bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrition Knowledge and Confidence Levels of Parents of Children With Cystic Fibrosis
Authors: McDonald Catherine M. , Christensen Nedra K. , Lingard Catherine , Peet Kimberly A. , Walker Sarah
Published: December 2009

Optimal growth and nutrition status predict better lung function and longevity for children with cystic fibrosis (CF). Daily nutrition therapy for children with CF requires adequate food resources, parental knowledge of nutrition and behavior management, and confidence in one’s ability to apply the skills. The Mountain West Cystic Fibrosis Consortium Questionnaire (MWCFC-Q) was designed to identify educational intervention targets to improve the growth and nutrition of children with CF. Parents of children with CF returned 305 anonymous MWCFC-Qs. Data analyzed included household food security, knowledge of nutrition and general CF therapies, and self-confidence in one’s ability to manage components of CF care. Factors associated with food insecurity were reported by 26.3% of respondents. The median accuracy for questions regarding nutrient content of commonly used foods was 71.4% and 57.9% for CF nutrition therapy. Parents’ self-confidence in overall CF management was relatively high at a mean value 8.28 ± 1.22 of 10 possible. However, mean self-confidence in the CF nutrition domain was significantly less than mean self-confidence for the CF-related tasks domain, which included chest physiotherapy and medication administration (7.75 ± 1.56, 8.62 ± 1.24, P < .001, respectively). Parental knowledge of nutrition for CF and confidence in the application of this knowledge can improve the growth and nutrition status of children with CF. Identification of food security issues may enable health care professionals to adjust nutrition interventions and direct families to appropriate food resources. The MWCFC-Q could be useful for designing and testing educational interventions for nutrition management of CF.
Role for ADAP in shear flow–induced platelet mechanotransduction
Authors: Kasirer-Friede Ana , Ruggeri Zaverio M. , Shattil Sanford J.
Published: December 2009

Binding of platelets to fibrinogen via integrin αIIbβ3 stimulates cytoskeletal reorganization and spreading. These responses depend on tyrosine phosphorylation of multiple proteins by Src family members and Syk. Among Src substrates in platelets is adhesion- and degranulation-promoting adapter protein (ADAP), an adapter with potential binding partners: SLP-76, VASP, and SKAP-HOM. During studies of platelet function under shear flow, we discovered that ADAP−/− mouse platelets, unlike ADAP+/+ platelets, formed unstable thrombi in response to carotid artery injury. Moreover, fibrinogen-adherent ADAP−/− platelets in shear flow ex vivo showed reduced spreading and smaller zones of contact with the matrix. These abnormalities were not observed under static conditions, and they could not be rescued by stimulating platelets with a PAR4 receptor agonist or by direct αIIbβ3 activation with MnCl2, consistent with a defect in outside-in αIIbβ3 signaling. ADAP+/+ platelets subjected to shear flow assembled F-actin–rich structures that colocalized with SLP-76 and the Rac1 exchange factor, phospho-Vav1. In contrast, platelets deficient in ADAP, but not those deficient in VASP or SKAP-HOM, failed to form these structures. These results establish that ADAP is an essential component of αIIbβ3-mediated platelet mechanotransduction that promotes F-actin assembly and enables platelet spreading and thrombus stabilization under fluid shear stress.
Identification of iGb3 and iGb4 in melanoma B16F10-Nex2 cells and the iNKT cell-mediated antitumor effect of dendritic cells primed with iGb3
Authors: Dias Bianca R , Rodrigues Elaine G , Nimrichter Leonardo , Nakayasu Ernesto S , Almeida Igor C , Travassos Luiz R
Published: December 2009

Background

CD1d-restricted iNKT cells are protective against murine melanoma B16F10-Nex2 growing subcutaneously in syngeneic C57Bl/6 mice as inferred from the fast tumor development in CD1d-KO in comparison with wild type animals. CD1d glycoproteins are related to the class I MHC molecules, and are involved in the presentation, particularly by dentritic cells (DC), of lipid antigens to iNKT cells. In the present work we attempted to identify the endogenous lipid mediator expressed in melanoma cells inducing such immunesurveillance response and study the possibility of protecting animals challenged with tumor cells with lipid-primed DC.

Results

Crude cytosolic and membrane fractions fromin vivogrowing melanoma contained iNKT-stimulating substances. Lipids were then extracted from these cells and one of the fractions (i.e. F3A) was shown to prime bone marrow-derived dendritic cells (BMDC) to stimulate iNKT murine hybridoma (DN32D3) cells to produce IL-2. The active fraction was analyzed by electrospray ionization-mass spectrometry (ESI-LIT-MS) and both iGb3 and iGb4 were identified along with GM3. When iGb3 was incubated with BMDC and tested with DN32D3 cells, IL-2 was equally produced indicating iNKT cell activation. GM3 consistently inhibited this response. To assess the antitumor response-induced by iGb3, a cytotoxicity assayin vitrowas used with [3H]-thymidine labeled B16F10-Nex2 cells. At target/effector (iGb3-activated iNKT) cell ratio of 100-1-100-4tumor cell lysis was shown. The antitumor activityin vivowas tested in mice challenged i.v. with B16F10-Nex2 cells and treated with iGb3- or α-galactosylceramide-primed DCs. A 4-fold lower tumor load in the lungs was observed with either treatment.

