The Israeli Maternal Perinatal Database: methods and preliminary evaluation

The Israel Maternal Perinatal Database (IMPD) includes the 1980–92 birth cohorts and was created using deterministic linkage, based on a unique identity number. This number is assigned at birth for Israeli-born infants and upon acquiring permanent or temporary residential status for immigrants and is used widely. The IMPD includes ≈1.3 million births and about 400000 mothers with more than one birth, 40 000 mothers with more than three births and 20 000 grand multipara mothers with four births or more. The pretest-based estimates of incorrectly matched births are 2%. The expected percentage of underlinkage is 5–10% for births occurring before 1985. Since 1985, incorrect maternal underlinkages result only when a birth occurs out of Israel to an Israeli resident. One of the advantages of the IMPD is the ability to estimate linkage reliability, validity and censoring effects by comparison with an external data source, the National Population Register, which groups each mother with all her living children under the age of 18 years. One of the potential analysis pitfalls is the effect of censoring at entry as a result of influx of immigrants from the former Soviet Union and Ethiopia.     

An anaphylactic reaction to succinylcholine. A clinical case

A case of severe anaphylactic reaction provoked by suxamethonium during the induction of general anaesthesia is reported. Diagnosis of reaction and the trigger effect of suxamethonium was identified by intradermal testing. Diagnosis of anaphylactic reaction was confirmed on serial blood estimations of IgE and C3-C4 of complement fractions.     

A noninvasive method of predicting pulmonary-capillary wedge pressure.

BACKGROUND. The noninvasive prediction of pulmonary-capillary wedge pressure (PCWP) is important for the recognition and treatment of a variety of cardiovascular disorders. The response of the arterial pressure to the Valsalva maneuver has been shown to correlate with the PCWP. We therefore devised a noninvasive method to measure this pressure response at the bedside and correlated these measurements with the PCWP measured directly with a pulmonary-artery catheter. METHODS. Simultaneous, blinded, noninvasive measurements of the ratio of the final amplitude to the initial amplitude of the pulse wave form during the stress phase of the Valsalva maneuver (pulse-amplitude ratio) and direct measurements of the PCWP were obtained in 20 clinically stable patients and in 14 clinically unstable patients who were receiving vasoactive agents, 12 of whom also had endotracheal tubes in place. RESULTS. Using linear regression analysis, we found that the pulse-amplitude ratio strongly correlated with the measured PCWP over a range of base-line values from 4 to 32 mm Hg for the 20 clinically stable patients (R2 = 0.80) and the 14 clinically unstable patients (R2 = 0.85). The method also correctly predicted changes in the PCWP after the administration of nitroglycerin or furosemide and after expansion of the intravascular volume (R2 = 0.79). CONCLUSIONS. These preliminary data indicate that a simple noninvasive method can accurately predict the PCWP and changes in the PCWP in response to medical therapy.     

Vulvar papillary hidrocystadenoma. Description of a case]

Papillary hidradenoma of the vulva is a benign neoplasm arising from apocrine sweat glands of the skin. The treatment of choice is local excision. The prognosis for the patient is excellent. We present one case observed recently.     

Role of aminophylline and allopurinol in the reformation of peritoneal adhesions

The role of aminophylline in the re-formation of peritoneal adhesions was considered in 23 rats. Since the adhesions were obtained, the animals were subsequently divided into three groups, the first one containing seven units, the others containing eight animals each. During the four days prior the surgery, allopurinol at the dose of 50 mg/kg/die was added to the regular ground laboratory chow in the animals of the second group; aminophylline at the dose of 40 mg/kg/die was administered four hours and immediately prior the surgery, to the animals of the third group. The adhesions that we observed, were graded and evaluated assigning them a score. At the moment of the lysis of adhesions, we observed the score of 2.71 +/- 1.11 in the first group, 3.12 +/- 1.13 in the second group, and 2.75 +/- 1.03 in the third one. Matching each group one another no statistically significant difference was found. At the end the experiment, we observed a score of 3.71 +/- 0.49 for the adhesions in the first group, 2 +/- 0.75 in the second group, and 3.87 +/- 0.35 in the third one. Matching these scores with those observed at the moment of their lysis, they appeared significantly higher in the animals of the first group (p less than 0.02) and of the third group (p less than 0.05), but they were lower in the second group (p less than 0.05). Such results indicate that the re-formation of peritoneal adhesions following their lysis is constant, that allopurinol decreases the intensity of the process, while aminophylline increases it.     

