bluuebunny/crossref_metadata_2025 huggingface dataset:
Participation in Prenatal Screening Tests and Intentions Concerning Selective Termination in Finnish Maternity Care
Authors: Santalahti Päivi , Hemminki Elina , Aro ArjaR. , Helenius Hans , Ryynänen Markku
Published: April 2003

Aims: The study examined how prenatal screening tests are presented to women, factors associated with women’s participation in screening, their experience of decision-making and intentions concerning pregnancy termination, and hospital data on rates of selective terminations. Methods: Questionnaires were given to pregnant women visiting maternity centres in two Finnish towns in which serum screening was offered (n = 1,035) and in one town where midtrimester ultrasound screening was offered (n = 497). Response rates to the questionnaires were 88 and 85%, respectively. Other questionnaires asking about selective terminations following detected fetal disorders were sent in 1993 to all public hospitals with obstetrics or gynaecology departments (response rate 100%). Results: The serum screening test had usually been offered to women as a free choice, but for 22% of them it was presented as a routine procedure. Most women (92%) underwent serum screening and most (86%) found the decision to participate or not easy. In almost every aspect of presentation and participation studied, serum and ultrasound screening differed from each other. 85% of respondents to ultrasound screening answered that it was offered as a routine procedure. Close acquaintance with a person with congenital disability was negatively associated with participation in serum screening and with the intention to terminate pregnancy in case of a detected disability. 27% of women in the serum screening survey and 22% in the ultrasound survey declared that they would have declined pregnancy termination if a fetal disorder had been detected. However, according to the hospitals’ data, only 13% of pregnancies with a serious fetal disorder detected were continued. Conclusions: All prenatal screening tests, including ultrasound examinations, require an adequate process of informed consent. Because the aim of such tests is to detect fetal malformations and syndromes, health care professionals should discuss the implications with women before they decide. Because acquaintance with a disabled person was found to associate with participation in screening and with intentions about selective termination, women’s perceptions of lives of the disabled should receive more attention in future studies.
Hodgkin’s Disease during Pregnancy: Diagnostic and Therapeutic Management
Authors: Anselmo A.P. , Cavalieri E. , Maurizi Enrici R. , Pescarmona E. , Guerrisi V. , Paesano R. , Pachì A. , Mandelli F.
Published: April 2003

Objectives: To evaluate the possibility that women affected by Hodgkin’s disease (HD) during their second or third trimester of pregnancy can safely carry their pregnancy to term. Methods: From 1986 to 1997, 6 women came to our Center during the second trimester of pregnancy and were diagnosed as having HD. Three of these 6 patients were treated with chemotherapy before delivery and 3 of them were kept under observation and started treatment after delivery. Results: All 6 women gave birth to a healthy female. Conclusions: The pregnancy does not worsen the course of the illness and does not compromise long-term clinical remission and recovery.
Prenatal Diagnosis of Down’s Syndrome in the Presence of Isolated Ebstein’s Anomaly
Authors: Silva Sandra R. , Bruner Joseph P. , Moore Cherri A.
Published: April 2003

Ebstein’s anomaly is a rare congenital cardiac defect, characterized by the displacement of the tricuspid valve into the right ventricle, that occurs approximately once in 20,000 live births. The association of Ebstein’s anomaly and chromosomal abnormalities, such as Down’s syndrome, is extremely unusual. Prenatal diagnosis of trisomy 21 in a fetus with isolated Ebstein’s anomaly has not been previously reported.
Prenatal Sonographic Imaging of an Immature Intracranial Teratoma
Authors: Pinto V. , Meo F. , Loiudice L. , D’Addario V.
Published: April 2003

This article describes the prenatal sonographic diagnosis of a rare case of intracranial immature teratoma in a fetus at the 35th week of gestation which looked normal at previous examinations. At sonography a markedly enlarged fetal head containing a complex irregular mass and hydrocephalus was detected. Color Doppler examination of the mass showed intense vascularization with low resistance flows.
Sectio Parva for Fetal Preservation
Authors: Bruner Joseph P. , Wheeler Thomas C. , Bliton Mark J.
Published: April 2003

Selective abdominal delivery, or sectio parva, is cesarean delivery of one of multiple fetuses, but not the other(s). Eleven cases have been reported for the purpose of aborting one twin, and this is the second report of an attempt to improve the outcome of both twins. Perinatal outcomes have ranged from almost immediate delivery of the second twin because of placental abruption, to elective delivery of the survivor at term.
Ontogeny of Isolated Ultrasound Markers for Fetal Aneuploidy
Authors: Drugan Arie , Bronshtein Moshe , Itskovitz-Eldor Joseph , Johnson Mark P. , Evans Mark I.
Published: April 2003

Objective: To evaluate the natural history of isolated ultrasound markers for fetal aneuploidy observed at 14–16 weeks of affected gestations. Study Design: 76 aneuploid gestations were diagnosed among a predominantly low-risk population undergoing targeted ultrasonography in the early second trimester. Indications for evaluation of fetal karyotype included fetal malformations or sonographic markers for aneuploidy, maternal age over 35 years and abnormal serum screening results. Markers were re-evaluated at the time of amniocentesis or at pregnancy termination for fetal anomalies. Results: Sonographic markers for aneuploidy (SMA) were observed in 68 of 76 aneuploid gestations diagnosed in the study group. In 46 cases, SMA were associated with major fetal malformations and in 22 cases, markers were isolated. Only 2 of 22 isolated markers for aneuploidy were documented at the time of amniocentesis. Conclusion: Isolated ultrasound markers for aneuploidy are transient and may disappear later on in gestation. Transvaginal sonography at 14–16 weeks of gestation appears to provide the best time window for detection of markers for fetal abnormal karyotype.
Amnioreduction: How Much to Drain?
Authors: Abdel-Fattah Sherif A. , Carroll Stephen G. , Kyle Phillipa M. , Soothill Peter W.
Published: April 2003

