bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular and cortisol responses to a psychological stressor during pregnancy
Authors: DE WEERTH CAROLINA , GISPEN‐DE WIED CHRISTINE C. , JANSEN LUCRES M.C. , BUITELAAR JAN K.
Published: September 2007

Background. The goal of this study was to describe the physiological reactions of pregnant women confronted with an experimental psychosocial stressor, and to determine whether the protocol is adequate for stress testing during pregnancy. Methods. Healthy primiparae (n = 120) took part in a public speaking and mental arithmetic test. Results. The protocol was found to induce significant increases in saliva cortisol, systolic and diastolic blood pressure and heart rate. The physiological reactions were relatively large compared to those of earlier published studies using physical and psychological stressors during pregnancy, but comparable or slightly lower than those of a group of non‐pregnant participants (n = 31) tested with a similar protocol. Also, inter‐individual variability in reactivity was found, with subjects differing substantially in the magnitude of their reactions to the experimental situation. The cardiovascular responses were correlated to each other and to the overall level of cortisol during the test. Finally, reactivity showed circadian variations with cortisol and systolic blood pressure reactions significantly different (i.e. smaller or even absent) in subjects tested in the morning compared to those tested in the afternoon. Testing in the afternoon hours is recommended. Conclusions. The protocol described in this paper appears to constitute an adequate tool for studying differences in maternal stress reactivity during pregnancy, and as such, can be valuable for studies on maternal prenatal stress.
Alterations in the ‘local umbilical cord blood renin‐angiotensin system’ during pre‐eclampsia
Authors: ACAR KADIR , BEYAZIT YAVUZ , SUCAK AYHAN , HAZNEDAROGLU IBRAHIM C. , AKSU SALIH , TUNCER SERDAR , OZTURKKAN DEMET , DANISMAN NURI , PURNAK TUGRUL , MISIRLIOGLU MUGE , KEKILLI MURAT , MOLLAMAHMUTOGLU LEYLA
Published: September 2007

Background. Local autocrine‐paracrine renin‐angiotensin system (RAS), independently functioning from the circulating RAS, is present in major organs of the female reproductive tract. We have previously demonstrated ‘a local RAS in human umbilical cord’ via verifying the corresponding ACE, renin, and angiotensinogen mRNAs. The aim of this study is to search alterations of the local umbilical cord RAS during pre‐eclampsia. Methods. Cord blood samples were obtained from 19 patients with pre‐eclampsia (aged mean 26.60±5.83 (range 18–42) years) and 20 women with normal pregnancy (aged mean 28.26±7.30 (range 19–37) years). Women with uncomplicated pregnancy formed the control group. Real time quantitative PCR analysis for ACE, renin and angiotensinogen gene expressions were carried out using a LightCycler™ instrument. Results. The mean expression ratios were 0.0029±0.0015 for renin, 0.153±0.166 for angiotensinogen, and 0.220±0.294 for ACE, in control samples. The mean expression ratios of pre‐eclamptic patients were 0.0061±0.00068, 0.035±0.008, and 0.030±0.006 for renin, angiotensinogen and ACE genes, respectively. While renin expressions increased in the local cord blood of pre‐eclampsia in comparison to the normal cord blood, unpredictable decrements in the angiotensinogen and ACE expressions were observed within the same pre‐eclamptic samples. There were no statistically significant differences between intrauterine growth restriction (IUGR) and appropriate for gestational age (AGA) newborns in respect to renin, angiotensinogen and ACE gene expressions. Conclusions. These findings indicate that the gene expression in the major components of the local RAS does not represent a constant mathematical model, but is affected from the ongoing pathobiological events associated with the disease course. Local umbilical cord blood RAS alterations at the basis of genetic expression are evident in pre‐eclampsia.
Sulforaphane induces growth arrest and apoptosis in human ovarian cancer cells
Authors: CHUANG LINUS T. , MOQATTASH SATEI T. , GRETZ HERBERT F. , NEZHAT FARR , RAHAMAN JAMAL , CHIAO JEN‐WEI
Published: September 2007

Objectives. Isothiocyanates (ITC) from broccoli and other cruciferous vegetables have long been shown to have chemopreventive properties, as demonstrated in cancer models in rodents. Sulforaphane (SFN) is a major ITC present in broccoli. We examined the effects of SFN on the growth of the OVCAR‐3 and SKOV‐3 ovarian carcinoma cell lines. Methods. Cell cycle phase determination was performed using a Coulter flow cytometer. DNA strand breaks in apoptotic cells were measured by terminal deoxynucleotidyl transferase‐mediated biotinylated UTP nick end‐labelling (TUNEL). Results. There was a concentration dependent decrease in cell density. Approximately 50% decrease was observed after 48h of incubation with SFN (2 μM). Analysis of cell cycle phase progression revealed a decrease in the cell populations in S and G2M phases, with an increase of G1 cell population, indicating a G1 cell cycle arrest. The degree of decrease in the replicating population was concentration and time dependent. Incubation of OVCAR‐3 cells in cultures with concentrations of 2, 10 and 50μM of SFN showed 6, 8 and 17% apoptosis, respectively. In addition, when OVCAR‐3 cells were exposed to SFN for various time periods (1, 2 or 3 days), the percentage of cells undergoing apoptosis was directly proportional to the incubation period. In this regard, while 18% of the cells underwent apoptosis after 2 days, 42% of the cells showed apoptosis after 3 days of incubation. Conclusions. These results clearly demonstrated an effect of SFN in inducing growth arrest and apoptosis in ovarian carcinoma cell lines.
Correlations between unsatisfactory colposcopy, cytology, and biopsy in patients with cervical abnormalities
Authors: LAMBERT B. , LEPAGE Y.
Published: September 2007