Conclusion

Our results show the expression of globo and isoglobohexosylceramides in murine melanoma B16F10-Nex2. The expression of iGb3 and its precursor, iGb4, on tumor cells may prime an effective iNKT cell-dependent antitumor response, modulated negatively by GM3 which is also produced in these cells. iGb3-primed BMDC exerted a significant iNKT cell-mediated anti-tumor activity in mice challenged with melanoma cells.
A rapid and efficient method for studies of virus interaction at the host cell surface using enteroviruses and real-time PCR
Authors: Jonsson Nina , Gullberg Maria , Israelsson Stina , Lindberg A Michael
Published: December 2009

Background

Measuring virus attachment to host cells is of great importance when trying to identify novel receptors. The presence of a usable receptor is a major determinant of viral host range and cell tropism. Furthermore, identification of appropriate receptors is central for the understanding of viral pathogenesis and gives possibilities to develop antiviral drugs. Attachment is presently measured using radiolabeled and subsequently gradient purified viruses. Traditional methods are expensive and time-consuming and not all viruses are stable during a purification procedure; hence there is room for improvement. Real-time PCR (RT-PCR) has become the standard method to detect and quantify virus infections, including enteroviruses, in clinical samples. For instance, primers directed to the highly conserved 5' untranslated region (5'UTR) of the enterovirus genome enable detection of a wide spectrum of enteroviruses. Here, we evaluate the capacity of the RT-PCR technology to study enterovirus host cell interactions at the cell surface and compare this novel implementation with an established assay using radiolabeled viruses.

Results

Both purified and crude viral extracts of CVB5 generated comparable results in attachment studies when analyzed with RT-PCR. In addition, receptor binding studies regarding viruses with coxsackie- and adenovirus receptor (CAR) and/or decay accelerating factor (DAF) affinity, further demonstrated the possibility to use RT-PCR to measure virus attachment to host cells. Furthermore, the RT-PCR technology and crude viral extracts was used to study attachment with low multiplicity of infection (0.05 × 10-4TCID50/cell) and low cell numbers (250), which implies the range of potential implementations of the presented technique.

Conclusion

We have implemented the well-established RT-PCR technique to measure viral attachment to host cells with high accuracy and reproducibility, at low cost and with less effort than traditional methods. Furthermore, replacing traditional methods with RT-PCR offers the opportunity to use crude virus containing extracts to investigate attachment, which could be considered as a step towards viral attachment studies in a more natural state.
Increased hepatic oxidative metabolism distinguishes the action of Peroxisome proliferator-activated receptor δ from Peroxisome proliferator-activated receptor γ in the ob/obmouse
Authors: Roberts Lee D , Hassall David G , Winegar Deborah A , Haselden John N , Nicholls Andrew W , Griffin Julian L
Published: December 2009

Background

The peroxisome proliferator-activated receptors (PPARs) are ligand-activated transcription factors and members of the nuclear receptor superfamily. The PPAR family consists of three members: PPARα, PPARγ, and PPARδ. PPARδ controls the transcription of genes involved in multiple physiological pathways, including cellular differentiation, lipid metabolism and energy homeostasis. The receptor is expressed almost ubiquitously, with high expression in liver and skeletal muscle. Although the physiological ligands of PPARδ remain undefined, a number of high affinity synthetic ligands have been developed for the receptor as a therapeutic target for type 2 diabetes mellitus, dyslipidemia and the metabolic syndrome.

Methods

In this study, the metabolic role of PPARδ activation has been investigated in liver, skeletal muscle, blood serum and white adipose tissue from ob/ob mice using a high affinity synthetic ligand and contrasted with PPARγ activation. To maximize the analytical coverage of the metabolome, 1H-nuclear magnetic resonance (1H-NMR) spectroscopy, gas chromatography-mass spectrometry (GC-MS) and ultra performance liquid chromatography-mass spectrometry (UPLC-MS) were used to examine metabolites from tissue extracts.

Results

Analysis by multivariate statistics demonstrated that PPARδ activation profoundly affected glycolysis, gluconeogenesis, the TCA cycle and linoleic acid and α-linolenic acid essential fatty acid pathways.

Conclusions

Although activation of both PPARδ and PPARγ lead to increased insulin sensitivity and glucose tolerance, PPARδ activation was functionally distinct from PPARγ activation, and was characterized by increased hepatic and peripheral fatty acid oxidative metabolism, demonstrating the distinctive catabolic role of this receptor compared with PPARγ.
Constrained deformable layer tomostatics
Authors: Zhou Hua-wei , Li Peiming , Yan Zhihui , Liu Hui
Published: December 2009