Objectives: To assess the relationship between the volume of amniotic fluid removed and the change in amniotic fluid index (AFI) and calculate an equation describing this association. Materials and Methods: A retrospective analysis of 19 amnioreduction procedures performed in our unit. Multiple regression analysis was used to assess the effect of gestational age and pre-procedure AFI on the change in AFI (ΔAFI) after adjusting for the volume removed. Results: As expected, a significant linear relationship was found between the change in AFI and the volume removed (r = 0.82, n = 19, p < 0.0001). ΔAFI was not dependent on the gestational age or the pre-procedure AFI. The equation describing the association between the volume removed and ΔAFI was: volume = (ΔAFI – 2.26)/0.008, which is close to 1 cm ΔAFI for every 100 ml removed. Discussion: Using the described equation, it is possible to predict the required volume to be removed in order to achieve a particular ΔAFI, which may reduce the need to interrupt the procedure to measure the AFI. However, the limitation of AFI as a semiquantitative assessment of the liquor volume, together with its inter- and intra-observer variations mean this equation should be used only as a guide.
Significance of Echogenic Foci in the Left Ventricle of the Fetal Heart in a Low-Risk Population
Authors: Jaffe Richard , Cherot Elizabeth , Allen Tamara , Glantz J. Christopher
Published: April 2003

Objective: To determine if there exists a significant association between prenatally detected left ventricular echogenic foci and chromosomal abnormalities. Methods: Over a 10-month period the presence of intracardiac echogenic foci was recorded on all low-risk patients referred for anatomical assessment. The study group consisted of 113 singleton fetuses and was compared to a control group with no foci. Results: Among the study group with echogenic foci, 5 chromosomal abnormalities (three trisomies) were detected. In the control group only one chromosomal abnormality was diagnosed. Conclusion: An association exists between the finding of intracardiac echogenic foci in the fetus and the presence of chromosomal abnormalities.
Amniotic Band Syndrome in Triplet Pregnancy
Authors: Suzuki Shunji , Yoneyama Yoshio , Sawa Rintaro , Sinagawa Toshiya , Hayashi Takashi , Araki Tsutomu
Published: April 2003

We present a case of amniotic band syndrome leading to encephalocele in one triplet. In this case, discordance in fetal growth was observed at 9 weeks’ gestation, and the amniotic membrane was not recognized in the sac of the smallest fetus. Thus, significant first-trimester growth discordance in multifetal pregnancies suggests congenital anomalies, and examinations considering amniotic band syndrome should be performed. Absence of the amniotic membrane in the gestational sac may be a useful marker of amniotic band syndrome.
Initiating Extradural Analgesia during Labour: Comparison of Three Different Bupivacaine Concentrations Used as the Loading Dose
Authors: Harms C. , Siegemund M. , Marsch S.C.U. , Surbek D.V. , Hösli I. , Schneider M.C.
Published: April 2003

Objective: Potential effects of extradural analgesia on the progress of labour and obstetric outcome are still a matter of concern and the focus of ongoing debates. Despite this, little attention is paid to the initiation of extradural labour analgesia. The objective of this prospective, randomized, double-blind trial was to identify the optimal of three concentrations of bupivacaine used as a loading bolus for initiating extradural analgesia during labour. Methods: Sixty-seven full-term parturients requesting extradural analgesia received either bupivacaine 0.25% (group A), 0.125% (group B) or 0.0625% (group C). Bupivacaine administration was titrated to achieve a pain score ≤1.5 on a 10-cm visual analogue scale (VAS) and was limited to a maximum of 20 ml of the study drug. We recorded the time to achieve a VAS ≤1.5, the total amount of local anaesthetic used, sensory level, maternal and foetal as well as neonatal side effects. Results: The probability of obtaining a VAS pain score ≤1.5 was significantly lower in group C. Although mean times to reach a VAS pain score ≤1.5 were not statistically different, survival curves show a significantly lower probability for reaching this score. Significantly more parturients in group A developed a motor block ≥1 based on using a modified Bromage scoring scale. There were no differences in incidence of maternal hypotension, ephedrine requirements, foetal heart rate abnormalities, mode of delivery and neonatal outcome. Conclusions: Of the three concentrations used in this clinical setting, 0.125% was the most suitable concentration of plain bupivacaine to initiate extradural analgesia in labour. Using 0.25% bupivacaine increased the incidence of motor block, whereas for 0.0625% plain bupivacaine the probability to achieve adequate analgesia was unacceptably low.
Mixed Lymphocyte Culture of Human Fetal Liver Cells
Authors: Lindton Bim , Markling Lola , Ringdén Olle , Kjaeldgaard Anders , Gustafson Owe , Westgren Magnus
Published: April 2003