Background. The main purpose of this study is to review the clinical features of negative loop electrosurgical procedure (LEEP)‐cones, in order to lower their rate. Methods. Some 162 patients with LEEP‐cones were reviewed. Control cytology, satisfactory‐unsatisfactory colposcopy, biopsies and endocervical curettage (ECC) were compared to the presence or absence of cone pathology. Statistical analysis, t‐tests and Pearson χ2 tests were performed, with a significance level of p<0.05. Results. Negative cones are associated with unsatisfactory colposcopy in 47/60 cases (78.3%) compared to 13/60 (21.8%) for satisfactory colposcopy (p = 0.011). Unsatisfactory colposcopy is associated with a negative ECC in 53/74 (71.6%) cases, compared to 21/74 (28.4%) for satisfactory colposcopy (p = 0.024). Finally, negative ECC are associated with negative cones in 32/41 (78%) compared to 9/41 (22%) for positive ECC (p = 0.002). Conclusions. Low grade cytology, CIN1 biopsies and ECC should be followed for at least 1 year. This results in a lowering of cone negativity from 60/162 (37%) to 32/162 (19.8%).
Does childbirth after fertility treatment influence sense of coherence? A longitudinal study of 1,934 men and women
Authors: HABROE MARIA , SCHMIDT LONE , EVALD HOLSTEIN BJØRN
Published: September 2007

Background. Infertility is a severe, stressful experience. Sense of coherence (SOC) is an individual attribute which reflects the ability to resist severe strain. According to Antonovsky, SOC is stable throughout adulthood, but there is little empirical evidence to support this. In a prospective study, we focused on 2 research questions: (i) Does childbirth after assisted reproductive technology (ART) result in high SOC? (ii) Does the level of SOC at baseline influence the association between childbirth after ART and SOC at 1‐year follow‐up? Methods. The study included a consecutive sample of patients in ART from a prospective, longitudinal survey in Denmark; baseline response rate 80.0%, 1‐year follow‐up 87.7% (n = 1,934). The dependent variable was SOC at 1‐year follow‐up measured by Setterlind's 9‐item scale. The independent variable was having achieved childbirth after ART. Data were analysed by logistic regression analysis adjusted for baseline SOC. Results. Having achieved childbirth after ART was associated with higher SOC at 1‐year follow‐up (women OR=1.81, 95% CI: 1.20–2.74; men OR = 1.27, 95% CI: 0.88–1.86). Unexpectedly, the association between achieving childbirth after ART and high SOC at 1‐year follow‐up was significant among women who had low SOC at baseline. There was no association among participants with high SOC at baseline. Conclusions. The study indicated that SOC is not necessarily stable throughout adulthood, since a successful outcome of ART among women was associated with a significant increase in SOC.
Postmenopausal endometriosis
Authors: OXHOLM DORTHE , KNUDSEN ULLA BRETH , KRYGER‐BAGGESEN NIELS , RAVN PERNILLE
Published: September 2007

Background. Postmenopausal endometriosis is rare. The purpose of this presentation is to give a review of the topic based on existing literature. Methods. A Medline search concerning postmenopausal endometriosis was carried out. Hormone therapy and risk of malignancy in these patients are discussed. Results. Some 32 case reports on postmenopausal endometriosis were found. The most common location is in the ovaries. Estrogens stimulate endometriosis. There is a risk of recurrence or de novo occurrence of endometriosis after the menopause in patients who take hormone therapy (HT); especially estrogen only therapy (ET). So far, treatment has primarily been surgery (hysterectomy (TAH) and bilateral oophorectomy (BSO)). There is little experience with medical treatment (aromatase inhibitors). The risk of malignant transformation of premenopausal endometriosis is around 1%. Furthermore, patients with endometriosis have an increased risk of ovarian cancer, and, apparently, other malignancies. The risk of malignant transformation appears to be further elevated in patients who take ET, although this subject is not fully elucidated. Conclusions. Although the condition is rare, it is important to be aware of endometriosis after the menopause. Postmenopausal endometriosis infers a risk of recurrence and malignant transformation. Although solid evidence is lacking, the risk of malignant transformation appears to be lower during combined HT compared to ET. Thus, hormone replacement therapy should generally be reserved for patients with severe climacteric complaints, and if indicated, combined therapy should be used.
Reliability of an automatic ultrasound system for detecting postpartum urinary retention after vaginal birth
Authors: LUKASSE MIRJAM , RENÉ CEDERKVIST HENRIK , ARNE ROSSELAND LEIV
Published: September 2007

