Urea and 15-me-prostaglandin F2 alpha for midtrimester abortion

This study evaluates the efficacy of combining urea and prostaglandin in inducing a midtrimester abortion. The results are compared with that of other methods (e.g., ureapitocin combination and urea alone). 50 women (17-45 years of age; mean age, 26.20 years) of from 16-20 weeks' gestation and with no medical disorders complicating pregnancy were studied. 30 minutes before abortion was performed, the patients were given antiemetic and antidiarrheal agents. Hypertonic urea was given intra-amniotically by transabdominal amniocentesis. 125 u gm or 0.5 ml. of 15 me-PGF2 (prostaglandin) was then administered intramuscularly. Serial intramuscular administration of the prostaglandin analogue was given 3 hours for 30 hours or until the fetus was expelled, which ever came first. The combined method induced abortion in all patients within 72 hours (mean induction to abortion interval, 25 hours and 15 minutes). Comparison of the regimen with 2 other methods (urea and pitocin, urea alone) indicated that the urea-prostaglandin combination is a more effective and quicker method than the other 2. Complications included gastrointestinal side effects, hemorrhage, and cervical tear. This method should not be used on grandmultiparous women because of their greater risks of uterine rupture and hemorrhage. Cervical injuries can be avoided by inserting laminaria tents before administration of urea, especially those wth hypoplastic cervices.     

The first year of clinical experience with concurrent post abortal insertion of copper "T" 200

Immediate postabortion period is a strategic time for providing contraceptive protection, especially insertion of IUD concommitent with the abortion procedure. One can be reasonably safe in assuming that copper T 200 may be used with comparable degrees of clinical effectiveness in such situations. A higher incidence of IUD removals for bleeding and IUD displacements in the postabortal insertion is justifiable when it is considered that a greater number of women are reached and thus protected against the risks of an unwanted pregnancy. Major problems such as cervical or uterine perforations were not associated with this type of insertion. IUD removal was effected in 5.39% for bleeding, and in 4.69% of cases where there was either complete or incomplete expulsion of the device. Expulsion rate was high within the 1st week of insertion, and it is reasonable to believe that abortion complications were responsible for this high expulsion rate. Even though IUD removal was not required, about 15% of the patients had menstrual irregularities at the end of 1 year of use. Embedding of the copper device did not pose any problem for removal of the device after 1 year of use and no fragmentation of copper wire was found in the IUDs removed. In those who wanted, conception had occurred within 4 months of removal of the device. The follow-up data suggests that the use-effectiveness of the device gradually increase with the duration of use and is found to be highest after 1 year of use.     

Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance

The lateral femoral cutaneous nerve (LFCN), a branch from the lumbar plexus, may come to the clinician's or surgeon's attention. We studied this nerve to determine its location and its relationship with neighboring structures around the anterior superior iliac spine (ASIS) and the inguinal ligament (IL). Additionally, cross‐sectional microanatomy of the LFCN at the IL was studied. The LFCN was dissected in 47 lower limbs from formalin‐fixed cadavers. The distances from the ASIS to the point where the LFCN crossed the IL and the lateral border of the sartorius were measured. The distance between the ASIS and the point it pierced the deep fascia was also measured. Twelve nerve specimens at the IL were collected for histological sectioning and were stained with hematoxylin and eosin. On examination of the cross‐sectional area, the nonfascicular area was wider than the fascicular area because of an increased amount of thick collagen fibers. This study may be of help to clinicians managing meralgia paresthetica and may also assist in defining a safe area for surgical intervention on the anterolateral aspect of the thigh. Clin. Anat. 23:978–984, 2010. © 2010 Wiley‐Liss, Inc.     

Long term observations on an anterior chamber Ridley intraocular lens

In 1965 the patient, aged 6, sustained a perforating eye injury which was repaired and a traumatic cataract was aspirated within five weeks. Five years later a Ridley Mk 2 A/C intraocular lens was inserted. Several episodes of blunt trauma occurred over a three year period following this procedure. This paper reports the clinical, corneal pachometric and specular microscopic findings of both traumatized and normal fellow eyes 18 years after the initial incident. The corneal endothelial mosaic of the traumatized right eye was very irregular in the vicinity of the initial site of perforation. These marked variations in cell size and shape were less apparent at peripheral corneal areas. The estimated cell loss to the traumatized eye was in the region of 74% although in spite of this corneal function was maintained. The effects of trauma on the corneal endothelium are discussed and a brief review of the literature presented.     

Prolonged hypoxia modulates platelet activating factor receptor-mediated responses by fetal ovine pulmonary vascular smooth muscle cells

Hypoxia augments PAF receptor (PAFr) binding and PAFr protein expression in venous SMC (SMC-PV). We compared effect of acute and prolonged hypoxia (pO₂ < 40 torr) on PAFr-mediated responses in arterial SMC (SMC-PA) and SMC-PV. Cells were studied for 30 min (acute) or for 48 h (prolonged) hypoxia and compared to normoxic (pO₂ ~ 100 torr) conditions. PAF binding was quantified in fmol/10⁶ cells (mean ± SEM). PAF binding in normoxia were SMC-PA, 5.2 ± 0.2 and in SMC-PV, 19.3 ± 1.1; values in acute hypoxia were SMC-PA, 7.7 ± 0.4 and in SMC-PV, 27.8 ± 1.7. Prolonged hypoxia produced 6-fold increase in binding in SMC-PA, but only 2-fold increase in SMC-PV, but binding in SMC-PV was still higher. Acute hypoxia augmented inositol phosphate release by 50% and 40% in SMC-PA and SMC-PV, respectively. During normoxia, PAFr mRNA expression by both cell types was similar, but expression in hypoxia by SMC-PA was greater. In SMC-PA, hypoxia and PAF augmented intracellular calcium flux. Re-exposure of cells to 30 min normoxia after 48 h hypoxia decreased binding by 45–60%, suggesting immediate down-regulation of hypoxia-induced PAFr-mediated effects. We speculate that re-oxygenation immediately reverses hypoxia effect probably due to oxygen tension-dependent reversibility of PAFr activation and suggest that exposure of the neonate to prolonged state of hypoxia will vilify oxygen exchange capacity of the neonatal lungs.     

Hormone-Responsive Model of Primary Human Breast Epithelium

Retention of hormone responsiveness in primary culture models of human breast is essential for studies aimed at understanding the mechanisms of action of the ovarian hormones in the human breast. In this chapter we describe the development of a culture model of primary human breast that retains critical features of the tissue in vivo. We find that primary normal human breast tissue in embedded culture recapitulates the morphology, cell lineages, functional gene expression characteristics and estrogen and progesterone receptor responsiveness of the breast in vivo. The ratio of luminal to myoepithelial cells after culture recapitulates that observed in the uncultured tissue, highlighting the fact that progenitor cells capable of giving rise to both epithelial cell lineages are retained in this model system. By contrast, primary cells placed into monolayer culture, even for a single passage, lose bipotent progenitors, and the myoepithelial lineage predominates, demonstrating the rapidity with which phenotypic changes and selection occur in normal breast cells, unless cultured under conditions that prevent this outcome. Primary matrix-embedded culture of normal human breast cells provides researchers with a new opportunity to understand ovarian hormone action in the human breast.