Objective: In order to study the immunological function of the human fetus in the first and second trimesters, mixed lymphocyte culture (MLC) of fetal liver and thymic cells was performed. MLC is a functional test to determine human lymphocyte antigen-D incompatibilities. Methods: Human fetal liver and thymic tissue was obtained from abortions in gestational weeks 7–17.5. Forty-seven fetuses were studied with one-way MLC. The cells were stimulated by adding irradiated fetal liver cells, adult bone marrow and peripheral blood lymphocytes. The activity was measured as DNA incorporation of radiolabeled thymidine. Results: The results indicate that the human fetus is competent to react as early as 11–12 weeks of gestation and in some cases even earlier. In very immature fetal livers (< 8 weeks), the MLC seems to be inhibited. Conclusions: Our data suggest that the human fetus can react against foreign transplantation antigens earlier than previous papers have claimed. The onset of reactivity seems to differ considerably among fetuses. The present findings may explain some of the limited success of in utero transplantations of hematopoietic stem cells in human fetuses of normal immunological status.
Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome
Authors: Joern Hendrik , Rath Werner
Published: April 2003

Objective: Subject of the study was the significance of umbilical artery Doppler velocimetry findings for the further course of pregnancy and fetal outcome in cases of twin pregnancies. Methods: In 206 cases of twin pregnancy, the umbilical artery was examined using Doppler velocimetry in the median 9 days prior to delivery, and the result was correlated with the further course of pregnancy and fetal outcome. 174 pregnancies showed normal Doppler findings of the umbilical artery (group A), 32 twin pregnancies showed pathological Doppler findings of at least one twin (group B). The median of the maternal age and the parity between the groups were not different. Results: In group B (pathological Doppler findings), intrauterine growth retardation and pre-eclampsia occurred 5 times more often than in group A (normal Doppler findings). The total rate of cesarean sections was not different between the study populations; the rate of deliveries by cesarean section in group B was significantly increased by a factor of 2.4 due to a pathological CTG. The median birth weight and the gestational age at birth were significantly lower in group B (1,660 g; 35 weeks) as compared to group A (2,460 g; 37 weeks; p < 0.001). In group B, the rate of premature deliveries up to reaching the 34th week of gestation was 3.4 times higher; the rate of SGA newborns was 6.3 times higher. Perinatal mortality was increased by a factor of 1.5 in group B compared to group A. Conclusion: The Doppler velocimetry findings have considerable effects on the further course of a multiple pregnancy. In case of pathological Doppler findings, early hospitalization and close monitoring of the pregnancy should be performed. In cases of additional pathological findings (maternal illness, pathological Doppler findings of fetal blood vessels), termination of the pregnancy has to be considered.
Mid-Trimester Thoracoamniotic Shunting for the Treatment of Fetal Primary Pleural Effusions in a Twin Pregnancy
Authors: Grisaru-Granovsky S. , Seaward P.G.R. , Windrim R. , Wyatt P. , Kelly E.N. , Ryan G.
Published: April 2003

Thoracoamniotic shunting has been described as having a beneficial role in the antenatal management of primary pleural effusions in singleton pregnancies. We report a case of a twin pregnancy in which progressive pleural effusions and hydrops were diagnosed in one of the fetuses at 16 weeks of gestation. An initial evaluation ruled out underlying genetic and anatomic abnormalities in both twins. At 19 weeks gestation, the first procedure of bilateral thoracoamniotic shunting was performed in the affected fetus, subsequent to which the lungs re-expanded and the hydrops resolved. Three additional shunt replacements and one therapeutic amniocentesis were required on follow-up. At 35 weeks, labor was induced. The first fetus (healthy) was delivered vaginally and the second fetus (affected) was delivered by cesarean section. Both neonates are healthy at one year follow-up.
Discrepancy between Cytogenetic and FISH Results on an Amniotic Fluid Sample of 45,X/46,X,idic(Y)(p11)
Authors: Gole L.A. , Anandakumar C. , Yang R. , Chan J. , Wong Y.C. , Bongso A.
Published: April 2003

The presence of abnormal ultrasound markers showing a thick nuchal fold with short middle phalanx of the fifth finger in an otherwise normal-appearing female fetus led to the sampling of amniotic fluid at 16 weeks gestation. Cytogenetic analysis with routine G-banding showed a 45,X karyotype in all 20 cells analysed from two flasks. However, fluorescent in situ hybridization on uncultured cells showed presence of a Y signal in 9 cells, 11 cells showing a single signal for the X. A cytogenetic analysis of the fetal blood at 23 weeks confirmed the presence of two cell lines, 45,X and 46,X,idic(Y)(p11). The couple opted to have the pregnancy terminated. However, the fetus was not available to carry out confirmatory tests.
Parental Decision-Making Differences between Patients in Two Healthcare Systems for Choroid Plexus Cysts
Authors: Apodaca Christina C. , Hume Jr. Roderick F. , Evans Wendy J. , Martin Laura S. , Evans Mark I. , Calhoun Byron C.
Published: April 2003

