Induction of urinary tract infection by intraurethral inoculation with Escherichia coli: refining the murine model

Murine models are important for studying the induction and pathophysiology of ascending urinary tract infections (UTI). However, when vesicoureteral reflux occurs during intravesical inoculation of mice with bacterial suspensions, it is difficult to distinguish between naturally ascending infections and those resulting from the inoculation procedure. The current study investigated whether introducing a bacterial suspension into the urethra rather than into the bladder could minimize or eliminate this complication. There were no differences in the intensity or time course of bladder infections induced by intraurethral or intravesical inoculation. In contrast, the prevalence of kidney infections was < 7% in mice given 10 microliters of intraurethral inoculations versus nearly 60% in animals inoculated intravesically with 100 microliters. There were equivalent numbers of bacteria in the kidneys after inoculation by either route. Thus, intraurethral inoculation of female mice with a small volume of bacteria appears to simulate most closely the pathophysiology of ascending UTIs in humans.

Human sperm morphology evaluation pre- and post-Percoll gradient centrifugation

Previous experiments have established a relationship between the morphological characteristics of human spermatozoa and their fertilizing potential in vitro. To assess further the efficiency of Percoll gradient centrifugation (PGC) as a method of sperm selection, we have examined morphological characteristics of spermatozoa from 86 teratozoospermic patients attending Nottingham University Research and Treatment Unit in Reproduction (NURTURE). Patients were divided into groups according to percentage normal morphology in the fresh sample: group A (n = 14), < 5% normal morphology; group B (n = 41), 5-14% normal morphology; and group C (n = 31), > 14% normal morphology. Morphology slides were prepared using Diff Quik staining techniques and evaluated by Kruger strict criteria, under oil immersion, at a magnification of x1000; specific defects, viz. head, neck, cytoplasmic droplets, tail, immature cells, were assessed individually. Following PGC, a sperm sample with enhanced morphology was recovered for group B (P < 0.01) and C (P < 0.005); however, for group A (very severe teratozoospermia) PGC did not select a sample with significantly improved morphological quality. Specific sperm defects affected by PGC were head, neck and immature cells. No significant difference was found for tail abnormalities or cytoplasmic fragments.

Gender in medical encounters: an analysis of physician and patient communication in a primary care setting

The relation of physician and patient gender to verbal and nonverbal communication was examined in 100 routine medical visits. Female physicians conducted longer visits, made more positive statements, made more partnership statements, asked more questions, made more back-channel responses, and smiled and nodded more. Patients made more partnership statements and gave more medical information to female physicians. The combinations of female physician-female patient and female physician-male patient received special attention in planned contrasts. These combinations showed distinctive patterns of physician and patient behavior, especially in nonverbal communication. We discuss the relation of the results to gender differences in nonclinical settings, role strains in medical visits, and current trends in medical education.

Satisfaction, gender, and communication in medical visits

The authors conducted two studies of routine medical visits, investigating the relation of physician gender, patient gender, and physician age to patient satisfaction, and the correlations between communication behaviors and satisfaction separately for different combinations of patient and physician gender. Study 1 was based on videotaped visits to a hospital-based internal medicine practice (n = 97 visits). Study 2 was based on audiotaped visits to 11 different community and hospital-based practices in the United States and Canada (n = 524 visits). In both studies, patients examined by younger physicians, especially younger female physicians, reported lower ratings of satisfaction. These findings were true for male and female patients; however, in both studies, the lowest satisfaction in absolute terms was among male patients examined by younger female physicians. The effects were not explained by patient and physician background characteristics or by measured communication during the visit. Correlations between verbal and nonverbal communication and satisfaction for different combinations of physician and patient gender suggested that gender-related values and expectations influence patients' reactions to physicians' behavior. There also was evidence that patient satisfaction is reflected in the patient's affective behavior during the visit.

Dermatoglyphic asymmetry and sexual orientation in men

Dermal ridges on the fingertips are formed early in fetal life and remain unchanged throughout the life span. The researchers examined dermatoglyphic characteristics (total ridge count and directional ridge asymmetry) in homosexual and heterosexual men. There was no difference between the 2 groups of men in total ridge count, but more gay men demonstrated leftward asymmetry than did nongay men. Although this effect was not accounted for by differences in hand preference, an association was observed between leftward dermatoglyphic asymmetry and an increased incidence of adextrality in homosexual men, but not in heterosexual men. These findings are consistent with a biological contribution to sexual orientation and indicate that such an influence may occur early in prenatal life.