Although first-arrival tomography provides an effective way to estimate near-surface velocities and static corrections, the undulation of velocity interfaces such as the base of the weathered zone may not be easily determined by this method. The main reason is that first arrivals are insensitive to small geometric changes in velocity interfaces because their raypaths tend to traverse along those interfaces. To improve the solution of interface geometry, we developed a deformable layer tomostatics method that approximates the near-surface velocity field as several layers of constant velocity and variable thickness that can be inverted for the geometry of the velocity interfaces. We use a multiscale model parameterization in the inversion for interface geometry. Synthetic and field data tests showed that the method can determine the interface geometry. Constraining the depth range of the basal boundary of the weathered zone increases the convergence rate of the iterative inversion process. Tests on field data showed greater reflection coherency in a stacked section based on constrained static corrections than in one from unconstrained static corrections. The method yielded a better match with statics computed from sand-dune curves than does a match obtained by using two commercial grid tomography packages.
First-arrival traveltime tomography based on the adjoint-state method
Authors: Taillandier Cédric , Noble Mark , Chauris Hervé , Calandra Henri
Published: December 2009

Classical algorithms used for traveltime tomography are not necessarily well suited for handling very large seismic data sets or for taking advantage of current supercomputers. The classical approach of first-arrival traveltime tomography was revisited with the proposal of a simple gradient-based approach that avoids ray tracing and estimation of the Fréchet derivative matrix. The key point becomes the derivation of the gradient of the misfit function obtained by the adjoint-state technique. The adjoint-state method is very attractive from a numerical point of view because the associated cost is equivalent to the solution of the forward-modeling problem, whatever the size of the input data and the number of unknown velocity parameters. An application on a 2D synthetic data set demonstrated the ability of the algorithm to image near-surface velocities with strong vertical and lateral variations and revealed the potential of the method.
Male Breast Cancer: A Population-Based Comparison With Female Breast Cancer
Authors: Anderson William F. , Jatoi Ismail , Tse Julia , Rosenberg Philip S.
Published: December 2009

Purpose

Because of its rarity, male breast cancer is often compared with female breast cancer.

Patients and Methods

To compare and contrast male and female breast cancers, we obtained case and population data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program for breast cancers diagnosed from 1973 through 2005. Standard descriptive epidemiology was supplemented with age-period-cohort models and breast cancer survival analyses.

Results

Of all breast cancers, men with breast cancer make up less than 1%. Male compared with female breast cancers occurred later in life with higher stage, lower grade, and more estrogen receptor–positive tumors. Recent breast cancer incidence and mortality rates declined over time for men and women, but these trends were greater for women than for men. Comparing patients diagnosed from 1996 through 2005 versus 1976 through 1985, and adjusting for age, stage, and grade, cause-specific hazard rates for breast cancer death declined by 28% among men (P = .03) and by 42% among women (P ≈ 0).

Conclusion

There were three intriguing results. Age-specific incidence patterns showed that the biology of male breast cancer resembled that of late-onset female breast cancer. Similar breast cancer incidence trends among men and women suggested that there are common breast cancer risk factors that affect both sexes, especially estrogen receptor–positive breast cancer. Finally, breast cancer mortality and survival rates have improved significantly over time for both male and female breast cancer, but progress for men has lagged behind that for women.
Measurement of benzodiazepines in urine by liquid chromatography-tandem mass spectrometry: confirmation of samples screened by immunoassay
Authors: Glover Sarah J , Allen Keith R
Published: December 2009

Background

Liquid chromatography linked to tandem mass spectrometry (LC/MS/MS) provides the ability to identify a range of benzodiazepines in accordance with European Union criteria and is an attractive method for the confirmation of benzodiazepines following immunoassay screening.

Methods

An LC/MS/MS method to detect and quantitate the six most common benzodiazepines/metabolites (diazepam, nitrazepam, nordiazepam, oxazepam, temazepam and 7-aminonitrazepam) was developed together with a qualitative screening method for a further 11 benzodiazepines/metabolites. These methods were used for confirmation of 250 urine samples submitted for routine drug screening by immunoassay for benzodiazepines (100 samples positive for a benzodiazepine, assay cut-off >200 μsg/L).

Results

The lower limits of detection and quantitation were less than 2.5 and 5 μg/L for the six most common benzodiazepines. Recoveries ranged between 97% and 102% and calibration curves were linear to at least 4000 μg/L ( r = 0.99). Intra and inter-assay imprecision were <10% ( n = 10) and <20% ( n = 15), respectively. Confirmation of benzodiazepines using LC/MS/MS was achieved for 89% of the immunoassay-positive urine samples. Of the immunoassay-negative urine samples, 31% of these demonstrated a benzodiazepine using LC/MS/MS.

Conclusion

The validated LC/MS/MS method developed is effective for the confirmation of immunoassay screening results for benzodiazepines. The lower limit of detection and assay specificity offers a longer window of detection and more detailed clinical information compared with immunoassay screening.
Quantitative Caveats of Standard Immunohistochemical Procedures: Implications for Optical Disector–based Designs
Authors: Melvin Neal R. , Sutherland Robert J.
Published: December 2009

Immunohistochemistry is a ubiquitous technique in histology. Often, the goal of such studies is the quantification of some parameter associated with a particular antigen. When used correctly, the optical disector offers a statistically relevant approach to achieve this goal without bias from cell size, shape, or orientation. This three-dimensional counting probe is virtually embedded within the depth of the tissue section, thus avoiding sampling near the cut surfaces of the section, where cells are often lost during the cutting and subsequent processing steps. It follows that the probability that a cell could be immunolabeled should be equal throughout the section depth to correctly employ the optical disector. In this report, we demonstrate that parameters commonly used in immunohistochemistry often leave the middle of the section unlabeled. Furthermore, the degree of incomplete penetration varies among antibodies but can be overcome in some cases by extending the incubation time of the secondary antibody. The detection of this phenomenon in immunofluorescence preparations and the implications of these findings for quantitative stereology using the optical disector are discussed.
Dynamic Effects among Movie Ratings, Movie Revenues, and Viewer Satisfaction
Authors: Moon Sangkil , Bergey Paul K. , Iacobucci Dawn
Published: December 2009

