Effect of epidermal growth factor on hormone secretion by term placenta in organ culture

Labor, delivery, and newborn course were studied in 621 pregnancies in which labor was electively induced at or after 39 weeks, and in 3,851 control pregnancies in which the onset of labor was spontaneous. Induced labors were not prolonged, nor was the duration of ruptured membranes. Fetal distress and birth asphyxia were not more frequent after induction, and release of meconium occurred much less frequently (9.3% for induced labor versus 16.7% for spontaneous). There was greater use of epidural analgesia and of forceps delivery in induced labor. Among primiparous patients, cesarean delivery for “failure to progress” was performed in 14% of electively induced labors and 7% of spontaneous control labors, a difference not noted among multiparous patients who had a primary cesarean birth rate of less than 2%, latrogenic prematurity was not a problem; none of the 621 infants who was born after elective induction developed respiratory distress syndrome, and only one weighed less than 2,500 gm.     

Psychodiagnosis of axis II

The DSM-III method of diagnosing Axis II personality disorders is reviewed, and the following points are emphasized, (a) Axis II uses a categorical system for diagnosing personality disorders, but the advantages of a dimensional system appear to outweigh the categorical approach. Two alternative dimensional models are discussed (i.e., Millon's three dimensions of active-passive, self-other, and pleasure-pain and Leary's interpersonal circumplex), and research suggestions are presented, (b) Axis II is inconsistent in the extent to which it is based on a classical or a prototypic model of categorization. Implications of a prototypic typology for testing hypotheses concerning specific etiology and treatment and for determining relative diagnostic efficiency, are presented, (c) An innovative feature of DSM-III is the use of explicit and fixed rules to increase the reliability of diagnosis. Fixed rules, however, can decrease diagnostic efficiency when the cut-off points for diagnosis are not adjusted for the local base rates. Furthermore, while it is acknowledged that operational definitions increase reliability, increased reliability can result in decreased validity. An alternative to operational definitions is the use of multiple methods of measurement of constructs convergent and divergent to the hypothetical construct in question.     

Paroxysmal ventricular tachycardia in Wolff-Parkinson-White syndrome: Case report and review of the literature

A case with Type A Wolf f-Parkinson-White pattern and recurrent sustained ventricular tachycardia is presented. Because of ventricular pre-excitation, electrocardiographic clues suggestive of ventricular tachycardia were ignored and the diagnosis of supraventricular tachycardia with conduction to the ventricles over the accessory pathway was made during reach admission to the hospital. Ventricular tachycardia was suspected only when programmed stimulation studies performed twelve years after initial presentation and many hospitalizations failed to induce a tachycardia with a QRS pattern similar to that of spontaneously occurring tachycardia. The diagnosis of ventricular tachycardia was later confirmed by intracardiac recordings made during a spontaneous episode of tachycardia. Tachycardia was unresponsive to all conventional antiarrhythmic agents but was controlled with amiodarone.The differential diagnosis of wide QRS complex tachycardia in patients with Wolff-Parkinson-White syndrome, the implications of correctly diagnosing the tachycardia, and the usefulness of intracardiac electrophysiologic studies in differentiating supraventricular tachycardia with aberrant conduction from ventricular tachycardia are discussed.     

Management of Ascending Aortic Aneurysm Complicating Coarctation of the Aorta

Four patients with coarctation of the aorta complicated by an aneurysm of the ascending aorta are described. One patient, treated only medically, died suddenly. For the 3 patients who underwent operation, management was similar. Pharmacological control of blood pressure and repair of the aortic coarctation to achieve anatomical reduction in afterload (stage I) were followed after an interval of one to five weeks by surgical repair of the ascending aortic aneurysm (stage II).Initial repair of the coarctation relieves proximal hypertension, thereby decreasing the chance of progressive dissection or rupture of the aneurysm. It also permits safe arterial cannulation for perfusion during correction of the aneurysm in the second stage. In patients not requiring valve replacement in stage II, continued long-term follow-up for progression of aortic valvular disease appears to be necessary.     

Induction and potentiation of lethal and genetic effects of ultraviolet light by tobacco smoke condensates in yeast

Tobacco smoke condensates (TSC) were tested for DNA repair inhibition in both repair proficient and different classes of repair deficient strains of Saccharomyces cerevisiae. TSC was also tested for induction and potentiation of mutations and mitotic gene conversion in unirradiated and uv-irradiated yeast cells. TSC was found to sensitize all the strains of yeast to uv-inactivation indicating that it acts in a nonspecific manner and does not specifically inhibit a particular repair pathway. Genetic studies showed that TSC, without exogenous metabolic activation, failed to produce mutations while it induced mitotic gene conversion in the diploid strain. At specific concentrations, TSC potentiated both mutagenic and gene convertogenic effects uv-light while at higher concentrations of TSC a reduction of mutations was observed. The results are discussed as they relate to carcinogenesis and cocarcinogenesis/tumor promotion.