Background. Urinary retention is a common postpartum condition which may lead to short‐ and long‐term complications. Objective. To assess the reliability of a commercially available automatic bladder volume scanner in the puerperium, and to specifically identify women with a post‐void residual volume of 400ml or more. Methods. A prospective comparison of ultrasound estimated bladder volume and urine volume measurement after catheterisation in 100 women at risk for postpartum urinary retention (PUR) after vaginal delivery. Results. The mean difference between the ultrasound estimates and the catheter volume measurements was 26ml, with the corresponding 95% confidence interval (2.6, 49.4ml). The sensitivity and specificity for the scanner, using the clinically desired value of a 400‐ml threshold, are 0.76 and 0.96, respectively. With a perfect classification for sensitivity at a 300‐ml threshold, specificity may drop to about 50%. Even using this cut‐off point, the number of women catheterised would be reduced by half compared to a procedure of catheterising all women at risk for postpartum urine retention diagnosed by clinical judgment alone. Conclusion. The ultrasound scanner is a reliable screening instrument for detecting PUR after vaginal birth.
Longitudinal study of Doppler flow resistance indices of the uterine arteries after normal vaginal delivery
Authors: MULIC‐LUTVICA AJLANA , EURENIUS KARIN , AXELSSON OVE
Published: September 2007

Objectives. To measure Doppler flow resistance indices in the uterine arteries, and to observe when the early diastolic notches appear during the normal puerperium. Methods. Some 45 women took part in this prospective longitudinal study after normal, vaginal delivery. Ultrasound examinations were scheduled for days 1, 3, 7, 14, 28 and 56 postpartum. A transabdominal probe was used during the first two postpartum weeks, and a transvaginal probe for the later examinations. The pulsatility (PI) and resistance (RI) indices in the uterine arteries were measured, and the presence or absence of early diastolic notches was recorded. Results. Compared to day one, the resistance indices did not change markedly until day 28 postpartum. The mean PI was 1.23 at day 1, 1.22 at day 3, 1.22 at day 7, 1.33 at day 14, 1.81 at day 28, and 2.25 at day 56. The mean RI was 0.65 at day 1, 0.65 at day 3, 0.66 at day 7, 0.65 at day 14, 0.77 at day 28, and 0.84 at day 56. The presence of at least 1 uterine artery notch was found in 13.3% of the women at day 1, and in 90.6% at day 56 postpartum. Bilateral notches were recorded in 6.7% of the women at day 1, and in 84.4% at day 56 postpartum. Conclusion. Reference values of the resistance indices from uncomplicated puerperium are needed when the diagnostic efficacy of Doppler ultrasound for pathological conditions is to be tested. This study confirms that the time needed for the vascular physiology to revert from a pregnant to a non‐pregnant state appears to be longer than previously assumed.
Attitudes towards and management of single embryo transfer among Nordic IVF doctors
Authors: BERGH C. , SÖDERSTRÖM‐ANTTILA V. , SELBING A. , AITTOMAKI K. , HAZEKAMP J. , LOFT A. , NYGREN K.G. , WENNERHOLM U.B.
Published: September 2007

Background. The objective of this study was to investigate the attitudes towards and management of single embryo transfer (SET) among Nordic in vitro fertilisation (IVF) doctors, and to present the rate of SET and multiple pregnancies in the different countries. Methods. A questionnaire was sent to all IVF doctors in the Nordic countries (n = 198, 78.5% responded). Pregnancy rates, SET and multiple births rates were extracted from registries. Main outcome measure was attitudes and management of SET. Results. Almost all doctors thought that a twin pregnancy compared unfavourably to a singleton. A twin rate >10% was acceptable for 5% of Swedish doctors. Corresponding figures for Finnish, Danish and Norwegian doctors were 21, 35 and 35%, respectively. For a woman <36 years, performing her first cycle and with two good quality embryos, almost all doctors would recommend SET. For a woman ≥36 years in a similar situation, SET would be recommended only in Sweden and Finland. The pregnancy rate per embryo transfer (ET), the SET rate 2003, the multiple birth rate, and the estimated SET rate 2004 were 33.3, 21.5, 22.7 and 25% (Denmark), 31.3, 43.4, 14 and 51% (Finland), 40.5, 10.5, 26.5 and 16% (Iceland), 30.6, 18, 25.2 and 26% (Norway), and 35.3, 55.1, 11.8 and 71% (Sweden). Conclusions. The SET and multiple birth rates reflect the attitudes of Nordic IVF doctors to SET and multiple births well. When introducing SET, the attitude of the IVF doctor seems to be important.
The application of ‘endovaginal’ sonography during a laparoscopy‐assisted Vecchietti operation
Authors: CSERMELY TAMÁS , HALVAX LÁSZLÓ , VIZER MIKLÓS , TAMÁS PÉTER , KOVÁCS KÁLMÁN , GÕCZE PÉTER , SZABÓ ISTVÁN , SZILÁGYI ANDRÁS
Published: September 2007