This research investigates how movie ratings from professional critics, amateur communities, and viewers themselves influence key movie performance measures (i.e., movie revenues and new movie ratings). Using movie-level data, the authors find that high early movie revenues enhance subsequent movie ratings. They also find that high advertising spending on movies supported by high ratings maximizes the movie's revenues. Furthermore, they empirically show that sequel movies tend to reap more revenues but receive lower ratings than originals. Using individual viewer–level data, this research highlights how viewers’ own viewing and rating histories and movie communities’ collective opinions explain viewer satisfaction. The authors find that various aspects of these ratings explain viewers’ new movie ratings as a measure of viewer satisfaction, after controlling for movie characteristics. Furthermore, they find that viewers’ movie experiences can cause them to become more critical in ratings over time. Finally, they find a U-shaped relationship between viewers’ genre preferences and genre-specific movie ratings for heavy viewers.
The Psychological Effects of Empowerment Strategies on Consumers’ Product Demand
Authors: Fuchs Christoph , Prandelli Emanuela , Schreier Martin
Published: December 2009

Companies have recently begun to use the Internet to integrate their customers more actively into various phases of the new product development process. One such strategy involves empowering customers to cooperate in selecting the product concepts to be marketed by the firm. In such scenarios, it is no longer the company but rather its customers who decide democratically which products should be produced. This article discusses the first set of empirical studies that highlight the important psychological consequences of this power shift. The results indicate that customers who are empowered to select the products to be marketed show stronger demand for the underlying products even though they are of identical quality in objective terms (and their subjective product evaluations are similar). This seemingly irrational finding can be observed because consumers develop a stronger feeling of psychological ownership of the products selected. The studies also identify two boundary conditions for this “empowerment–product demand” effect: It diminishes (1) if the outcome of the joint decision-making process does not reflect consumers’ preferences and (2) if consumers do not believe that they have the relevant competence to make sound decisions.
The Information Value Applying to the Newsboy Model with the Cutoff Transaction Size
Authors: Tsai Hui-Yin , Lin Chin-Tsai
Published: December 2009

In this investigation, we adopt the perspective of a retailer and incorporate information flow between a retailer and customers. Meanwhile, the retailer can gain for the complete information about the state of customers’ demand from the exporter and pay them in order to make correct decisions and obtain more profits. Hence, precise expressions are derived for the expected total profit with incomplete and complete information of demand to measure the value of information. Moreover, we determine an optimal order-up-to level S and a cutoff transaction size q systematically. Finally, the numerical example is given to illustrate the result derived.
In Situ Thermal Conductivity Measurements of Building Materials with a Thermal Probe
Authors: Pilkington B. , Goodhew S. , deWilde P.
Published: December 2009

Transient line source measurements have been employed in various industries, e.g., plastics, foodstuffs, and refractory bricks, to measure thermal conductivity and sometimes thermal diffusivity. Measurements have traditionally been carried out in carefully controlled thermal environments. In pursuance of better data to inform energy efficiency calculations for building envelopes, a transient line source using thermal probe technology is assessed for in situ measurements, where materials may be subject to varied moisture content under diverse environmental conditions. A robust stand alone field apparatus has been developed. Laboratory based measurements have been undertaken, and results are reported for agar immobilized water and polytetrafluoroethylene, as well as aerated concrete and oak at specific moisture contents. The field apparatus was used to measure in situ the thermal properties of walls in real buildings, one of aerated concrete and one of mass earth construction. A new and simplified method of identifying appropriate analysis time windows has been developed, which allows an assessment of confidence levels in thermal conductivity results. Thermal diffusivity results were discounted as the effects of contact resistance between the probe and sample could not be differentiated from the heat capacity effects of the sample material. Valid thermal conductivity results were achieved for reference materials containing moisture and in situ measurements. The in situ thermal conductivity values were shown to be at significant variance with design values. Consistent thermal conductivity results were achieved for common building materials above 0.15 W⋅m −1⋅K−1, and indicative results were achieved for values below this despite measurements being taken under varying environmental conditions. The principal cause of error in the measurement of materials with higher thermal resistance was identified.
Adolescent Medicine Training in Pediatric Residency Programs
Authors: Fox Harriette B. , McManus Margaret A. , Klein Jonathan D. , Diaz Angela , Elster Arthur B. , Felice Marianne E. , Kaplan David W. , Wibbelsman Charles J. , Wilson Jane E.
Published: December 2009

OBJECTIVES: The aim of this study was to provide an assessment of pediatric residency training in adolescent medicine.

METHODS: We conducted 2 national surveys: 1 of pediatric residency program directors and the other of faculty who are responsible for the adolescent medicine block rotation for pediatric residents to elicit descriptive and qualitative information concerning the nature of residents' ambulatory care training experience in adolescent medicine and the workforce issues that affect the experience.

