Nutritional, physiological, and menstrual status of distance runners

Amenorrheic runners (AR; N = 8), regularly menstruating runners (RMR; N = 9), and regularly menstruating sedentary controls (RMSC; N = 7) were compared for plasma progesterone levels, plasma lipid levels, menstrual cycle characteristics, physical characteristics, and nutritional adequacy to determine whether exercise training was the major factor associated with menstrual cycle disturbances. Plasma progesterone levels were significantly lower in the AR group subjects than those found during either the follicular or luteal phases of the menstrual cycle for either the RMR or the RMSC subjects. The RMR subjects had a shorter luteal phase length relative to their cycle length than did the RMSC subjects. The AR subjects consumed significantly less fat, red meat, and total calories than did the RMR subjects, while the RMSC subjects consumed significantly less total calories than did the RMR subjects. Serum LDL-C was significantly higher in the AR subjects when compared to that of the RMR subjects, while serum HDL-C was significantly higher for both the AR and RMR subjects when compared to that obtained for the RMSC subjects. The nutritional inadequacy would appear to separate the AR from the RMR, and, thus, the exercise training performed by the athletes at the time of the present investigation alone does not appear to be the major factor associated with athletic amenorrhea.     

Effect of Escherichia coli alpha-hemolysin on human peripheral leukocyte function in vitro.

To gain further evidence for the role of the Escherichia coli alpha-hemolysin in pathogenesis, its in vitro effects on human peripheral leukocyte function were studied. Leukocytes exposed to low doses of alpha-hemolysin responded with a marked chemiluminescence response, indicating activation of oxidative metabolism. This response was time and dose dependent. Pretreatment of leukocytes with doses of alpha-hemolysin at which nearly 80% of the cells survived decreased the ability of the cells to phagocytize bacteria and particles and to undergo chemotaxis. Premature activation of leukocytes and inhibition of phagocytosis and chemotaxis by alpha-hemolysin, if they occur in vivo, would greatly enhance the survival of an invading E. coli strain.     

Ascorbic acid in bronchoalveolar wash

The ascorbic acid concentration of bronchoalveolar wash has not been measured directly in the past. When attempts were made to measure this vitamin in the wash, it was found that the existing methods were not sensitive enough to measure the ascorbic acid in these highly dilute samples. Using ascorbic acid standards at concentrations approximating those of sequential wash samples, we have developed an accurate microassay method. The major feature of this new method is reduction of sample dilution by the reagents with the use of trichloroacetic acid in lieu of H₂SO₄. Using this method, we measured ascorbic acid in the first to the sixth sequential bronchoalveolar wash, the values ranging from about 5.0 µg/ml to 0.3 µg/ml. Pooled lavage content of ascorbic acid constituted approximately 10–12% of the whole lung ascorbate. The close agreement between the content of reduced ascorbic acid and the total ascorbic acid in the bronchoalveolar lavages establishes that the ascorbic acid in the airway is present in the reduced state.     

Vaginal wall sling

We describe a new technique for the treatment of urinary incontinence due to intrinsic sphincteric damage in which a sling constructed from vaginal wall is used to provide compression and support of the urethra. A rectangular island of in situ anterior vaginal wall underlying the urethra and bladder neck is developed, the 4 corners are anchored with polypropylene sutures and a ligature carrier is used to transfer the sutures to a suprapubic location. An anterior vaginal wall flap proximal to the island is advanced to cover the island. When the sutures are tied the resulting sling will support the urethra and increase urethral resistance by compression, restoring continence. The advantages are its simplicity, need for only a small incision, short operative time and hospital stay, and reliance on healthy, well vascularized, in situ tissue. Continence has been achieved in 29 of 32 cases. All patients voided spontaneously except for those with neuropathic urethral incompetence who required self-catheterization.     

Differential effects of amiodarone and desethylamiodarone on calcium antagonist receptors.

Amiodarone and its pharmacologically active metabolite desethylamiodarone have a sodium channel blocking action that explains some of their antiarrhythmic efficacy. However, the well-documented depression of the calcium channel-dependent sinus node and atrioventricular node function that occurs with amiodarone therapy suggests that amiodarone also blocks calcium influx through voltage-dependent calcium channels. Recent electrophysiologic data support the notion that amiodarone, but not desethylamiodarone, acts as a calcium channel antagonist. In this study, the effects of amiodarone and desethylamiodarone on calcium antagonist receptors associated with the voltage-dependent calcium channels were characterized. Amiodarone, but not its active metabolite desethylamiodarone, was a potent competitor at dihydropyridine and phenylalkylamine (verapamil-like) calcium antagonist binding sites in rat heart, brain, and skeletal and smooth muscles. Substantial inhibition of calcium antagonist binding was retained even after extensive washing of membranes and 2 days after in vivo treatment of rats with amiodarone. The pattern of inhibition of calcium antagonist binding suggests that amiodarone acts at phenylalkylamine binding sites. It is suggested that the acute effects of amiodarone--sinus and atrioventricular node inhibition, vasodilatation, and negative inotropic actions--may reflect calcium antagonist influences of amiodarone itself. Chronic effects of drug therapy, such as inhibition of ventricular conduction by sodium channel blockade, may selectively involve desethylamiodarone.     

An American Board of Orthodontics case report

A case report is presented of a Class II, Division 1 malocclusion with severe overjet and deep overbite with crowding and irregularities of the anterior teeth. The case was treated according to the standards of the American Board of Orthodontics.     

A 40-year multinational retrospective study of 880 Swenson procedures

This report reviews the experience of pediatric surgeons in seven cities in North American and Western Europe where the Swenson procedure was performed on 880 patients. Information on the diagnosis, treatment, complications, and long-term results was collected by reviewing the hospital records, the treating physicians' office records, and by interviewing the patients in person or by telephone. A follow-up evaluation was obtained on 814 patients. The patients' ages at the time of the resection ranged from four days to 50 years. The length of follow-up averaged 10.3 years, while the longest follow-up was 39.5 years. The overall postoperative mortality was 2.4% during the entire 40 years of the study. The postoperative mortality has decreased to 1.25% for the last 20 years. Significant factors influencing postoperative mortality included Down's syndrome, the patient's age at the time of the operation, and leak of the distal colonic anastomosis. Most of the patients followed for over 5 years have normal bowel habits, report one to three bowel movements per day, and have no soiling. No patient has urinary incontinence or impotence.