associated with thoughts of or interaction with the fetus. Altruistic attachment refers to a desire to protect the unborn child. Existing measurements on maternal-fetal attachment are developed based on low-risk and white pregnant women and previous research has not yet resulted in a consistent theoretical model. Future research should focus on development of culturally sensitive instruments and combining qualitative and quantitative measures to broaden theoretical understanding of the concept. Nursing assessment of maternal-fetal attachment is an on-going process. The nurse's role is to reassure those who have developed attachment to their fetuses and to motivate those who are unaware of or unconcerned about their attachment to their fetuses. Collecting data from different attributes of attachment helps nurses identify each woman's attachment patterns and areas of concern.     

Printed Health Information Materials: Evaluation of Readability and Suitability

Interdisciplinary collaboration and coordination of services are receiving new emphasis in Birth to Three Early Intervention programs under Part H of Public Law (PL) 102-119 (Individuals with Disabilities Education Act, formerly PL 99-457, the Education for All Handicapped Children Act). Public Health Nurses (PHNs) have historically provided health promotion services in the home to families of infants and children with special health and developmental needs, whereas other community programs have provided specific developmental and related services. Now, as the number of professional specialties involved with children with special needs increases, overlap also increases. Nursing is frequently questioned as to its unique contribution. The holistic health perspective of nursing, which integrates all aspects of the health and well-being of individuals and families, can provide especially valuable insight to the assessment, planning, and service delivery processes. Nurses need to not only participate in the planning process during the interdisciplinary planning meetings, but also to contribute their own assessment and recommendations from a nursing perspective. Under PL 102-119, the Individual Family Service Plan (IFSP) provides the framework for family-centered planning of services for the infant or young child with special needs. Developed in partnership with the family, this plan identifies strengths, resources, concerns, and priorities based on the family's determination of relevancy (Sokoly &; Dokecki, 1992). IFSP development includes formal and informal assessments by qualified professionals who provide their special expertise as shaped by the family's priorities. The health assessment and services called for within PL 102-119 are consistent with public health nursing's focus on prevention and early intervention. Health issues are basic to the definition of children with special health needs and often must be addressed before developmental goals can be...     

Degenerative changes of neurons in the superior cervical ganglion following an injection of Ricinus communis agglutinin-60 into the vagus nerve in hamsters

Summary The present study describes neuronal changes in the superior cervical ganglion of hamsters following injection of Ricinus communis agglutinin-60 (RCA-60) into the ipsilateral vagus nerve in the cervical region. There were no noticeable structural changes in the ganglion 1 day after injection. Between 3 and 15 days after injection, a small number of neurons located in the caudal part of the ganglion underwent degenerative changes including disappearance of rough endoplasmic reticulum and cytoplasmic vacuolation. The structural alterations were most acute 7 days after the injection when some neurons showed signs of total vacuolation and lysis. A second phase of neuronal change occurred after longer survival periods extending from 60 to 120 days after injection. The most striking feature of such neurons was darkening of their dendrites associated with abnormally high density cytoplasm that contained mitochondria with disrupted cristae. As distinct from the early phase in which cell necrosis was observed, there was no evidence of cell death of neurons bearing darkened dendrites. Since examples of exfoliation of the affected dendrites and their phagocytosis by satellite cells were extremely rare, it is postulated that these structural alterations are probably reversible but over an extended period. The significance of the two phases of degenerative change is discussed in connection with the acute and possible chronic effects of the toxic lectin. The present study also confirms the presence of postganglionic sympathetic axons in the cervical vagus nerve.     

Anterolateral thigh flaps for reconstruction of head and neck defects.

PURPOSE: This article presents our clinical experience with head and neck reconstruction using a free anterolateral thigh (ALT) flap and describes the morbidity of the donor site. MATERIALS AND METHODS: From October 2001 to October 2003, 20 free ALT flaps were transferred for reconstructing soft tissue defects of the head and neck. The age and gender of the patients, the site of the primary tumor, tumor stage, previous operative condition, types of associated operation, results of flap transfer, donor site morbidity, and clinical course were analyzed. RESULTS: Of 20 cases, 19 free flaps were successfully performed. The success rate was 95%. The size of the ALT flaps ranged from 6 to 10 cm in width and 9 to 20 cm in length (54 to 200 cm2 in area). Sixteen of the 20 donor sites were closed primarily, whereas 4 cases required a split-thickness skin graft to cover the donor site. Complications and morbidity of the donor site were minimal. CONCLUSION: The ALT flap has some advantages over other free flaps, including a long pedicle with a suitable diameter for anastomoses, the availability of different tissues with large amounts of skin, the ease of closing the donor site, and the ability for 2 teams to simultaneously perform the operation.     

Utilization of screening mammography: comparison of different physician specialties

Data obtained on 426 consecutive patients referred to a breast center by 122 physicians, including family practitioners, general surgeons, and other specialists, showed that the obstetricians-gynecologists referred the greatest average number of patients per physician, with more than 50% of these referrals for screening mammography. Internists referred fewer patients by nearly a factor of ten, with only one-third of these patients referred for screening mammography. Internists may be the weakest link in the utilization of screening mammography.     