RESULTS: Required adolescent medicine topics that are well covered pertain to normal development, interviewing, and sexual issues. Those least well covered concern the effects of violence, motor vehicle safety, sports medicine, and chronic illness. Shortages of adolescent medicine specialists, addictions counselors, psychiatrists, and other health professionals who are knowledgeable about adolescents frequently limit pediatric residency training in adolescent medicine. Considerable variation exists in the timing of the mandatory adolescent medicine block rotation, the clinic sites used for ambulatory care training, and the range of services offered at the predominant training sites. In addition, residents' continuity clinic experience often does not include adolescent patients; thus, pediatric residents do not have opportunities to establish ongoing therapeutic relationships with adolescents over time. Both program and rotation directors had similar opinions about adolescent medicine training.

CONCLUSIONS: Significant variation and gaps exist in adolescent medicine ambulatory care training in pediatric residency programs throughout the United States. For addressing the shortcomings in many programs, the quality of the block rotation should be improved and efforts should be made to teach adolescent medicine in continuity, general pediatric, and specialty clinics. In addition, renewed attention should be given to articulating the core competencies needed to care for adolescents.
News Coverage of FDA Warnings on Pediatric Antidepressant Use and Suicidality
Authors: Barry Colleen L. , Busch Susan H.
Published: December 2009

OBJECTIVE: In 2004, after an 18-month investigation, the Food and Drug Administration (FDA) directed pharmaceutical manufacturers to add a black box warning to antidepressants regarding increased risk of suicidality in children. Our objective was to evaluate the quality and content of and overall impression conveyed in news coverage of this issue.

METHODS: We collected all news stories on pediatric antidepressant use and suicidality published in a convenience sample of 10 of the highest-circulation print newspapers in the United States, the 3 major television networks, and a major cable news network in 2003 and 2004 (N = 167). Two researchers coded news articles by using a 9-item instrument.

RESULTS: The quality of news reporting on key health messages included in FDA warnings was mixed. The overwhelming majority of news stories correctly described a risk of suicidality associated with pediatric antidepressant use, as opposed to suicide itself. However, other key health messages highlighted in FDA warnings often were absent from news coverage. News stories were more likely to include anecdotes of children harmed versus children helped by antidepressants, whereas expert sources quoted were more likely to emphasize the benefits of antidepressants over their risks. However, the majority of news stories conveyed neither the overall impression that the risks of pediatric antidepressant use outweighed the benefits nor the impression that the benefits outweighed the risks, and coverage became increasingly neutral over time.

CONCLUSIONS: Inclusion of key health messages in FDA safety warnings was not sufficient to ensure their communication to the public through the lay press.
Design Analysis for the Marlim Field Deepwater Calm System
Authors: Hwang Yuh-Lin , Bensimon Luiz Fernando Callado
Published: December 2009

This paper presents the analysis for the design of a deepwater Single Point Mooring (SPM) system in the Marlim Field, offshore Brazil. The mooring analysis was carried out for both storm and operational conditions using a dynamic analytical procedure. This procedure predicts the extreme mooring line tension and fatigue life, considering the effect of wave frequency and wave drift response, mooring line dynamics and the effects of coupled CALM buoy-hawser and tanker dynamics.

State-of-the-art computer analysis was extensively used throughout the design process to analyze the performance and behavior of the SPM system to insure an adequately sized mooring system. Model tests have been conducted to verify the computer analysis and the overall design of the SPM system. Results of the mooring analysis and model testing are compared.
Achievement goals and perfectionism of high school students
Authors: Milojevic Milica , Stojiljkovic Snezana , Todorovic Jelisaveta , Kasic Kristina
Published: December 2009

This research has been investigating one of the most contemporary approaches of achievement motivation - Achievement Goal Theory, which uses the construct of achievement goals. The construct of achievement goals involves three types of achievement goals: mastery goals, performance approach goals and performance avoidance goals. The main goal of the research was to examine correlation between perfectionism and its aspects with particular types of achievement goals. Also, the goal was to investigate the difference concerning gender regarding the achievement goals. The sample consisted of 200 senior year high school participants. The following instruments were used: Multi-dimensional scale of perfectionism (MSP) and Test of achievement goals (TCP). The research results indicate that there is significant positive correlation between: perfectionism with performance approach goals and performance avoidance goals, concern over mistakes and parental expectations with performance approach goals and performance avoidance goals, personal standards and organization with mastery goals and performance approach goals, parental criticism and doubts about action with performance avoidance goals. Significant negative correlation was found between parental criticism and mastery goals. The results concerning the second goal indicates the female subjects have higher average scores in mastery goals.
Insurance and Assurance: Teachers' Strategies in the Regimes of Risk and Audit
Authors: Lindqvist Per , Nordänger Ulla Karin , Landahl Joakim
Published: December 2009

