How I was almost aborted: reflections on a prenatal brush with death.

After recently meeting with his biological parents, the author--a 29-year-old-married male--learned he had been an hour away from being aborted, being 'saved' only by extraordinary circumstances. In the paper the author reflects upon previous strong pro-choice beliefs and reasserts his commitment to a pro-choice philosophy, integrating his new personal experience. The paper pays particular attention to the biological mother's experience and how her fresh insights have reinforced the author's views on abortion.     

Reversed vein graft stenosis: early diagnosis and management.

Conscientious surveillance of intrainguinal bypass grafts is mandatory to detect vein graft stenoses, which, if uncorrected, can lead to graft occlusion. It is now widely accepted that noninvasive vascular laboratory studies are the best way to detect these lesions. However, controversy still exists over treatment, specifically whether balloon angioplasty is an acceptable substitute for surgery (patch angioplasty or short jump grafts) in the treatment of these lesions. We have always favored balloon angioplasty as primary treatment and have summarized our experience with treating 72 stenotic reversed femoropopliteal and femorotibial vein grafts, which represent 12% of 521 bypass grafts performed at our institution. Prosthetic and in situ grafts are specifically excluded from this report, as well as occluded grafts, found to have stenotic lesions after lytic therapy. The most common stenotic lesion occurred within 4 cm of the proximal anastomosis (29/72 = 40%). The other sites were near the distal anastomosis (7/72 = 10%), and in the middle of the graft (15/72 = 12%). Eighty-one percent (58/72) of the lesions were treated initially by balloon angioplasty with a 31% recurrence. Twenty-nine percent of the 14 grafts treated surgically by vein patch angioplasty or short jump grafts experienced recurrence. Overall 61% (44/72) of the stenotic grafts were treated by balloon angioplasty alone. The 5-year life-table assisted primary patency after correction of the stenotic lesion was 61%. The patency of the grafts from the time of initial bypass surgery, however, was 80%. Location of the stenosis within the graft was a major determinant of patency. Lesions in the proximal graft, proximal anastomosis, and distal graft taken as a group had significantly better patency than the midgraft and distal anastomotic lesions (5-year patency, 65% vs 48%, p less than 0.001 log rank test). We continue to recommend balloon angioplasty as primary therapy for vein graft stenosis except for those occurring in the midgraft and distal anastomosis. Fortunately, this group accounts for only 36% of lesions seen with reversed veins. Recurrent stenosis after balloon angioplasty should be repaired surgically.     

Decrements in vigilance and cognitive functioning associated with ragweed-induced allergic rhinitis.

BACKGROUND AND OBJECTIVE: The adverse effects of untreated seasonal allergic rhinitis (AR) on performance in the workplace, school, and home are poorly understood. To delineate more clearly the impact and consequences of the disease on performance, the effect of symptomatic AR on vigilance and a wide range of cognitive functions was investigated. METHODS: A battery of automated neuropsychological tests was administered to asymptomatic adult subjects with histories of AR. Subjects were randomized to either a symptomatic or to an asymptomatic group. Subjects in the symptomatic group were exposed to ragweed pollen in a controlled exposure setting until they demonstrated predetermined severities of AR symptoms. Subjects in the asymptomatic group were not exposed to ragweed pollen in the environmental unit and retained a minimum symptom profile. The battery of cognitive measures was re-administered to both groups. RESULTS: AR had major adverse impacts on measures of vigilance. Further, AR adversely affected a broad range of cognitive functions. Specifically, subjects with AR symptoms demonstrated longer response times and decreased efficiency on measures of working memory, psychomotor speed, reasoning/computation, and divided attention as compared with asymptomatic subjects. CONCLUSIONS: In addition to decreased vigilance, AR was associated with decrements in speed and efficiency across several cognitive domains. This is similar to findings in research on medications and medical conditions that cause sedation. Findings may represent a link between AR and poor productivity/personal safety among AR sufferers. This suggests that these results have implications with regard to public health.     

Post-translational processing of thyrotropin-releasing hormone precursor in rat brain: identification of 3 novel peptides derived from pro TRH

The sequence of rat hypothalamic pro-thyrotropin releasing hormone, deduced by sequencing of cDNA, in addition to 5 TRH progenitor genitor sequences contains leader, trailer and 4 intervening sequences separated by paired basic amino acid sequences. We have developed radioimmunoassays to synthetic peptides corresponding to portions of these cryptic proTRH sequences and have used these assays to identify and partially characterize proTRH peptides, distinct from TRH, in extracts of rat brain. Two of these peptides correspond closely in size to one intervening sequence and the car☐y-terminal sequence of proTRH. Three other peptides correspond to the intact amino-terminal leader sequence and two peptides formed by a further cleavage of the leader sequence at an internal paired basic amino acid sequence.     

Immunological blockade of endogenous thyrotropin-releasing hormone impairs recovery from hyperglycemia in mice

Administration of antiserum to thyrotropin-releasing hormone (TRH) into the lateral cerebral ventricle of mice significantly attenuated recovery from hyperglycemia induced by treatment with 2-deoxyglucose but had no effect on the plasma glucose of saline-treated mice. TRH, injected centrally together with the anti-TRH antibody, reversed the effect of the antiserum and blocked the development of hyperglycemia. These findings suggest that activation of TRH neurons in the central nervous system may be a physiological event influencing recovery from hyperglycemia.     

Congratulation on World Journal of Gastroenterology

Dear Professor Lian-Sheng Ma, Professor Michael Hobsley and I have greatly enjoyed reading the account of all you have done towards the development of "The World Journal of Gastroenterology", as described in the article by Zhen-Xi Li in the November 21st. Issue of the Journal.