6-Pentadecylsalicylic acid: an antithrombin component isolated from the stem of Rhus semialata var. roxburghii

Bioassay-directed fractionation of the n-hexane extract of the stem of Rhus semialata Murr. var. roxburghii DC (Anacardiaceae) has led to the isolation of 6-pentadecylsalicylic acid. It showed antithrombin activity at 50 micrograms/ml in the amidolytic method. It also prolonged the clotting time in a dose-dependent manner in the clotting assay of thrombin-fibrinogen interaction.     

Detrended fluctuation analysis of short-term heart rate variability in late pregnant women

Spectral analysis of heart rate variability using short or long time series is a common method in the assessment of autonomic nervous activity. Nonlinear method such as detrended fluctuation analysis was proposed and proved to be useful for the possible non-stationary and nonlinear characteristics in the time series of heart period. In this study, we investigated the detrended fluctuation analysis and conventional heart rate variability measures in 16 late pregnant women before and 3 months after delivery and in 16 healthy controls. Global and discrete, short-term (≤ 11 beats, α1) and long-term (> 11 beats, α2), scaling exponent were calculated in detrended fluctuation analysis. We found that the late pregnant women have elevated global scaling exponent, elevated short-term scaling exponent and lower heart rate variability measures in the low and high frequency ranges than those of the healthy controls and 3 months after delivery. The deranged measures recovered 3 months after delivery. In addition, the detrended fluctuation scaling exponent did not correlate with most conventional time and frequency domain measures of heart rate variability. Our study suggested that the global and short-term detrended fluctuation scaling exponents might be new and independent measures of heart rate variability in late pregnancy, in addition to those conventional time and frequency domain measures.     

Acute acalculous cholecystitis: sensitivity in detection using technetium-99m iminodiacetic acid cholescintigraphy

Forty-one proved cases of acute acalculous cholecystitis imaged with technetium-99m iminodiacetic acid (IDA) cholescintigraphy were retrospectively analyzed. After the exclusion of one indeterminate scan (showing poor initial hepatic uptake and excretion), the study yielded a 92.5% (37 of 40) sensitivity for the detection of cystic or common bile duct obstruction. Each of the three patients with false-negative scintigrams had other abnormal scintigraphic findings suggestive of biliary tract disease. Of the 20 patients (48.8%) with focal or diffuse gangrenous cholecystitis or perforation, seven (35%) exhibited either free peritoneal spill or increased pericholecystic activity to indicate the presence of advanced disease.     

A comparison of the antagonisms by neostigmine and diaminopyridine against the neuromuscular block caused by cobrotoxin and (+)-tubocurarine

Cobrotoxin was about 11-fold more potent than (+)-tubocurarine on a weight basis in blocking neuromuscular transmission in mouse isolated phrenic nerve-diaphragm preparations. Neostigmine and diaminopyridine increased the concentrations of cobrotoxin for 70% inhibition of indirect contraction by 290 and 320%, and increased those of (+)-tubocurarine by 180 and 230%, respectively. More than additive increases were obtained when neostigmine and diaminopyridine were used simultaneously. Cobrotoxin, however, was only 6-fold more toxic than (+)-tubocurarine after intraperitoneal injection in mice. The lethal dose of (+)-tubocurarine was increased by 80% when both antidotes were used together, but only by 15-20% when used alone. In contrast, the lethality of cobrotoxin was not decreased by these drugs. Unexpectedly, the time to death after treatment with cobrotoxin was shortened when mice were pretreated with these antidotes.     

犬内皮与平滑肌细胞的短期静态联合培养

目的:为获得组织工程化自体血管,观察体外静态培养条件下犬内皮细胞与平滑肌细胞联合培养组织学及形态学的特征。方法:实验于2004-07/2005-06在首都医科大学宣武医院外科院级实验室完成。①实验材料:雄性杂种犬,3个月龄,体质量8～12kg。②实验方法:贴块法及酶解法对犬内皮细胞及平滑肌细胞进行原代分离培养及扩增,将第Ⅱ代平滑肌细胞以1×109L-1的密度种植于胶原膜上培养13d,再将第Ⅱ代内皮细胞接种于生长平滑肌细胞的胶原膜上2d。③实验评估:行苏木精-伊红染色同时扫描电镜和透射电镜观察平滑肌细胞和内皮细胞在胶原载体上联合培养后的形态。结果:苏木精-伊红染色见平滑肌细胞较均匀的分布于支架材料表面及内部;扫描电镜下,平滑肌细胞可以在胶原载体材料上生长,增殖明显并在短期内形成多层细胞。内皮细胞与平滑肌细胞联合培养2d就可在平滑肌细胞层表面获得连续的单层内皮细胞层。结论:在短期静态培养条件下犬的血管平滑肌细胞和内皮细胞可以在胶原载体材料上形成具有两层细胞结构的组织工程化动脉血管组织片。