This article deals with how the increasing use of notions such as ‘risk awareness' and ‘blame’ in relation to school affects the daily work of Swedish teachers. With the help of empirical excerpts from documents and focus group interviews, the authors provide examples of how the introduction of the risk society and audit cultures encourages the creation of new strategies for coping. Two of these concern the mediation of ‘safe school’ images and preventions in order to avoid future blame. The authors depict them as strategies of assurance and insurance. The increasing handling of these strategies seems to draw attention away from relations to students and actual time spent on teaching. When considering an action, teachers seem to balance the risk of attracting blame against the didactic potential. Finally, the possibility of practices which reflect more positive risk logic is discussed.
Interlocked Twins. A Report of Two Cases
Authors: Stenström Bengt
Published: December 2009

At the Clinic of Obstetrics, University Hospital, Uppsala, where the annual number of deliveries approaches 3,000, only one case of interlocked twins has occurred. Since this complication is extremely rare, the case will be described below, together with another similar case from the hospital in Borås, Sweden.
Cytogenetic Investigations in Male Infertility
Authors: Philip John , Skakkebæk Niels E. , Hammen Rich. , Johnsen Svend G. , Rebbe Heinrich
Published: December 2009

Abstract. Sex‐chromatin and chromosomal investigations were carried out on 98 men, who were examined because of infertility. They all had severely impaired or totally absent fertility as evaluated by seminal analyses. Six were sex‐chromatin positive and had a 47, XXY chromosome complement. Furthermore one had a 47, XYY complement. This patient as well as the other 91 were chromatin‐negative. In another selection of hypogonadal men, both sex‐chromatin positive and sex‐chromatin negative patients with abnormal chromosome complements were found. It is therefore concluded that chromosomal abnormalities are important aetiological factors in male infertility. Chromosome analysis as well as sex‐chromatin analysis is thus necessary in the investigation of male infertility.
Oral Contraceptives and Glucose Tolerance
Authors: Pehrson Sigvard L.
Published: December 2009

Abstract. Three oral contraceptives with different oestrogen‐progestogen combinations were given to 22 women of fertile age. The possible diabetogenic effect was studied after intravenous glucose tolerance test before the treatment was started and after 1, 6 and 12 months of cyclical therapy. All of the women had a normal menstrual cycle before treatment began. They showed none of the features which suggest prediabetes. The k‐ and the T ½ values were calculated. The intra‐individual variation of k between two tolerance tests was calculated on the basis of figures available in the literature. When the k‐value did not rise linearly, attempts were made to calculate the variation within different k‐value ranges. The possible diabetogenic effect of the three different drugs was studied in the light of these calculations. In the cases tested, Drug no. 1, which contained nor‐ethisterone acetate (4 mg) – ethinyloestradiol (0.05 mg) (Anovlar), and Drug no. 2, which contained megestrol acetate (4 mg) – ethinyloestradiol (0.05 mg) (Volidan) did not seem to have any diabetogenic effect. On the other hand, Drug no. 3, which contained ethynodiol acetate (1 mg) – mestranol (0.1 mg) (Ovulen), appears to have had a transient diabetogenic effect. It was slightly evident after one month of treatment, statistically significant after 6 months and practically negligible after 1 year of treatment. Further experiments with specific hormones are indicated. Women in the danger zone, i.e. women who have latent diabetes or are in a prediabetic stage should be included in these investigations.
Estimation of Fetal Maturity by Amniotic Fluid Cytology
Authors: Rosborg J. , Kristensen E. Bjørn , Trautner H.
Published: December 2009

Abstract. Eighty‐three specimens of liquor amnii from the 30th to the 42nd gestational week were examined cytologically by the Nile Blue sulphate method, and the results were compared with earlier investigations. From the 37th week a large increase in the percentage of orange cells was found, expressing fetal maturity. However, it seems that the large number of specimens with a low content of orange cells late in pregnancy makes the method less suitable as a routine method. On the other hand it may be useful in the evaluation of possible placental insufficiency.
Investigation of Urinary Protein and Lactate Dehydrogenase in Normal Pregnancy and in Pre‐Eclampsia by Means of Disc Electrophoresis
Authors: Hemmingsen L. , Skaarup P.
Published: December 2009

Dialysed, unconcentrated 24 h specimens of urine from 24 normal, non‐pregnant women, 28 normal pregnant women and 12 women with pre‐eclampsia were examined using disc electrophoresis. The normal pregnant group showed minor variations from the non‐pregnant group. In particular a significantly raised transfer‐rinuria was noticed. The pre‐eclamptic group showed albuminuria and transferrinuria which was significantly greater than in the normal pregnant group, and the transferrin excretion was found to be 26 times as great as in the normal non‐pregnant group. U‐LDH was inconstant, but the LDH isoenzyme pattern showed a low LDH‐I and/or raised LDH‐III, IV and V activity. The raised albumin excretion is explained by increased albumin synthesis in pre‐eclampsia. It is suggested that similar conditions hold true for the excretion of transferrin. The characteristic shift of the LDH isoenzymes is considered to be due to renal ischaemia.
Experiences with Paracervical Block: A Double‐blind Study with Bupivacaine (Marcaine®)
Authors: Westholm Hans , Magno Ricardo , Å‐Sonberg Anders
Published: December 2009

The authors have studied paracervical blocks with bupivacaine, physiological saline and bupivacaine with adrenalin 1: 200 000 by means of a double‐blind technique.