Background. Many types of operations are described to create a neovagina in a patient with Mayer‐Rokitansky‐Küster‐Hauser (MRKH) syndrome, that sometimes result in injury of the surrounding organs. Many trials are detailed in the literature to avoid these complications. Our goal was to examine the benefit of ‘endovaginal’ sonography during a laparoscopy‐assisted Vecchietti operation to avoid bladder injuries. Methods. A neovagina was created in 15 women with MRKH syndrome by the method of Vecchietti assisted by laparoscopy. The method was modified with the use of ‘endovaginal’ sonography, in order to reduce bladder and rectal injuries. The vaginal ultrasound transducer, placed in front of the vaginal dimple, can guide penetration from the perineum into the peritoneal cavity. With this technique, the narrow space between the bladder and rectum can be well identified. Results. All operations were successful, without any complication, forming a well‐functioning 8–10 cm long neovagina, allowing easy introduction of two fingers in all cases, and with good quality of sexual life for the couples. Conclusion. Creation of a neovagina by any method in MRKH syndrome may sometimes result in injury of the bladder or rectum due to the narrow space between the bladder and rectum. The placement of the endovaginal ultrasound transducer in front of the vaginal dimple seems to be a promising method to avoid these complications during a laparoscopy‐assisted Vecchietti operation.
Diabetes and urinary incontinence – prevalence data from Norway
Authors: EBBESEN MARIT HELEN , HANNESTAD YNGVILD S. , MIDTHJELL KRISTIAN , HUNSKAAR STEINAR
Published: September 2007

Background. Few large epidemiological studies have investigated whether diabetes might increase the risk for, or cause greater severity of, urinary incontinence. The aim of the present study was to investigate the association between diabetes and urinary incontinence, including the possible influence of diabetes on the severity of incontinence. Methods. The study was a cross‐sectional, population‐based, study from the county of Nord‐Trøndelag, Norway, from 1995 to 1997. Data were collected by means of questionnaires, simple clinical measurements, and some blood tests. A total of 21,057 women, 20 years or older, answered the questions on both diabetes and incontinence, and 685 women were identified with diabetes. Results. The prevalence of incontinence among women with diabetes was 39% compared to 26% in women without diabetes. The women with diabetes had more urge and mixed incontinence. The associations between diabetes and urge incontinence (OR: 1.49; 95% CI: 1.03–2.16), mixed incontinence (OR: 1.32; 95% CI: 1.05–1.67), and severe incontinence (OR: 1.54; 95% CI: 1.21–1.96) were still significant after adjusting for age, body mass index, parity and smoking. Conclusion. We found a strong association between diabetes and urinary incontinence, especially for urge incontinence and severe degree of incontinence.
Surgical repair of posterior compartment prolapse: preliminary results of a novel transvaginal procedure using a four‐armed polypropylene mesh with infracoccygeal and pararectal suspension
Authors: GABRIEL BORIS , FARTHMANN JULIANE , BRINTRUP BERNHARD , FÜNFGELD CHRISTIAN , JEZEK PETER , KRAUS ALFONS , LENZ FLORIAN , KUMBIER EBERHARD , NIESEL ACHIM , STICKELER ELMAR , WATERMANN DIRK
Published: September 2007

Background. Anatomical defects of the posterior vaginal compartment are a common reason for pelvic floor reconstructive surgery. The implantation of a four‐armed monofilamentous polypropylene mesh with infracoccygeal and pararectal suspension is a recently introduced innovative technique, which is believed to reduce the risk of mesh retraction and prolapse recurrences, and additionally, allows a tension‐free adjustment of the mesh. Methods. In this preliminary case series, we aimed to evaluate feasibility, intraoperative complications and short‐term follow‐up results of this novel surgical procedure in a multicentre approach. Seventy‐three patients undergoing surgery for posterior vaginal compartment prolapse were enrolled. The mean follow‐up time was 3.8 months (range: 2–6 months), and follow‐up information was available in 60/73 (82.2%) women. Results. Intraoperative complications were observed in 4.2% of cases, 2 patients with blood loss >500 ml, and one bladder injury occurring during concomitant anterior compartment surgery. Importantly, there were no intraoperative complications directly related to the implantation technique (e.g. rectum perforations), and no prolapse recurrences at follow‐up examinations 3–6 months postoperatively. Our short‐term mesh erosion rate was 3.1%. Conclusions. We conclude that this innovative procedure is a feasible and safe technique for the treatment of posterior vaginal compartment prolapse. Further prospective and multicentre trials are warranted.
New Firm Formation — is VAT Registration Data an Accurate Indicator?
Authors: Ball John
Published: September 2007

This paper utilises a novel and original data set collected from a survey of entirely new firms in south Wales. It compares this survey with published VAT data to address the extent to which published VAT registration actually reflects the amount of new firm formation taking place. Using this survey and a chi square test, this article offers evidence of the deficiencies of published VAT data when used as a proxy for new firm formation and suggests caution in the use of VAT data.
New Labour's Evolving Regeneration Policy: The Transition from the Single Regeneration Budget to the Single Pot in Oxford
Authors: Brownill Sue
Published: September 2007

Regeneration policy under New Labour has been subject to a constant restlessness, evolving over time into a complex and diverse landscape. This paper explores how these policy changes have played themselves out in one city, Oxford, focusing on the transition from the Single Regeneration Budget initiative to the more regionally focused ‘single-pot’. In doing this it charts the continuing complexities in policy focusing on the tensions between the competitiveness and social inclusion agendas and around changed governance arrangements. It identifies the restructuring of activity around social inclusion towards more economic outcomes and the difficulties of retaining community voices within regeneration activity at the subregional level as two particular outcomes of these changes which require further responses from all sectors involved. The paper concludes that it is unhelpful to typify such changes as a shift from one policy era to another and instead argues for a focus on the complexities, continuities and contradictions that such change reveals.
‘The End of the Beginning’? Taking Forward Local Democratic Renewal in the Post-Referendum North East
Authors: Shaw Keith , Robinson Fred
Published: September 2007