Objective: We evaluated the medical-sociological implications of parental perception of risk and decision-making choices for prenatally ascertained choroid plexus cysts (CPCs) between two obstetric populations with similar clinical situations. Methods: The Wayne State University (WSU) Reproductive Genetics database and the Madigan Army Medical Center (MAMC) experience were reviewed to compare the rates of aneuploidy and invasive testing for cases with CPC. Aneuploidy rates were compared between those with isolated CPC, CPC with advanced maternal age (AMA), and CPC associated with multiple anomalies. Results: 186 cases were identified in the WSU cohort, of whom 27 (15%) declined invasive fetal testing. In the remaining 159 cases, aneuploidy was present in 2/132 (1.5%) isolated CPCs, 3/11 (27%) CPCs with AMA, and 15/16 (93%) CPCs with multiple anomalies. 107 cases were identified in the MAMC cohort, of whom 99 (92%) declined invasive fetal testing. No cases of aneuploidy were found in the 3/12 AMA cases or 5/95 non-AMA cases who underwent amniocentesis. Conclusions: The 2 cases of aneuploidy with isolated CPC cannot be ignored, and provide an estimated attributable risk of at least 0.8%, a higher risk than 38 years of age. However, the parental sociologic context may be as important as the genetic-prognostic risk for decision-making.
Frequency of Prenatal Diagnosis of Birth Defects in Houston, Galveston and the Lower Rio Grande Valley, Texas 1995
Authors: Waller D.K. , Pujazon M.A. , Canfield M.A. , Scheuerle A.E. , Byrne J.L.B.
Published: April 2003

Background: Estimates of the proportion of birth defects diagnosed before birth exist for only a few types of birth defects and for a few geographic regions in the United States. This population-based study examines rates of prenatal diagnosis for previously unstudied birth defects in a new geographic region. Methods: Active surveillance of 23 categories of birth defects among 111,902 infants born in 77 birthing hospitals in Texas in 1995 identified 852 infants or fetuses with major birth defects. Surveillance was conducted by the Texas Birth Defects Monitoring Program of the Texas Department of Health. Two regions were covered, the Houston/Galveston metropolitan area as well as the Lower Rio Grande Valley of Texas. Rates of prenatal diagnosis were evaluated for 23 different types of birth defects, using proportions and 95% confidence intervals. Results: One third of the 852 infants or fetuses with birth defects were prenatally diagnosed. Diagnosis rates varied greatly depending on the type of birth defects and were lower among infants born to Black and Hispanic women. More than 60% of anencephaly, encephalocele, gastroschisis and trisomies 13 and 18 were diagnosed antenatally. Many of the fetuses that were electively terminated had birth defects or combinations of birth defects that were potentially lethal. Prevalence rates for birth defects generally do not include fetuses that die or are electively terminated before 20 weeks of gestation. Thus, 36% of anencephaly, 21% of omphalocele, 15% of encephalocele and between 7 and 10% of spina bifida, hydrocephaly, renal agenesis, and trisomies 13, 18, and 21 were not included in our published rates. Conclusions: Published rates for specific types of birth defects are spuriously low. This should be considered when investigating alleged clusters and comparing rates of birth defects across geographic areas. Since many elective abortions are for lethal or potentially lethal birth defects, a major effect of prenatal diagnosis is the resultant decrease in infant mortality attributable to birth defects.
Ultrafast Scan Magnetic Resonance in Prenatal Diagnosis
Authors: Wagenvoort A.M. , Bekker M.N. , Go A.T.J.I. , Vandenbussche F.P.H.A. , van Buchem M.A. , Valk J. , van Vugt J.M.G.
Published: April 2003

Objective: To determine whether magnetic resonance (MR) can give additional information in prenatal diagnosis of congenital anomalies, when the ultrasound (US) analysis is not conclusive. Methods: Ultrafast MR scanning examined 39 pregnant women with 41 fetuses in whom US was suspicious of fetal congenital abnormalities. Two techniques were used namely (1) HASTE inversion recovery sequence and (2) FISP 2D. Results: Thirty-nine patients with 41 fetuses were referred for MR because of an equivocal US with regard to brain, spine, skeletal and miscellaneous anomalies. In 1 twin pregnancy, 1 co-twin has not been examined with MRI because of its demise. In 22 of them, additional information was obtained by MR. In 9 the MR was confirmative with the US examination. Four were false negative, comparing with the postnatal diagnosis. Three failed because of maternal claustrophobia and in 2 a diagnosis could not be made. From the 40 fetuses in this study, 38 were examined postnatally by MR, US, plain X-ray or autopsy was performed to confirm the prenatal diagnosis. Conclusion: The use of MRI in obstetrics has been limited, until recently. With fast MRI sequences it is not necessary to sedate the fetus. It is advisable in cases where US is equivocal concerning congenital anomalies of the fetus to use MR with fast or ultrafast scan technique, especially when the central nervous system is concerned.
Gender and Teachers’ Rating of Linguistic Skills among Second-Grade Schoolchildren
Authors: Luotonen Mirja , Uhari Matti , Uhari Marja , Aitola Lempi , Lukkaroinen Aino-Maija , Luotonen Jukka
Published: April 2003

The aim of the study was to evaluate the possible differences in linguistic skills and school achievement between girls and boys. In a nation-wide study, the achievement of 1,936 second-grade Finnish girls and boys was appraised according to the teachers’ rating. The results were compared with the linguistic test performance of 364 pupils from the nearby area. The mean rates of girls in writing, reading, oral performance and attention were significantly higher than those of boys as evaluated by the teachers (p < 0.01). Also, the risk of boys to be below the median in their achievement rates compared with girls was higher (risk ratios 1.3–1.6, 95% confidence intervals 1.2–1.7, p < 0.01). In multiple regression analysis where birth order, duration of nursery day care, number of otitis media episodes and parental education were controlled for, male gender proved to be a risk factor for linguistic skills as graded by the teachers. Yet, performance in linguistic tests did not support the superiority of girls in linguistic skills. Professionals taking care of linguistic problems in children should be aware that teachers’ evaluations are influenced by the gender of the pupil.
Values and Limitations of Pharyngolaryngoscopy (Transnasal, Transoral) in Patients with Dysphagia
Authors: Schröter-Morasch Heidrun , Bartolome Gudrun , Troppmann Norbert , Ziegler Wolfram
Published: April 2003