Periaqueductal grey CB1 cannabinoid and metabotropic glutamate subtype 5 receptors modulate changes in rostral ventromedial medulla neuronal activities induced by subcutaneous formalin in the rat

This study was undertaken to analyze the involvement of periaqueductal gray (PAG) cannabinoid or group I metabotropic glutamate receptors in the formalin-induced changes on the rostral ventromedial medulla (RVM) ON- and OFF-cells activities. S.c. injection of formalin into the hind paw produced a transient decrease (4-6 min) followed by a longer increase (25-35 min) in tail flick latencies. Formalin also increased basal activity in RVM ON-cells (42+/-7%) and decreased it in OFF-cells (35+/-4%). Intra-PAG microinjection of (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl) pyrrolo[1,2,3-de]-1,4-benzoxazin-6-yl]-1-naphthalenylmethanone mesylate (WIN 55,212-2) (2 nmol/rat), a cannabinoid receptor agonist, prevented the formalin-induced changes in RVM cell activities. Higher dosages of WIN 55,212-2 (4-8 nmol/rat) increased the tail flick latencies, delayed the tail flick-related onset to ON-cell burst, and decreased the duration of OFF-cell pause. Furthermore, WIN 55,212-2 at a dosage of 8 nmol/rat decreased RVM ON-cell (57+/-7%) and increased OFF-cell ongoing activities (26+/-4%). These effects were prevented by N-piperidino-5-(4-chlorophenyl)-1-(2,4dichlorophenyl)-4-methyl-3-pyrazolecarboxamide SR141716A, (1 pmol/rat), a CB1 cannabinoid receptor antagonist, or by 2-methyl-6-(phenylethynyl)pyridine (MPEP 20 nmol/rat), a selective mGlu5 glutamate receptor antagonist. T7-(hydroxyimino) cyclopropa[b]chromen-1alpha-carboxylate ethyl ester (CPCOOE/50 nmol/rat) and (S)-(+)-alpha-amino-4-carboxy-2-methylbenzeneacetic acid (LY367385, 20 nmol/rat), selective mGlu1 glutamate receptor antagonists, were ineffective in preventing the WIN-induced effects. This study suggests that s.c. injection of formalin modifies RVM neuronal activities and this effect is prevented by PAG cannabinoid receptor stimulation. Moreover, the physiological stimulation of PAG mGlu5, but not mGlu1 glutamate receptors, seems to be required for the cannabinoid-mediated effect.     

ErbB2 and the antimetastatic nm23/NDP kinase in regulating serum induced breast cancer invasion

The erbB2 gene is often found amplified and/or overexpressed in breast cancer in which it has clinical relevance as prognostic and predictive factor. It is involved in growth regulation and has a role in the initial phases of cell proliferation, while in vivo and in vitro studies have suggested an involvement also in cell invasion and metastases. It is not clear if these two roles are mutually exclusive and little is known about the mechanisms by which erbB2 may be involved in the control of these processes. Our previous data on patient series suggested that erbB2 might be regulated in different ways depending on the neoplastic status of the cells and that it might be involved in different regulatory pathways. To test this hypothesis we have measured the serum-dependent regulation of erbB2 as a function of the expression of the antimetastatic gene, nm23, in a panel of breast cancer cell lines. The experimental model consisted of three cell lines having different proliferative and invasive potentials: a non-metastatic estrogen receptor (ER) positive cell line, MCF-7; a highly metastatic ER negative cell line, MDA-MB435; and the MDA-MB435 cell line transfected with the nm23-H1 antimetastatic gene (clone H1-177) which has lost the ability to invade and metastasize. We first analysed the serum concentration dependence of invasion and proliferation after 3-4 days of serum deprivation confirming the proliferative and invasive potential of the three cell lines. Modulation of erbB2 expression by different concentrations of serum was then studied. ErbB2 expression in MCF-7 cells showed a complex pattern due to serum modulation, whereas, it was not longer regulated by serum in the MDA-MB435 cell line. In H1-177 cells the erbB2 response to serum was restored and it was very similar to that observed in MCF-7. These data showed a tight association between nm23 and the regulation of erbB2 expression by serum factors suggesting that the role of erbB2 in invasion might be dependent on nm23 expression.