Gall bladder volume and serum bile acids in cholestasis of pregnancy

Summary. Gall bladder volume was measured by ultrasound in eight patients with cholestasis of pregnancy, in 21 normal pregnant women and in 14 non-pregnant women, and at the same time serum cholic and nodeoxycholic acid levels were estimated. The gall bladder volume was 60% larger in cholestasis than that in normal pregnancy and more than two times larger in normal pregnancy than in non-pregnant women. The serum cholic and chenodeoxycholic acid concentrations were significantly higher in cholestasis of pregnancy than those in normal pregnancy.     

Effects of a chlorhexidine-fluoride-strontium rinsing program on caries, gingivitis and some salivary bacteria among Finnish school children

Abstract – In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine-fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (GXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid-NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, GXF, GXFS, and GX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81–38; GXF, 88–42; GXFS, 89–56; GX, 89–37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine-fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.     

Morbid Obesity,Gastric Plication and a Severe Neurological Deficit

ABSTRACT. SomerH, BergstrÖm L, Mustajoki P, Rovamo L. (Department of Neurology, Third Department of Internal Medicine and Children's Hospital, University of Helsinki, Helsinki, Finland.) Morbid obesity, gastric plication and a severe neurological deficit. A 39-year-old man had protracted vomiting after gastric plication for morbid obesity. Within three months he lost 53 kg in weight and developed neuromuscular weakness, especially in the lower extremities. Clinical and laboratory studies suggested both radicular and peripheral neuropathy. One year later the condition was only marginally improved: he took only few steps unsupported. The apparent etiology is malnutrition but the primary cause remained unknown.     

Labetalol does not alter the placental and fetal blood flow or maternal prostanoids in pre-eclampsia

Summary. The effect of intravenously administered labetalol (1 mg/kg) on placental and fetal blood flow was studied in 13 pre-eclamptic women. Although the maternal blood pressure decreased, no changes occurred in the blood flows in the intervillous space, the umbilical vein or the fetal descending aorta, nor did the indices of peripheral vascular resistance in the fetal aorta change, but the placental vascular resistance did decrease. Labetalol had no effect on prostacyclin or thromboxane A₂ as measured by urinary 6-keto-prostaglandin F_1α and serum thromboxane B₂ respectively. These findings are clinically relevant since they suggest that labetalol reduces maternal blood pressure without interfering with the placental or fetal blood flow.     

Multiple caesarean sections: outcomes and complications

Summary. The outcome and complications of caesarean section were compared between 64 women who had had between three and eight previous sections (mean four) and 61 women sectioned for the first or second time. Gestational age was slightly less in the group with multiple operations. Of the women with three or more previous sections 27% had developed a fenestration in the transverse uterine scar; this was symptomless in half of them, and there was no associated severe ante- or intrapartum haemorrhage. Operation time was longer in women with multiple caesarean sections, and 13% required a caesarean hysterectomy. There were no other differences in the operative or postoperative courses between the two groups. In most women who have had multiple caesarean sections it is possible to wait for elective delivery until the fetus is mature. No absolute upper limit for the number of repeat caesarean sections can be given.     

NUCLEAR MORPHOMETRY AS A PREDICTOR OF DISEASE OUTCOME IN GASTRIC CANCER

Nuclear morphometric features including nuclear area (NA), nuclear perimeter (PE), their variation (SDNA, SDPE), and mean largest and smallest nuclear diameters (Dmax, Dmin) were examined in 116 patients with stage I–II gastric adenocarcinoma. Morphometric measurements were compared with tumour differentiation, depth of invasion (pT), lymph node status (pN), and Lauren classification. All morphonuclear features were significantly larger in the intestinal type than in the diffuse type of cancer. None of the morphometric variables was related to TNM status or tumour size. Nuclear area and perimeter and their variation were closely related to survival in univariate analysis, patients with small and regular nuclei surviving longer. In the multivariate analysis, pT, pN, perineural invasion, and the standard deviation of nuclear perimeter (SDPE) were independent predictors of survival. Nuclear morphometry is a quantitative, objective, and highly reproducible method of revealing malignant features in several neoplasms. The results of the present study suggest that nuclear morphometric data may help in defining prognosis in gastric cancer. © 1997 by John Wiley & Sons, Ltd.     

METOCLOPRAMIDE-INDUCED HYPERPROLACTINAEMIA: EFFECTS ON CORPUS LUTEUM FUNCTION, ENDOMETRIAL STEROID RECEPTOR CONCENTRATIONS AND 17β-HYDROXYSTEROID DEHYDROGENASE ACTIVITY

Induced hyperprolactinaemia impairs ovarian follicular development, especially during the recruitment period. The consequences of hyperprolactinaemia during the luteal phase alone on corpus luteum function have not been characterized, nor have the actions of excessive circulating PRL on the endometrium. In this study, postovulatory 5-d administration of metoclopramide (MC) increased serum concentrations of PRL and decreased those of pregnenolone and progesterone indicating inhibition of steroidogenesis in the corpus luteum. This effect may partly explain the relatively common failure of implantation in association with induced ovulation using regimens leading to transient hyperprolactinaemia. In contrast to this, MC-induced hyperprolactinaemia during the mid-follicular (4 d) or early luteal phase of the cycle did not alter the concentrations of cytosol or nuclear oestrogen and progestin receptors or the activity of 17 beta-hydroxysteroid dehydrogenase in endometrial tissue. Thus, transiently elevated circulating PRL does not seem to have direct effects on female sex steroid receptors or their function in the proliferative or secretory endometrium.     

Glucose Intolerance and Insulin Resistance Accompany Immobilization

ABSTRACT. Physical activity is known to increase glucose tolerance and insulin sensitivity. To examine the influence of physical inactivity on insulin sensitivity, we measured oral glucose tolerance (OGTT) and insulin response to glucose in 18 patients immobilized to bed for six weeks after acute spine fracture. The results were compared to those of nine chronically immobilized spinal cord injury patients and to eight healthy mobile controls. During the first week after trauma both glucose and insulin responses in the OGTT were two- to three-fold above normal (p<0.01). The index of insulin resistance (glucose area × insulin area) was seven-fold greater than in healthy controls (p<0.001). After three weeks' immobilization insulin resistance had declined by 30–35% (p<0.05) being then at the level observed in chronically immobilized subjects. After remobilization the insulin resistance was further decreased but remained still 2.3 times higher than in controls. Thus, trauma causes a manifold increase in insulin resistance, which is reduced but not normalized during the subsequent immobilization and remobilization.     

Comparison of polyclonal and monoclonal antibodies to Actinomyces and Arachnia species

Abstract – Polyclonal (PoAbs) and monoclonal (MoAbs) antibodies were produced to Actinomyces israelii serotypes 1 and 2, to Actinomyces naeslundii, and to Arachnia propionica, and their specificities were studied by an enzyme immunoassay (EIA). All PoAbs except those to A. propionica reacted also with at least one other Actinomyces species. Only the MoAb to A. naeslundii proved to be more specific than the corresponding PoAbs. This MoAb did not cross-react with other Actinomyces or Arachnia species, nor with any other anaerobic or aerobic bacteria studied by inhibition EIA. Immunoblotting studies indicated that the antibody specific to A. naeslundii is directed against a large molecular weight antigen (>150 kd), probably polysaccharide in nature. The produced PoAbs and MoAbs can be used for further analyses of the antigenic determinants of different Actinomyces and Arachnia species.