During the last decade, videoendoscopic evaluation of structures and sensorimotor functions of the pharynx and larynx has been established as a valuable tool in the assessment of dysphagia. This method is feasible at a very early stage and in critically ill patients, is not invasive and frequently repeatable. Several authors described the high sensitivity and specificity of this method in detecting the presence of the most important symptoms of swallowing dysfunction: retention, penetration and aspiration. In our study of 39 patients with neurogenic dysphagia, we found high agreement between the results of videoendoscopic and videofluoroscopic examination regarding the registration of the most critical symptom, i.e. aspiration. Moreover, we observed patients who aspirated only their saliva and whose endoscopically verified aspiration problem remained undetected by radiographic examination, probably due to the lower sensory input of saliva as compared to a contrast medium. Since the detection of aspiration of saliva is of high clinical relevance for pulmonary function, the endoscopic examination turned out to be superior, in this particular respect, to the radiographic examination. However, the method fails to provide sufficient information regarding the cause of the observed symptoms or the amount of aspirated material. Six patients in our study exhibited, in addition to the neurological signs, structural changes (diverticula, pouches) or unexpected functional esophageal disturbances (persistent opening of the upper esophageal sphincter, retrograde peristalsis) which could only be detected by radiographic examination. The two methods should therefore be considered complementary.
Children of Yesterday, Today and Tomorrow: Global Implications for Child Language
Authors: Cheng Li-Rong Lilly
Published: April 2003

The entire global population is waiting for new opportunities of the new millennium. This paper will report selected global trends; describe briefly children of yesterday, today and tomorrow; detail a case study explaining the multiple challenges of working with children in a multicultural environment and probe into the implications for the future of child language.
Sweet and Bitter Taste Discrimination in Primates: Scaling Effects across Species
Authors: Simmen B. , Hladik C.M.
Published: April 2003

The adaptive nature of taste discrimination has been questioned on the basis that marked differences in taste thresholds for soluble sugars across mammals may not correspond to distinct dietary tendencies and further imply inaccurate prediction of the energetic value of food. Appropriate models of the evolution of taste, however, require not only consideration of adaptations to diet but also recognition of phylogenetic and allometric effects. Here, we analyse these factors in primates exhibiting various diets and covering a wide range of body weights. Taste thresholds for sucrose and fructose are negatively related to body weight overall but are commonly similar in closely related species irrespective of dietary specialisations. By contrast, major interspecific differences in the discrimination of quinine hydrochloride are observed in the absence of any allometric effect. We propose that this asymmetrical differentiation of sweet and bitter taste discrimination reflects divergent evolutionary trends for meeting energy requirements and for avoiding noxious substances.
Pollination of Ravenala madagascariensis and Parkia madagascariensis by Eulemur macaco in Madagascar
Authors: Birkinshaw Christopher R. , Colquhoun Ian C.
Published: April 2003

Primates are known to be important in dispersal of seeds of tropical rainforest trees, but their role in pollination is very poorly documented. Although the ‘traveller’s palm’ Ravenala madagascariensis is widespread, only a single well-documented report exists for its pollination by Malagasy prosimians. Black lemurs, Eulemur macaco, exploit nectaries of Parkia as well as Ravenala systematically at the massifs of Ambato and Lokobe, and almost certainly contribute substantially to their pollination, confirming a proposal first made by Sussman and Raven [Science 1978;200: 731–736].
Development of the Female Great Call in Hylobates gabriellae: A Case Study
Authors: Merker Björn , Cox Cathleen
Published: April 2003

Although the structure of adult gibbon duet singing has been characterised in most species, little is known about the ontogeny of gibbon song. The present study describes the developmental trajectory of the female great call in a captive infant Hylobates gabriellae female, on the basis of periodic tape recordings made while she participated in the duetting of her parents. The major part of great call development is completed between 5 and 32 months of age, and a differential time course is apparent for different portions of the female great call, raising the question of the role of the protracted period of vocal development in this species.
Preliminary Data on the Age-Dependent Decrease in Basic Fibroblast Growth Factor and Platelet-Derived Growth Factor in the Human Vein Wall and in Their Influence on Cell Proliferation
Authors: Drubaix I. , Giakoumakis A. , Robert L. , Robert A.M.
Published: April 2003

The roles of basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) in vein disease and aging were investigated. Smooth muscle cells from human saphenous veins were cultured. The age dependence of bFGF and PDGF activation of the smooth muscle cell proliferation was determined, and the bFGF and PDGF contents in vein wall homogenates were measured by an enzyme-linked sorbent assay. There were morphological alterations in the cells with more polygonal and polynucleated cells in cultures from aged donors, similar to those observed in vitro in aged cell cultures. Some cultures did not reach confluency after the tenth passage, suggesting early decay of the cultures from diseased veins. bFGF and PDGF stimulated the proliferation of the vein smooth muscle cells, but only in cultures treated with hyaluronidase. This stimulation decreased with the age of the donor. The amount of the two growth factors in human vein walls decreased with donor age. The amount of bFGF decreased faster (slope: 3.3138 ng/mg DNA/year) than that of PDGF (slope: 1.021 ng/mg DNA/year). This results in an age-dependent change in the bFGF/PDGF ratio from 4 mol/mol at the age of 20 years to 1 mol/mol at the age of 80. These growth factors also modulate the synthesis of extracellular matrix components. The continuous change in the bFGF/PDGF ratio may alter the composition of the extracellular matrix of the vein wall during aging and thus its susceptibility to varicose disease.
Effects of the Antioxidant (6,7-Dihydroxycoumarin) Esculetin on the Glutathione System and Lipid Peroxidation in Mice
Authors: Martín-Aragón Sagrario , Benedí Juana M. , Villar Angel M.
Published: April 2003