In a referendum in November 2004, the people of the North East decisively rejected the proposal to create a directly elected Regional Assembly. This result effectively put an end to proposals for Regional Assemblies elsewhere as plans for referenda in other regions were consequently abandoned. Drawing upon detailed interviews with a wide range of stakeholders in the North East, this article assesses why the North East voted ‘No’ and argues that, despite the subsequent emergence of the city-region as an alternative framework for governance, what is still needed is a serious commitment to democratic renewal. Democratic connections between citizens and the state, between the taxpayer and public services, need to be rebuilt. Only a reinvigorated democracy can begin to dispel the cynicism and alienation that characterises the contemporary political process — and which was a main factor behind the ‘No’ vote in the referendum. Given the failure of political devolution at the regional level, genuine democratic renewal must now be taken forward at the local level.
Immune Complexes Mediate Rapid Alterations in Microvascular Permeability: Roles for Neutrophils, Complement, and Platelets
Authors: LISTER KARYN J. , JAMES WILL G. , HICKEY MICHAEL J.
Published: September 2007

Objective: Immune complex–induced responses involve multiple cellular and molecular mechanisms. However, how these pathways interact in the initiation of immune complex–induced response is poorly understood. Therefore the aim of this study was to investigate the immediate response of the microvasculature to immune complex formation.

Methods: The reverse passive Arthus (RPA) model was applied to the mouse cremaster muscle. Intravital microscopy was used to examine alterations in florescein isothiocyanate (FITC)‐dextran leakage from microvessels, and endothelial interactions of leukocytes and platelets in postcapillary venules.

Results: Immune complex deposition induced rapid increases in microvascular permeability and leukocyte adhesion and emigration. Inhibition of platelet‐activating factor (PAF) and leukotrienes inhibited the increase in permeability. Depletion of C3 reduced immune complex–mediated leukocyte recruitment and permeability, and a similar effect on permeability was observed following inhibition of leukocyte adhesion. Mast cell stabilization reduced increases in leukocyte adhesion and emigration but accelerated the increase in microvascular permeability. Platelet‐endothelial interactions also increased during the RPA response, and platelet depletion delayed the changes in permeability and inhibited leukocyte recruitment.

Conclusions: This study demonstrates that immune complexes induce a rapid induction of complement‐dependent leukocyte recruitment, and neutrophil‐dependent microvascular dysfunction. Furthermore, this study identifies a role for platelets in promoting immune complex‐induced leukocyte recruitment.
The Evolving Paradigm for Blood Cell‐Endothelial Cell Interactions in the Cerebral Microcirculation
Authors: GAVINS FELICITY , YILMAZ GOKHAN , GRANGER D. NEIL
Published: September 2007

Inflammation and microvascular dysfunction have been implicated in a variety of pathologic conditions affecting the brain. Features of the inflammatory response that are common to many of these pathological conditions and that are manifested in the neurovasculature include oxidative stress, diminished endothelial barrier function (increased vascular permeability), increased expression of endothelial cell adhesion molecules, and the recruitment of rolling and adherent leukocytes and platelets. The evidence implicating leukocyte–endothelial cell adhesion in cerebral microvessels as a rate‐determining component of the pathophysiology associated with conditions such as ischemia‐reperfusion, sickle cell disease, and γ ‐irradiation is summarized. Mechanisms that have been proposed to explain the recruitment of adherent leukocytes and platelets in the diseased/injured cerebral microvasculature are also addressed, and a common paradigm for blood cell recruitment induced by seemingly unrelated pathological conditions is outlined. Although there are many structural and functional characteristics of the cerebral microvasculature that distinguish it from other regional vascular beds, the processes that underlie the recruitment of injury‐causing inflammatory cells in the brain appear to closely resemble those described for other tissues.
Remote Microvascular Preconditioning Alters Specific Vasoactive Responses
Authors: FRAME MARY D. , MABANTA LAUREN
Published: September 2007

Objective: The mechanism by which remote microvascular preconditioning (RMP) response is initiated was recently reported (Am J Physiol 290:H264, 2006). The goal of this study was to further characterize RMP and to investigate the extent to which RMP altered local vasoactive responses.

Methods: Arteriolar networks were examined in the cheek pouch of anesthetized (pentobarbital, 70 mg/kg) hamsters (n = 143). RMP was initiated with nitroprusside (SNP) or adenosine (ADO) via micropipette to a downstream arteriole or via tissue bath. Upstream (∼ 800 μ m), at the entrance to the network, local vasoactive responses were obtained with local micropipette application.

Results: The RMP response requires 10 to 15 min to manifest, and cycles down with > 5 upstream challenges (local exposures). Without challenge, the response does not cycle down over 8 h. RMP results in enhanced dilation to SNP and attenuated dilation to ADO. SNP can initiate RMP with micropipette exposure to the local downstream arteriolar segment. ADO only initiates RMP with tissue bath exposure, but at low concentrations (10−8 M). RMP causes a shift in phosphodiesterase (PDE) maintenance of tone, as seen by using PDE inhibitors. This involves a shift from PDE4 to PDE3, and does not appear to affect PDE1 or PDE5.