The analgesic effect was good in nearly 80% of the cases with active substance and in about 20% of the cases with physiological saline. The duration of analgesia was shorter when physiological saline was used. No important difference in duration of analgesia was found between bupivacaine and bupivacaine‐adrenalin. Adrenalin did not seem to improve the effect when added to bupivacaine.

The dilatation of the cervix was no more rapid when active substance was used than with physiological saline. Bupivacaineadrenalin seemed to be associated with more uterine inertia than bupivacaine and physiological saline. Foetal bradycardia was found in 4%. 2 of the 8 cases of foetal bradycardia were after blocks with physiological saline. All these 8 foetuses were born with Apgar scores of 10. In the whole study there were no Apgar scores below 8.

A few maternal complications of short duration were recorded, all when bupivacaine‐adrenalm was used. The authors have the impression that paracervical block is not entirely free fnom risks. Foetal complications may be expected.

One case of foetal death, possibly connected with paracervical block using bupivacaine‐adrenalin is described.
Cervical Cerclage in the Treatment of Incompetent Cervix: A Retrospective Analysis of the Indications and Results of 164 Operations
Authors: Seppälä M. , Vara P.
Published: December 2009

Between 1959 and 1968 a cervical cerclage operation was performed 163 times in 159 women because of assumed cervical incompetence. The operation was carried out during pregnancy 156 times, and 3 times in a nonpregnant patient. 4 women had two operations during the same pregnancy. The operations represent 1 in 404 deliveries at the hospital during the study period. The diagnosis of cervical incompetence was based on the history of previous pregnancies in 99 cases (79%). The finding of a short and open cervix was made 85 times (68%), and the diagnosis was supported by the hystero‐graphic findings in 11 cases (9%). The average duration of gestation at the time of operation was 14 weeks, and the average total duration of the pregnancies was 35 weeks. The previous foetal salvage rate was 30.8%, and the final success rate 83.2%. The comparable rates for normal deliveries without cervical cerclage at the same clinic were 74.7% and 97.1%, respectively. The abortion rate in the series after treatment was 13.6%. Premature deliveries with loss of the child occurred 4 times, leading to a perinatal mortality rate of 3.2%. Breech presentation was found 10 times (6.3%). Caesarean section was undertaken 23 times (18%) in 21 patients. The ratio of the final success rate and the previous foetal salvage rate (foetal salvage ratio) in the whole series was 2.7, and in the randomly selected cases 1.3. This ratio was the highest (3.8) between 26 and 30 years, and when the operation was performed between the 16th and the 19th weeks of pregnancy (3.3). The minimum benefit rate of the operation was 30% [80.2–30.8 – (97.1–74.7)]%. This rate is little affected by unnecessary operations, while difference between the foetal salvage ratios in the operation and the control materials is greatly affected by them. This difference was 1.4 (2.7–1.3) in this material. The differences in abortion rates, laws and standards of obstetric care lead to differences in the materials. Therefore the following criteria are suggested to be included in the reports concerning cervical cerclage operations:

Number of operations per number of deliveries in the study period

Final success rate of the series

Previous foetal salvage rate

Foetal salvage ratio (the ratio of no. 2 and no. 3)

Final success rate and previous foetal salvage rate among the mothers without a cervical suture in the same hospital at the same study period

Foetal salvage ratio from no. 5

Difference between foetal salvage ratios in the operation and the control groups

Minimum benefit rate in the operation material
Cancerous and Precancerous States of the Cervix Uteri: A Histological and Histochemical Study
Authors: Stenbäck F. , Ojala A. , Vehaskari A.
Published: December 2009

In the present study, a hundred unselected biopsy specimens from the cervix uteri were examined for the presence of 13 chemical substances and 27 specimens for that of 9 enzymes, in an effort to obtain some information on the histochemistry of dysplasia, carcinoma in situ and squamous cell carcinoma of the cervix, on the relationship between precancerous and cancerous lesions of the cervix, and on the usefulness of histochemical studies in clinical practice. A definite correlation was found between the histochemical changes, viz. decrease in the amount of glycogen and increase in the amount of ribonucleic acid and lactate dehydrogenase activity, and increasing malignancy. The histochemical changes reflected a disturbance in cell differentiation and keratinization, and in stromal reaction. It was concluded that histochemical methods are of value as supplementary tools in differentiating histologically doubtful lesions and in determining future treatment of the patient.
Some Ophthalmological Observations in Toxaemic and Normal Late Pregnancy
Authors: Krause Ulf , Pystynen Paavo
Published: December 2009

Abstract. Various ocular fundus findings recorded by means of ophthalmoscopy and fluorescein angiography of the fundus towards the end of pregnancy in 11 healthy pregnant women and 13 patients with toxaemia of varying degree were analysed. Ten healthy non‐pregnant women formed the control group. The results showed that: (1) The healthy pregnant women showed both normal ocular fundi and changes which must be considered definitely pathological. (2) The toxaemic patients showed both pathological ocular fundus changes and perfectly normal findings. (3) On angiography, the healthy non‐pregnant women revealed a wide variation in the arterial caliber of the ocular fundus, expressed in terms of the artery/vein (A/V) ratio. (4) Variations of roughly the same degree in the A/V ratio occurred in the healthy and toxaemic pregnant women. (5) The A/V ratio was not correlated with the clinical status.
Ultrastructure of a Granulosa Cell Tumour
Authors: Pedersen Poul Hjortkjær , Larsen Jørgen Falck
Published: December 2009