The attempt to retard senescence by environmental manipulation includes the use of nutrients or drugs that decrease the oxidative damage to tissues associated with aging. The effects of esculetin treatment (25 mg/kg, orally for 30 days), a phenolic antioxidant compound, on the glutathione system and lipid peroxidation were examined in liver supernatants from male C57BL/6J mice. The effects of esculetin were compared to treatment with 3,5-di-terc-butyl-4-hydroxytoluene (BHT), a well-known synthetic phenolic antioxidant. Reduced glutathione (GSH) concentration in liver supernatants was only increased significantly in esculetin-treated mice compared to control animals, whereas the concentration of oxidized glutathione (GSSG) was significantly decreased by BHT treatment compared to the control group. The GSSG/GSH ratio was significantly lower in esculetin and BHT groups than in the control group. The decrease in this ratio was greater in BHT-treated mice than in esculetin-treated mice. Increases in glutathione reductase (GR) activity were observed with both treatments, although BHT resulted in a superior induction of this activity compared to esculetin. The extent of decline in the GSSG/GSH ratio was correlated with the increase in GR activity. The formation of thiobarbituric acid-reactive substances (TBARs), an index of stress, was lower following treatment with esculetin and BHT compared to control mice (although not significant). This index was very similar for both treatments. Based on the level of TBARs obtained in this study, the accumulation of lipid peroxides declines when the GSH levels are enhanced or GSSG levels are decreased. Finally, we found similar antioxidant effects in vivo with esculetin and BHT treatments and a decrease in the oxidative damage evaluated. The enhancement of glutathione status following esculetin treatment could be a possible defense strategy for the organism under ‘stress conditions’ and may be related to the delay of age-dependent degenerative disorders.
Consequences of Aging on Mitochondrial Respiratory Chain Enzymes in Cultured Human Fibroblasts Treated with Ascorbate
Authors: Sharma P. , Rupar C.A. , Rip J.W.
Published: April 2003

The activities of mitochondrial respiratory chain enzymes with and without ascorbate pretreatment were assayed in 10- to 20-week-old cultures of human fibroblasts. Aging was associated with a significant loss of respiratory chain enzyme activities. The presence of ascorbate in the medium reduced the rate of loss of these enzymes. Free radical-mediated injuries may also contribute to aging since the changes seen in respiratory chain enzyme activities are similar to those seen in oxidatively stressed cells. This study demonstrates an age-related decline in mitochondrial respiratory chain activity as well as a protective role for ascorbate in aging.
Splenic Function in Old Age
Authors: Ravaglia G. , Forti P. , Biagi F. , Maioli F. , Boschi F. , Corazza G.R.
Published: April 2003

Hyposplenism has been reported in elderly people. However, from previous studies, it was not clear whether the observed alterations in splenic function were a physiologic effect of advanced age itself or a consequence of age-related diseases. As hyposplenism is believed to predispose to infections, autoimmune phenomena and thrombosis, this question is of great clinical concern. In the present study splenic function was assessed by counting the pitted red cells in 65 healthy subjects aged 50–108 years. At variance from previous studies, our study population consisted of free-living individuals carefully selected in order to exclude any underlying disease. The percentage of pitted red cells in 37 subjects over 70 years was significantly higher than in 28 younger subjects, although only 1 subject had a pitted red cell count indicating splenic hypofunction. A positive, but weak, correlation between the percentage of pitted red cells and age was also found when considering the whole population (rs = 0.273, p = 0.029). In conclusion, although slightly reduced with advancing age, splenic function seems basically to be maintained in elderly people.
Correlates of Cognitive Function in Middle-Aged Adults
Authors: Cerhan James R. , Folsom Aaron R. , Mortimer James A. , Shahar Eyal , Knopman David S. , McGovern Paul G. , Hays Melissa A. , Crum Larry D. , Heiss Gerardo
Published: April 2003

The Atherosclerosis Risk in Communities Study administered cognitive function tests to more than 14,000 middle-aged adults in 1990–1992. The battery included the Delayed Word Recall test, the Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised, and the Controlled Oral Word Association (Word Fluency) test. Test performance was correlated positively with education level, negatively with age, was better in women than in men, and better in managers/professionals compared with other occupations. After controlling for these factors, race and community, the findings most consistent for both sexes were that Delayed Word Recall was negatively associated with depressive symptoms, diabetes, and fibrinogen level; the Digit Symbol Subtest was associated with marital status, negatively associated with depressive symptoms, smoking status, fibrinogen level, and carotid intima-media thickness, and positively associated with alcohol drinking and FEV1; and the Word Fluency test was positively associated with marital status, alcohol drinking, sports participation, and FEV1. Most of these cross-sectional results were in the predicted direction and have biologic plausibility, but mean differences between extreme categories were small (generally on the order of 0.1 to 0.2 of a standard deviation). Longitudinal study is warranted to evaluate whether small differences in middle-age lead to larger, clinically meaningful deficits with aging.
Lipoprotein Profile and High-Density Lipoproteins: Subfractions Distribution in Centenarians
Authors: Barbagallo Carlo M. , R. Averna Maurizio , Fradà Giovanni , Noto Davide , Cavera Giovanni , Notarbartolo Alberto
Published: April 2003