Conclusions: These findings are consistent with RMP inducing a fundamental shift from cAMP and towards cGMP maintenance of dilatory tone.
Bioassay Chamber for Angiogenesis with Perfused Explanted Arteries and Electrospun Scaffolding
Authors: RUBENSTEIN DAVID , HAN DONG , GOLDGRABEN SARA , EL‐GENDI HEBAH , GOUMA PELAGIA‐IRENE , FRAME MARY D.
Published: September 2007

Objective: The purpose of this study was to test the hypothesis that explanted perfused arteries can serve as the initial endothelial cell culture source to evaluate the onset of angiogenesis in a cellulose acetate electrospun scaffold.

Methods: Electrospun scaffolds with fiber diameters roughly controlled in three broad ranges: 0.01 to 0.2, 0.2 to 1, and 1 to 5 μ m (Nanomed Nanotechnol Biol Med 2:37–41, 2006), were used in cell culture to determine which provides the best culture topology. This scaffold was then tested in a bioassay chamber whose cellular source was an explanted abdominal aorta from donated euthanized mice. Scaffolds were draped over a cannulated vessel perfused for 24 h. Cell viability, density, and morphology were quantified.

Results: The largest fiber diameter group provided the best culture topology for human umbilical vein endothelial cells, showing high cell viability and density, and enhanced elongated cell morphology. Addition of single‐walled carbon nanotubes decreased cell density significantly but chitosan heightened cell density and promoted spontaneous capillary tube like structure. Viability of endothelial cells increased with higher flow in the bioassay chamber.

Conclusions: Endothelial cells showed a growth preference towards larger diameter fibers. Addition of chitosan improved culture conditions. Thus, this study provides a proof of principle for the possibility of co‐culturing tissue engineered vascular networks from a perfused explant.
Ascorbate Inhibits Reduced Arteriolar Conducted Vasoconstriction in Septic Mouse Cremaster Muscle
Authors: MCKINNON REBECCA L. , LIDINGTON DARCY , TYML KAREL
Published: September 2007

Objective: The mechanism of neuronal nitric oxide synthase (nNOS)‐dependent reduction in arteriolar conducted vasoconstriction in sepsis, and the possible protection by antioxidants, are unknown. The authors hypothesized that ascorbate inhibits the conduction deficit by reducing nNOS‐derived NO production.

Methods: Using intravital microscopy and the cecal ligation and perforation (CLP) model of sepsis (24 h), arterioles in the cremaster muscle of male C57BL/6 wild‐type mice were locally stimulated with KCl to initiate conducted vasoconstriction. The authors used the ratio of conducted constriction (500 μ m upstream) to local constriction as an index of conduction (CR500). Cremaster muscle NOS enzymatic activity and protein expression, and plasma nitrite/nitrate levels were determined in control and septic mice. Intravenous ascorbate bolus (200 mg/kg in 0.1 ml of saline) was given early (0 h) or delayed at 23 h post CLP.

Results: Sepsis reduced CR500 from 0.73 ± 0.03 to 0.21 ± 0.03, increased nNOS activity from 87 ± 9 to 220 ± 29 pmol/mg/h and nitrite/nitrate from 16 ± 1 to 39 ± 3 μ M, without affecting nNOS protein expression. Ascorbate at 0 and 23 h prevented/reversed the conduction deficit and the increases in nNOS activity and nitrite/nitrate level. NO donor SNAP (S‐nitroso‐N‐acetylpenicillamine) reestablished the conduction deficit in ascorbate‐treated septic mice. Superoxide scavenger MnTBAP (Mn(III)tetrakis(4‐benzoic acid)porphyrin chloride) did not affect this deficit. Conclusion: These data indicate that early and delayed intravenous boluses of ascorbate prevent/reverse sepsis‐induced deficit in arteriolar conducted vasoconstriction in the cremaster muscle by inhibiting nNOS‐derived NO production.
Hyperglycemia Stimulates a Sustained Increase in Hydraulic Conductivity In Vivo without Any Change in Reflection Coefficient
Authors: PERRIN RACHEL M. , HARPER STEVEN J. , CORRALL ROGER , BATES DAVID O.
Published: September 2007

Objective: Increased microvascular permeability contributes to the development of diabetic microvascular complications and diabetic vasculopathy is correlated with blood glucose levels. The mechanisms underlying increased permeability, however, are poorly understood.

Methods: The Landis‐Michel technique was used to measure water permeability (hydraulic conductivity, Lp) and macromolecular permeability (reflection coefficient, σ) of exchange capillaries in frogs and rats.

Results: Dialysed normoglycemic plasma from diabetic patients had no effect on Lp. The same plasma with 20 mM glucose increased hydraulic conductivity from (mean ± SEM × 10−7 cm · s−1· cm H2O–1) 5.73 ± 2.01 to 13.09 ± 2.67 (P < .01). Nondiabetic control plasma did not affect Lp, but addition of 20 mM glucose increased Lp to a similar degree. The effect of glucose alone was examined. Glucose at 20 mM increased Lp, from 2.82 ± 0.61 to 4.71 ± 1.35 × 10− 7 cm · s− 1· cm H2O–1 (P = .002, n = 13). A similar increase was seen in rat mesenteric microvessels, from 1.04 ± 0.40 in control perfusions to 2.18 ± 0.56, P < .05. The microvascular macromolecular reflection coefficient in all the above experiments was unaltered. The use of specific inhibitors indicated that the glucose‐induced increased Lp did not appear to be mediated through protein kinase C (PKC), free radical generation, glucose metabolism, or albumin glycation.