Abstract. The fine structure of a hormonal active granulosa cell tumour is described. The greater part of the tumour consisted of a cell type resembling the granulosa cell of the normal follicle. It contained many Golgi elements but was poor in smooth and rough endoplasmic reticulum. Another type of cell was found in the proximity of strands of connective tissue. The second type had large amounts of smooth endoplasmic reticulum and lipid droplets. This type is probably the thecal element and its ultrastructure indicates that it represents the endocrine active part of the tumour.
Menstrual Bleeding with Intrauterine Contraceptive Devices
Authors: Guttorm Eigil
Published: December 2009

Ninety women with an intrauterine device (IUD) in place measured their menstrual flow a maximum of 16 months after the insertion.

The average loss was 88.0 ml. Those who had subjective menorrhagia after the insertion (group II) had heavier bleeding than those without (group I), 116.7 ml as compared with 78.7 ml.

Menorrhagia (blood loss exceeding 80 ml) occurred in 42.6% of group I and in 63.6% of group II. The rate for the entire series was 47.7% (Table III).

36% had subjective menorrhagia although the blood loss was less than 80 ml, the upper limit of normal bleeding. On the average, these patients lost 53.1 ml (Table III).

The Hb level fell after the insertion of the IUD from 13.5 g/100 ml to 12.8 g/100 ml. The decrease was more marked in group II, and in 11% the level dropped by more than 1.5 g/100 ml.

The incidence of anaemia (Hb below 12.0 g/100 ml) increased from 3% to 16% after the insertion of the device. For groups I and II the increase in the rate was from 2% to 10% and from 9% to 32% respectively. All considered, a 4–5‐fold increase occurred (Table V).

The Hb level as well as the menstrual blood loss were the same whether they were measured within 2 months or 2–16 months after the insertion.

The distribution of the bleeding on the individual days of the period changed. 20 women measured the loss without and 90 with the IUD.

In the group without IUD 73% of the total loss occurred during the first 2 days of the period and 90% during the first 3 days. In the women with IUD the distribution was 44% and 74%, the 90% not being reached until after the 4th day (Tables VI and VII).

Twenty women measured the menstrual loss both before and after the insertion of the device. In all the menstrual flow became heavier, increasing by an average of from 35.5 to 73.1 ml (106%). The increase was most marked in women whose menstrual flow had been scanty before the insertion of the device (Table VIII). The mean values of the menstrual bleeding measured during the 1st, 2nd, 3rd, and 4th period after the insertion were practically the same, from 65.8 to 82.2 ml, but always significantly greater than prior to the insertion. There was no tendency for the menstruation to return to a normal level (Table IX).

The increase in the use of absorptive material during the menstrual periods was not in step with the bleeding, being only 28% despite an increase of 106% in the blood loss, and 25% of the women had an unchanged or even decreased consumption of absorptive material after the insertion of the IUD.
The Effect of Antibiotic Therapy on Mycoplasma in the Female Genital Tract: In vitro and in vivo Studies on the Sensitivity of Mycoplasma hominis and T‐Mycoplasmas to Tetracyclines and other Antibiotics
Authors: Weström Lars , Mårdh Per‐Anders
Published: December 2009

The susceptibility of M. hominis and T‐mycoplasmas to different antibiotics in vitro has been studied. A clinical assessment of metacycline, lincomycin and chloramphenicol in genital infections in the female, with special reference to M. hominis and T‐mycoplasmas is also presented. After treatment with metacycline or lincomycin, M. hominis was rarely isolated and in the majority of cases such therapy was followed by a disappearance of symptoms and signs of infection and a rapid re‐establishment of a vaginal flora dominated by Döderlein's bacillus. In patients who had received chloramphenicol, cultures yielded in most cases growth of M. hominis, and signs of infection persisted after treatment. The effect of treatment with metacycline, lincomycin or chloramphenicol on M. hominis correlated well with the susceptibility of this organism found in vitro. Cultures for T‐mycoplasmas showed that these organisms could be recovered in about the same frequency before and after therapy.
Carcinoma of the Ovary and Endometriosis
Authors: Aure J. Chr. , Høeg K. , Kolstad P.
Published: December 2009

The occurrence of ovarian endometriosis has been studied in 990 cases of primary epithelial carcinoma of the ovary. In 357 serous and 155 undifferentiated lesions no example of endometriosis was found and only one example in 203 mucinous tumours. In the 205 cases of endometrioid carcinoma the incidence of endometriosis was 9.3%. In the 36 cases of clear cell carcinoma and the 23 cases of mesonephroid carcinoma with tubular pattern the incidence was significantly higher, 19.4% and 25.9% respectively. The incidence in endometrioid tumours was significantly higher in those cases in clinical stage I b as compared with other stages. Possible histogenetic relationships between endometriosis and ovarian carcinoma are discussed. Follow‐up study of these patients clearly showed that it is of the utmost importance to attempt complete removal of all tumour tissue at the primary operation. Preoperative irradiation using super‐voltage technique is advocated.