Hinged anoscope

A hinged anoscope for insertion of rectal catheters is presented. Catheters attached to or integrally part of an external monitoring device or collecting system can be inserted through this endoscope. The endoscope can be removed without disconnecting the catheter from the external device.     

Executive functioning in preschool children born very preterm: relationship with early white matter pathology.

Despite evidence for executive dysfunction in school-aged preterm children, less is known about the early development of these difficulties or their underlying neuropathology. This study used prospective longitudinal data from a regional cohort of 88 very preterm and 98 full-term comparison children to examine the executive functioning (EF) of preschool children born very preterm. The relationship between the severity of neonatal cerebral white matter (WM) abnormalities on magnetic resonance imaging (MRI) at term equivalent and children's EF at ages two and four years (corrected age) was examined. At age four, very preterm children with WM abnormalities performed less well than full-term children on the Detour Reaching Box, a measure of behavioral inhibition and cognitive flexibility, even after controlling for child IQ, SES, and medical background. Examination of patterns of EF performance between the ages of 2 and 4 years showed that the performance of all groups improved with age. However, very preterm children with mild and moderate-severe WM abnormalities were characterized by higher rates of consistent performance impairments. These findings support the presence of early and persistent executive difficulties in preschool children born very preterm, and highlight the importance of white matter pathology in the development of executive impairments.     

Neutralizing and Non-neutralizing Antibodies to Bovine Thyroid-Stimulating Hormone and its Subunits

To test the possibility that the long-acting thyroid stimulator (LATS) might represent an immune complex either of thyroid-stimulating hormone (TSH) with anti-TSH or of a subunit of TSH with an appropriate antibody, we immunized rabbits with bovine TSH (bTSH), bLH (luteinizing hormone), and their alpha and beta subunits (bTSHalpha and bTSHbeta). Binding, neutralizing, and nonneutralizing antibodies were demonstrated in the antisera obtained. First, antisera to TSH, TSHbeta, and TSHalpha all bound [(125)I]TSH and [(125)I]TSHbeta. Anti-bTSHbeta antisera bound [(125)I]bTSHbeta better than did anti-TSH sera, while the binding of [(125)I]bTSH was similar with both types of antiserum. Second, the thyroid-stimulating activity (McKenzie bioassay) of TSH could be neutralized by incubation with various dilutions of anti-TSH or anti-TSHbeta. Finally, when incubation mixtures containing TSH and dilutions of anti-TSHbeta antisera that only partially neutralized TSH were treated with an antiserum against rabbit immunoglobulins to precipitate immune complexes, the bioassay response of the TSH was abolished. This phenomenon was not observed when antiserum to the intact hormone was substituted in the incubation mixture. The removal of TSH biological activity from a mixture of TSH and anti-bTSHbeta by addition of an anti-immunoglobulin indicated that biologically active immune complexes were formed between TSH and anti-TSHbeta but not between TSH and anti-TSH. The time-course of the bioactivity and several other characteristics of these complexes differentiate them from LATS.     

The acute effects of oral ethanol on the hypothalamic-pituitary-adrenal axis in normal human subjects

OBJECTIVE To evaluate the acute effects of oral ethanol on the hypothalamic-pituitary-adrenal axis in normal human subjects and, in particular, to examine the effect of background alcohol intake and gastrointestinal side-effects on this response. DESIGN Plasma ethanol, cortisol, ACTH, corticotrophin-releasing hormone (CRH) and AVP were measured half-hourly for 4 hours following 1·1 ml/kg of 95% ethanol or placebo in a cross-over study. At least one week elapsed between each procedure. SUBJECTS Twelve healthy non-alcoholic volunteers with a wide range of background alcohol Intakes. MEASUREMENTS Peptide hormones were measured by radioimmunoassay, cortisol by ELSA and blood ethanol by headspace gas chromatography. Results are expressed as mean ± SEM. RESULTS Blood ethanol levels peaked at one hour post ethanol ingestion. Three subjects developed significant gastrointestinal (GI) side-effects, with two vomiting and one experiencing moderate to severe nausea. There was no difference between peak blood ethanol levels in the groups with and without GI side-effects (34·5 ± 2·4 mmol/l vs 34·3 ± 1·7 mmol/l respectively). ACTH and cortisol rose in those subjects who experienced GI side-effects (P < 0·0001 for each). The remaining subjects had a tendency for ACTH and cortisol to be higher on the placebo day. The group with GI side-effects following ethanol administration had a significant rise in AVP (P < 0·02) that was synchronous with ACTH and cortisol. No consistent alcohol related changes were seen in peripheral CRH levels, although there was a significant increase over time on both active and placebo days (P < 0·0001). In the group with no GI side-effects, AVP did not significantly fail in the first half hour following ethanol, while a significant fall did occur following placebo (P < 0·05). Plasma renin activity was, however, increased by ethanol (P < 0·05). The background alcohol intake of the group with GI side-effects was significantly lower than the group without (18 ± 7 vs 235 ± 51 g/week, P < 0·05), but no hormonal response was seen in two subjects with a relatively low alcohol intake (< 100g/week) who did not experience GI side-effects. CONCLUSION intoxicating levels of ethanol per se do not result in activation of the hypothalamic-pituitary-adrenal axis in humans. However, gastrointestinal side-effects induced by the ethanol do result in such activation, which appears to be mediated by AVP as the dominant ACTH secretagogue. One of the factors which influences the blood ethanol level at which GI side-effects occur appears to be background alcohol Intake.