In order to assess the role of HDL on longevity, we studied HDL subfraction distribution in centenarian women compared with a group of weight- and gender-matched healthy normolipidemic controls. We did not find any significant difference in the mean plasma lipid, apolipoprotein, and Lp(a) levels. On the contrary, in spite of similar HDL-cholesterol concentrations (1.32 ± 0.41 mmol/l in centenarians vs. 1.32 ± 0.25 mmol/l in controls, p = not significant), HDL2b and HDL3a levels were, respectively, significantly increased and significantly reduced in centenarians in comparison with controls (HDL2b 32.4 ± 9.2% in centenarians vs. 23.4 ± 7.7% in controls, p < 0.002, and HDL3a 26.3 ± 9.8% in centenarians vs. 34.1 ± 7.3% in controls, p < 0.01). Moreover, HDL2b levels were significantly raised and HDL3a levels were significantly reduced in centenarians in comparison with both ‘middle-aged’ and ‘elderly’ subjects, whereas no difference for any HDL subfraction was found between the two groups of controls of different ages. Age was significantly correlated with HDL2b and HDL3a (respectively, +0.452, p < 0.001, and –0.370, p < 0.01) in all subjects, but not with all the other lipid, lipoprotein and apolipoprotein parameters, but we observed a large overlapping of individual values of HDL2b between centenarians and controls. Since HDL2b levels were found to be inversely correlated with coronary heart disease risk, we could speculate that, in some cases, this may probably favor a healthy ageing, but long-term longitudinal studies are necessary to define the relative importance of HDL subfractions distribution as a marker of longevity. Probably other factors or clinical characteristics play a major role in the ageing process.
Phenotypic Changes in Vascular Smooth Muscle Cells during Aging: Insulin Effect on Migration
Authors: Muñoz F.J. , Jiménez M. , Melón J. , Ruiz-Torres A.
Published: April 2003

We examined the mechanisms by which insulin may be atherogenic during aging. We postulated that an increase in insulin secretion during aging produces growth factor effects on vascular smooth muscle cells (VSMCs), promoting these cells to synthesize collagen and to migrate. We have previously demonstrated that insulin stimulates collagen synthesis and release in senescent VSMCs that were obtained from a human organism with high levels of insulin secretion. Using the same experimental model, we now study the effects of insulin on VSMC migration. We demonstrate that insulin has a chemoattractant effect on VSMCs which occurs through insulin binding to its own specific receptors as opposed to its effect on collagen production. Blocking the insulin receptor significantly eliminates the insulin effect on cell migration. At the same molarity, the chemotactic effect of insulin is less pronounced than that of insulin-like growth factor-1. In spite of different mechanisms, there is a remarkable correlation between the insulin effects on collagen secretion and cell migration (r2 = 97%, p < 0.0005). Our results indicate that distinct but closely related mechanisms may exist by which insulin becomes atherogenic. Our results also suggest the importance of normal aging processes in the development of atherosclerosis.
Clinical Associations of Lymphopenia in Elderly Persons Admitted to Acute Medical and Psychiatric Wards
Authors: Dennis Michael S. , Nicolson Anne , Lehmann Anthea B. , Junaid Ola , Byrne E. Jane , Hopkinson Neil
Published: April 2003

Lymphopenia is a common finding in old people admitted to medical and psychiatric wards. We describe a pilot study of the clinical associations, and prognostic significance of lymphopenia in elderly persons admitted to acute medical and psychiatric wards. Consecutive patients admitted to acute medical and psychiatric wards were prospectively selected according to initial peripheral lymphocyte count (PLC) into lymphopenic (PLC <1.0 × 109/litre, n = 41), and non-lymphopenic (PLC >1.5 × 109/litre, n = 23). Results of routine haematological and biochemical investigations were recorded, as well as drug history and medical diagnoses. Anthropometric measurements, assessment of functional ability (Barthel ADL Index), and cognitive function (Mini-Mental State Examination) were then performed by investigators blind to lymphocyte status. Patients were contacted between 3 and 6 months following recruitment into the study. Lymphopenia was associated with functional ability as measured by a lower Barthel score (p = 0.004), and cognitive impairment as measured by the Mini-Mental State Examination (p = 0.02). No association was found with medical diagnostic groupings, drugs known to cause lymphopenia, nutritional status, or survival. Lymphopenia may be a significant marker of vulnerability, and a larger study is required to elucidate the veracity and mechanisms of lymphopenia-associated debility.
Role of Advanced Glycation End Products in Aging Collagen
Authors: Odetti P. , Aragno I. , Garibaldi S. , Valentini S. , Pronzato M.A. , Rolandi R.
Published: April 2003