Conclusions: These data suggest that hyperglycemia induced increased apparent protein permeability may be secondary to a glucose‐mediated change in macromolecular convective flux rather than any change in protein permeability per se. The authors speculate that the increased microvascular permeability to water in vivo is mediated by direct interaction of glucose with the endothelial cells (perhaps with the glycocalyx).
Father's occupation and sex ratio of offspring
Authors: Magnuson Anders , Bodin Lennart , Montgomery Scott M.
Published: September 2007

Aims: Ecological studies have demonstrated that when national economies contract the proportion of male live births is reduced. It has been suggested that the relative disadvantage this causes influences sex ratio among births. Here the authors use individual data to investigate whether there is a persistent association of father's occupation with the sex of offspring and if it varies by industry sector. Associations with season of birth are also investigated. Methods: All fathers with a first singleton live birth in Sweden between 1940 and 1949 were identified using population registers (n=523,671). Fathers' occupations from the 1960 Census was categorized into: manual workers; agricultural sector (divided into workers and owners/ managers); and office sector (divided into workers and managers). Results: Compared with manual workers, the routine workers in other sectors were not statistically significantly more likely to have a male first offspring. Agricultural owners/ managers and office managers were both statistically significantly more likely to have male offspring with adjusted odds ratios (and 95% confidence intervals) of 1.045 (1.024—1.066, p<0.001) and 1.021 (1.003—1.039, p=0.022), respectively. Compared with autumn births, spring births were less likely to be male: 0.983 (0.967—0.998, p=0.029). Conclusions: Fathers' occupation level, even 10—20 years after childbirth, but not labour market sector is associated with the sex ratio of offspring, indicating that material or social conditions are responsible. Spring births are less likely to be male, probably due to infections differentially reducing male foetal survival.
Social capital, institutional (vertical) trust and smoking: A study of daily smoking and smoking cessation among ever smokers
Authors: Lindström Martin , Janzon Ellis
Published: September 2007

Objectives: The associations between vertical (institutional) trust in the healthcare system and the mass media (newspapers and television), and daily smoking and smoking cessation were investigated. Methods: The 2004 public-health survey in Scania is a cross-sectional study. A total of 27,757 persons aged 18—80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between institutional trust in the healthcare system and the mass media, and daily smoking and smoking cessation. A multivariate analysis was performed to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people) on the differences in daily smoking and smoking cessation according to trust in the healthcare system and the mass media. Results: 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than the young. Respondents with low trust in the healthcare system had significantly higher odds ratios of daily smoking, 1.88 (95% CI 1.38—2.57) among men and 2.05 (95% CI 1.51—2.78) among women, while respondents with low trust in the mass media had no significant odds ratios of daily smoking, 1.01 (0.67—1.52) among men and 1.55 (0.97—2.47) among women, after multiple adjustments. Conclusions: Institutional (vertical) trust in the healthcare system but not the mass media was significantly associated with lower odds of daily smoking and higher odds of having quit smoking if ever smoker. The healthcare system seems to be a potent arena for tobacco prevention.
Types of cultural capital and self-rated health among disadvantaged women in outer Beirut, Lebanon
Authors: Khawaja Marwan , Mowafi Mona
Published: September 2007

Aims: This study extends research on the social determinants of health by exploring the association between a new, potentially very significant dimension, cultural capital by type, and self-rated health among low-income women living in outer Beirut, Lebanon. Methods: Self-rated general health was assessed using household data from a cross-sectional survey of 1,869 women, conducted in 2003. Three types of cultural capital were included: watching cultural TV programs, producing art (e.g. drawing, theatre performance), and consuming art or literature (e.g. attending exhibitions, reading literary books). Associations between self-rated health status and types of cultural capital were assessed using odds ratios from binary logistic regression models. Results: With the exception of art production, lack of cultural capital increased the odds of self-perceived poor health status adjusting for sociodemographics and other risk factors. The adjusted odds ratios were 1.86 (95% CI 1.07—3.22) for not watching cultural TV programs and 1.52 (95% CI 1.12—2.06) for not consuming art. As expected, health-risk factors, age, social support, and community of residence were also associated with health status. Conclusions: Two types of cultural capital were strong predictors of self-perceived health status among women living in poor urban communities, regardless of social capital, income, and other relevant risk factors.
Hospital contacts for chronic diseases among Danish seafarers and fishermen: A population-based cohort study
Authors: Kaerlev Linda , Dahl Søren , Nielsen Per Sabro , Olsen Jørn , Hannerz Harald , Jensen Anker , Tüchsen Finn
Published: September 2007

