Localized scleroderma ''en coup de sabre'' with external eye muscle involvement at the same line

A case of localized scleroderma ‘en coup de sabre’ in the right side of the front associated with myopathy of external eye muscles (levator palpebrae and rectus superior) at the same line is reported. It is discussed whether a predisposition to the disease might be laid down in the mesenchyme in early foetal life before the differentiation of the anatomical structures.     

Vitamin D Deficiency after Highly Selective Vagotomy

ABSTRACT While bone disease is occasionally seen after gastrectomy, the influence of vagotomy on calcium and vitamin D metabolism is uncertain. We have, therefore, investigated 23 male patients who had undergone highly selective vagotomy for ulcer 4.3±1.2 years previously. The 25OHD concentrations were decreased (p<0.05), the 1,25(OH)₂D concentrations elevated (p<0.05) and the immunoreactive parathyroid hormone concentrations normal. Local and total bone mass were normal compared to age-matched men, and there was no biochemical evidence of increased bone turnover. We suggest that the changes in calcium absorption, which are described in the literature after vagotomy, are mediated by 1,25(OH)₂D. Although the changes in vitamin D metabolism do not lead to calcium-metabolic disturbances in selected patients, we believe that some will eventually develop vitamin D deficiency and that vitamin D supplementation should be considered. Keywords: vitamin D, bone mass, calcium homeostasis, vagotomy.     

Pain relief in labour using transcutaneous electrical nerve stimulation (TENS). A TENS/TENS placebo controlled study in two parity groups

Summary. The analgesic effects of transcutaneous electrical nerve stimulation (TENS) in labour and effects on outcome were investigated in a double-blind TENS/TENS placebo controlled trial in 100 primigravidae and 50 women in their third labour. There were no differences between the TENS and the TENS placebo users in terms of pain concept or relief, and only 12 and 13% of primigravidae and 48 and 39% of the para 2 women completed labour without requiring other analgesia in their respective groups. The primigravidae who used either TENS or TENS placebo alone had shorter labours than those who required further analgesia. Although the outcome of labour for mother and infant were similar in the two groups, there was a higher operative delivery rate in women who also had epidural analgesia. There were highly significant differences between the TENS and the TENS placebo users in terms of favourable and unfavourable comments by the mothers and the midwives at 1 and 24 h after delivery. The evident consumer satisfaction for TENS suggests TENS has a part to play in analgesia in labour but the equivocal findings in terms of factors associated with pain relief points to the need for apparatus more specifically designed to cope with the special characteristics of the pain of labour.     

Cyclic changes in serum cholesterol and lipoproteins following different doses of combined postmenopausal hormone replacement therapy

Summary. Cyclic changes in lipoproteins after sequential oestrogen-progestogen therapy were studied in a group of healthy postmenopausal women treated with three different hormone doses, and followed up for two consecutive cycles by twice weekly examinations (a total of 17 examinations). There was a significant rise in high density lipoprotein (HDL) cholesterol and a significant fall in low density lipoprotein (LDL) cholesterol closely related to the dose of the oestrogen component. Addition of the progestogen, 1 mg of norethisterone acetate, decreased the oestrogen-induced rise in HDL, but HDL levels remained higher than initial values in the high-dose (4 mg) and medium dose (2 mg) groups. The average increases in HDL cholesterol were 13%, 9% and 2% in the high-dose, medium-dose and low-dose (1 mg) groups, respectively, and the corresponding mean decreases in LDL cholesterol were 18%, 15% and 10% respectively. We conclude that postmenopausal treatment with sequentially combined oestrogen-progestogen has no adverse effects on the lipoprotein status.     

Variability in Sublingual Microvessel Density and Flow Measurements in Healthy Volunteers

Objectives: As sublingual microvascular indices are increasingly heralded as new resuscitation end‐points, better population data are required to power clinical studies. This paper describes improved methods to quantify sublingual microvessel flow and density in images obtained by sidestream dark field (SDF) technology in healthy volunteers, including vessels under 10 μm in diameter. Materials and Methods: Measurements of sublingual capillary density and flow were obtained by recording three 15‐second images in 20 healthy volunteeers over three days. Two independent observers quantified capillary density by using two methods: total vessel length (mm/mm²) and counting (number/mm). Both intraoral and temporal variabilities within subject and observer reproducibilities were determined by using coefficients of variability and reproducibility indices. Results: For small (1–10 μm), medium (11–20 μm), and large (21–50 μm) diameter, mean vessel density with standard deviations (SDs) in volunteers was 21.3(±4.9), 5.2 (±1.2), and 2.7 (±0.9) mm/mm², respectively. Also, 94.0±1.4% of small vessels, 94.5±1.4% of medium vessels, and 94.5±4.0% of large vessels had continuous perfusion. Within subjects, the means of all measurements over three days varied less than 13, 22, and 35% in small, medium, and large vessels, respectively. Interobserver reproducibility was good, especially for capillary (1–10 μm) density and flow measurements. Conclusions: Our methods of microvessel flow and density quantification have low observer variability and confirm the stability of microcirculatory measurements over time. These results facilitate the development of SDF‐acquired sublingual microvascular indices as feasible microperfusion markers in shock resuscitation.     

Contextual factors related to the drinking behaviors of American business and professional women

American women in business and professional occupations (n=453) completed a survey that included questions on alcohol use, drinking context, and work and other activities. Spouses' and best friends' consumption and subjects' frequency in drinking settings correlated with their consumption and negative consequences of alcohol use. Multiple regression analyses indicated that predictor variables for consumption were frequency in drinking settings, a measure of three personal motives for drinking, age, and number of organization memberships. Predictor variables for negative consequences were subject's consumption, spouse's drinking, frequency in drinking settings, and age. The results suggest that social context may be important in understanding women's drinking. Variables directly related to drinking, such as time spent in drinking situations, are correlated with increased drinking, while other contextual variables, such as membership in organizations, may play a preventive role.     

Metabolism of Testosterone In Vitro by Hypothalamus and other Areas of Rat Brain

Testosteronstoffwechsel in vitro im Hypothalamus und anderen Bezirken des Rattenhirns
Verschiedene Hirnareale ausgewachsener männlicher Ratten wurden in vitro mit ¹⁴C markiertem Testosteron inkubiert. Der Hauptmetabolit war 17β-OH-5α-androstan-3-on. Die Gewebe bildeten diesen Metaboliten in der absteigenden Reihenfolge von Mittelhirndach, Hypothalamus, Kleinhirn und dorsaler Hippocampus, Großhirnrinde und Mandelkerne. Es wurden minimale Konzentrationen anderer Metaboliten gefunden.