The collagen structure of young and old rats was examined using a scanning force microscope (SFM). Rat tail tendons of 8- and 24-month-old Wistar rats were frayed by two blades and examined using a Nanoscope III SFM. In the same tendons, the pentosidine concentrations, a marker of the Maillard reaction, were determined by HPLC. The SFM inspection of native fibrils produces images of collagen bundles, with parallel fibrils. The diameters of old rat collagen fibrils were large in comparison to the young ones. Moreover, fibrils obtained from old rats exhibited the same band interval, while the depth of the gap between two overlap zones showed a higher mean value with respect to young collagen. The pentosidine concentration was also higher in the old than in the young tendons. In conclusion, in the presence of an increased concentration of advanced glycation end products, significant structural alterations have been observed in old fibrils.
Differential Chromosome Sensitivity to 5-Azacytidine in Alzheimer’s Disease
Authors: Marques Payão Spencer Luiz , de Arruda Cardoso Smith Marília , Ferreira Bertolucci Paulo Henrique
Published: April 2003

Background: The methylation process in the DNA has been considered a control mechanism of gene activity, connected with genetic imprinting. 5-Azacytidine (5-AZC) is known to be a demethylation agent. Objective: We studied the cytogenetic effect of 5-AZC in Alzheimer’s disease patients and in two control groups. Methods: Peripheral lymphocyte cultures derived from 8 patients with Alzheimer’s disease and 8 elderly and 8 healthy young individuals, all female, were studied. The parameters investigated were: the undercondensation of constitutive heterochromatin of chromosomes 1, 9, and 16: the number of lesions in fragile sites 1q42 and 19q13; heterochromatin association, and the total number of induced lesions. Results: Our results showed a significantly increased frequency of undercondensation of chromosomes 1, 9, and 16 in Alzheimer’s disease patients when compared with elderly and young healthy groups. Conclusion: These results suggest that the demethylating action of 5-AZC could reveal differential gene activity in the Alzheimer group at the level of cellular division.
Apolipoprotein E Polymorphism Is Not Associated with Longevity or Disability in a Sample of Italian Octo- and Nonagenarians
Authors: Bader G. , Zuliani G. , Kostner G.M. , Fellin R.
Published: April 2003

Background: Apolipoprotein E (apo E) is a protein associated with plasma lipoproteins. Apo E polymorphism has been related to significant modifications of lipoprotein profile, as well as to the incidence of different pathologies including cardiovascular disease, Alzheimer’s disease, and vascular dementia. Furthermore, it was proposed that apo E polymorphism might be involved in the aging selection process. Objective: The purposes of the present study were the following: (1) to evaluate apo E polymorphism in ‘successful’ and ‘unsuccessful’ aging, defined as the absence or presence of disability and severe chronic diseases (mainly cardiovascular disease and dementia), respectively; (2) to evaluate the impact of apo E polymorphism on plasma lipids in very old individuals free of or affected by disability. Methods: 253 Italian subjects including 100 free-living healthy octo- and nonagenarians, 62 disabled octo- and nonagenarians, and 91 healthy adult controls, all matched for origin were studied. Apo E phenotypes were determined by PhastSystem (Pharmacia). Lipoprotein parameters (total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, lipoprotein (a), and apoprotein A-I and B) were measured by standardized methods. ADL were evaluated by the Katz index. Results: The frequency of σ2, σ3, and σ4 alleles was 0.062, 0.887, and 0.051 respectively in the entire sample; no differences in alleles distribution were found between the three groups. When the subjects were divided according to the E type (E2 type: E2/E2 and E2/E3; E3 type: E3/E3; E4 type: E3/E4 and E4/E4), no differences in lipoprotein parameters emerged, but a trend toward higher total and LDL-cholesterol from the E2 to the E4 type was observed. The σ4 allele had a raising effect, while σ2 had a lowering effect on total cholesterol levels, but these effects were much less profound in the disabled octo- and nonagenarians. Conclusions: We conclude that (1) the frequency of the σ4 allele is very low in this sample of subjects from central Italy; (2) no differences emerged in σ4 distribution between healthy and disabled octo- and nonagenarians, and adult controls; the very low frequency of σ4 allele might contribute to this finding; (3) our data do not support the hypothesis of a possible association between apo E polymorphism and longevity or disability in this population.
Measurement of the Amounts of Elastic Fibers in the Skin and Temporal Arteries of Healthy Aged Individuals by Automated Image Analysis
Authors: Gogly B. , Godeau G. , Septier D. , Hornebeck W. , Pellat B. , Jeandel C.
Published: April 2003

Background: A quantitative study of dermal and arterial elastic fibers as a function of age was carried out by computerized image analysis. Objective: We investigated whether any parallelism can be established between the morphometric parameters of elastic fibers from the skin and the temporal artery in elderly subjects. Methods: we quantitated the skin elastic fibers of the reticular dermis and the elastic fibers of the temporal artey using a specific staining procedure followed by automated image analysis in 16 subjects of age range 63–87 years. Results: There was a good correlation between the area fraction occupied by the elastic fibers in the unexposed skin (inner part of the upper arm) and aging (r = 0.669, p < 0.01). The area fraction occupied by elastic fibers in unexposed skin was correlated with the area fraction occupied by elastic fibers in the deep part of the temporal artery (r = 0.498, p < 0.05). Actinic elastosis affected both tissues, but there was no correlation between the amount of elastotic material in the exposed skin and the area fraction of elastic fibers in the superficial part of the temporal artery. Conclusion: We provided evidence that in sun-protected tissues the area fraction occupied by elastic fibers in dermis and deep part of the temporal artery showed a significant correlation. We proposed that skin biopsies were a valuable diagnostic tool for predicting arterial wall abnormalities of elastic fibers.