Objectives: Seafarers' and fishermen's working conditions may impact on their lifestyle and health. Standardized hospital contact ratios (SHCRs) were compared in two time periods and the relative risks of hospital contact as a function of employment time were estimated. Methods: Cohorts of all Danish seafarers (officers and non-officers) registered by the Danish Maritime Authority (DMA) 1989—98 and fishermen retrieved from a pension registry 1989—98 were linked to the nationwide Occupational Hospitalization Registry (OHR) and followed up for incident diseases in two five-year time periods, from 1 January 1994 and 1 January 1999, respectively, using rates specific for age and calendar time for the entire Danish workforce as a reference. Results: The SHCRs for lung and cardiovascular diseases were high for non-officers. Among male officers, the SHCR for diabetes was high in the 1999 cohort and the SHCR for chronic heart diseases was statistically significantly higher in the 1999 than in the 1994 cohort. For both time periods high SHCR values were found for bronchitis, emphysema, cancer of the lung, alcohol-related liver diseases, and diabetes among male non-officers, and lung cancer among male officers. Among female non-officers, a high SHCR for skin melanomas was seen. Among fishermen high SHCRs for bronchitis, emphysema, lung cancer, and Raynaud's syndrome were found in both cohorts. No duration— response pattern was observed in any of the analyses, which may reflect health- and lifestyle-related selection into the trades or a healthy worker effect. Conclusions: Danish seafarers, especially short-term employees, had an elevated risk of hospitalization for lifestyle-related diseases.
Patients with burnout in relation to gender and a general population
Authors: Stenlund Therese , Ahlgren Christina , Lindahl Bernt , Burell Gunilla , Knutsson Anders , Stegmayr Birgitta , Slunga Birgander Lisbeth
Published: September 2007

Aims: The aims of this study were to describe gender differences in patients with burnout and compare these patients with a general population with respect to physical, psychosocial and work variables. Methods: Data were collected from a total of 136 patients (96 women and 40 men, 41,6 ± 7,4 years), diagnosed with stress-related disease and burnout at the Stress Clinic, University Hospital of Umeå. Data on burnout, physical, psychosocial and work characteristics were compared with similar data from a geographical and age-matched population based survey, the 2004 Northern Sweden MONICA study. The survey sample included a total of 573 participants (283 women and 290 men, 40,7 ± 8,5 years). Results: Women with burnout reported a higher rate of impaired awakening, lower job control, greater proportion of unpaid work and worked to a greater extent ``with people'' compared to men. Men with burnout had a more restricted social network and reported working more overtime than women. Patients with burnout reported a higher rate of unemployment, a more restricted social network and higher work demands compared to a general population. Women with burnout reported less emotional support, a more sedentary work situation, high job strain and worked to a greater extent ``with people'' than women from the general population. Conclusions: There are some differences in working conditions and social network between women and men with burnout. Patients with burnout differ from a general population regarding individual and social factors as well as work-related factors.
Register-based follow-up of social benefits and other transfer payments: Accuracy and degree of completeness in a Danish interdepartmental administrative database compared with a population-based survey
Authors: Hjollund Niels Henrik , Larsen Finn Breinholt , Andersen Johan Hvd
Published: September 2007

Background: Social consequences of disease may be subject to register based follow-up. A Danish database, DREAM, allows weekly follow-up of any public transfer payment. This study aimed to evaluate the feasibility of the register for use in public health research. Material and methods: The DREAM database includes information on all public transfer payments administered by Danish ministries, municipalities, and Statistics Denmark for all Danish citizens on a weekly basis since 1991. The DREAM database was compared with self-reported information on sources of income in a population survey from 2001 with about 5,000 participants. Results: According to DREAM, 80.2% of respondents had received some kind of transfer income since 1991. For the week they filled in the questionnaire, 9.0% had a record of labour-market-related benefit (unemployment benefit, social assistance, wage subsidy), 6.4% a health-related benefit (sickness benefit, vocational rehabilitation allowance, salary from subsidized jobs for persons with limited work capacity, anticipatory pension), 10.1% a voluntary retirement pension, while 74.4% had no record of transfer payment for that week. The predictive value of DREAM was 74.8% for health-related transfer payment and 98.2% for self-support. Among persons with a record of sickness benefit, 52.4% reported no transfer payment. Conclusion: The DREAM database is feasible for follow-up of social and economic consequences of disease. Respondents may be unaware of payments transferred by the public authorities to the employer, and in such cases DREAM may be the best source of information. The database is useful for public health research, but may also be useful for socioeconomic analyses of selection bias and dropout from other studies.
Ethics of prevention: An interactive computer-tailored program
Authors: Van Hooren Rob H. , Van Den Borne Bart W. , Curfs Leopold M.G. , Widdershoven Guy A.M.
Published: September 2007

Aim: This article describes the contents of an interactive computer-tailored program. The program is based on previous studies of the practice of care for persons with Prader-Willi syndrome. This genetic condition is associated with a constant overeating behaviour with the risk of obesity. The aim of the program is to start a process of awareness, reflection, and discussion by caregivers who are confronted with the moral dilemma of respect for autonomy versus restricting overeating behaviour. The program focuses on values (such as health and well-being) that are relevant to caregivers in daily practice. Furthermore, the focus is on various ways of interaction with the client. Caregivers were expected to focus mainly on health, and on both paternalistic and interpretive/deliberative forms of interaction. Methods: Sixteen professionals and 12 parents pilot-tested the program contents. With a pre-test, responses on one central case were collected for tailored feedback; with a post-test, the effects of the program were measured. Results: Significant correlations were found between the values of autonomy and consultation and between autonomy and well-being. In contrast to our expectations respondents valued all categories (autonomy, consultation, health, well-being, and liveability for others) as equally important in the pre-test. No significant changes in scores were found between pre- and post-test. The open answers and remarks of participants support the program contents. Conclusions: Participants' responses support previous research findings, advocating a concept of autonomy in terms of positive freedom, through support by others. The promotion of the client's self-understanding and self-development is central in this concept.