Gender in medical encounters: an analysis of physician and patient communication in a primary care setting

The relation of physician and patient gender to verbal and nonverbal communication was examined in 100 routine medical visits. Female physicians conducted longer visits, made more positive statements, made more partnership statements, asked more questions, made more back-channel responses, and smiled and nodded more. Patients made more partnership statements and gave more medical information to female physicians. The combinations of female physician-female patient and female physician-male patient received special attention in planned contrasts. These combinations showed distinctive patterns of physician and patient behavior, especially in nonverbal communication. We discuss the relation of the results to gender differences in nonclinical settings, role strains in medical visits, and current trends in medical education.

Consequences of retaliatory aggression against siblings and peers: urban minority children's expectations

Expectations about the outcomes of retaliation against siblings were compared to those about peers in a group of 10-14-year-old, mostly African-American or Hispanic youth. Boys believed that parents would disapprove more of retaliation against siblings than friends, while girls believed parents would equally disapprove of retaliation against either target. Participants of both genders expected that retaliation would deter additional aggressive actions of friends more than of siblings. Participants expected younger siblings, especially brothers, to feel worse than older siblings following retaliation, and girls expected to feel worse retaliating against younger siblings. Siblings close in age expect fewer negative consequences of retaliation. Children's expectations seem to promote more aggression toward friends than siblings and to promote aggression toward siblings closer in age. No ethnic differences emerged in expectations about conflict. The findings are discussed in relation to research on expectations as a mediator of behavior.

Influence of the corpus luteum of pregnancy on ovarian function in postpartum ewes

This study was conducted to determine the effects of the corpus luteum (CL) of pregnancy and(or) the previously gravid uterine horn (g-UH) on the incidence and site of ovulation and the duration of luteal function in postpartum (PP) ewes. Ewes were laparotomized at d 60 to 80 of gestation and assigned to one of four groups: 1) single g-UH, CL left intact (SI, n = 35); 2) single g-UH, CL removed (SR, n = 30); 3) twin g-UH, CL on both ovaries left intact (TI, n = 21); and 4) twin g-UH, CL removed from one ovary (TR, n = 32). On d 20 PP, the number of follicles on each ovary was determined at laparoscopy, and ewes received (i.m.) 750 IU of hCG. Ovarian structures were determined at laparoscopy on d 24 PP. Blood samples were collected daily from d 20 to 40 PP and assayed for progesterone. more follicles (P < .05) were observed at laparoscopy on d 20 PP in SI/TI than in SR/TR groups (8.4 vs 6.0, respectively; SE = .4). Overall, 52% of the ewes had visible CL 4 d after hCG, and 73% of the ewes had elevated levels of progesterone by 7 d after hCG. The number of g-UH (S vs T) or status of the CL (I vs R) did not affect these responses. For SR ewes with hCG-induced CL on a single ovary, the incidence of CL formation on the ovary adjacent to g-UH was less (P < .05) than that for SI ewes (0 vs 57, respectively). Removal of the CL from S ewes, but not from T ewes, reduced follicular development and ovulation in response to hCG. Perhaps there is a positive systemic effect of the CL of pregnancy on postpartum ovarian function in ewes.

Gastric myoelectric and motor activity in dogs with gastric dilatation-volvulus

Electrical and contractile properties of the stomach were assessed in six adult dogs after recovery from surgical treatment for gastric dilatation-volvulus (GDV), a disorder characterized by delayed gastric emptying of the solid phase. Electrodes and strain-gauge force transducers were sutured to the serosa of the antrum and pylorus at the time of surgical intervention for GDV. Ten days after implantation, electrical and mechanical activities were recorded before and after a standardized meal. The analog FM tape recordings of the electrical and mechanical signals were converted to digital time series for analysis by computer. Recordings from dogs after GDV showed increased slow wave propagation velocity in both the fasting and the fed states compared with controls. In addition, the GDV dogs had atypical fasting state phase III activity fronts. We found no difference in gastric slow wave frequency, dysrhythmia, or electromechanical coupling between the two groups. These results indicate that delayed gastric emptying in this syndrome is associated with increased gastric slow wave propagation velocity.

Physicians' liking for their patients: more evidence for the role of affect in medical care

Correlates of physicians' liking for their patients were examined among 17 internists at a health maintenance organization and 530 of their patients 70 years of age and older. Analyses were conducted for the entire sample as well as for individual physicians, whose results were combined by meta-analysis. Both kinds of analysis showed that patients were more liked when they were in better health (based on psychometric measures of social, emotional, functional, and overall self-rated health) and when they were more satisfied with their care. In addition, male patients were liked more than female patients, and physicians who were female and less experienced liked their patients more.

Influence of ovarian steroids on relaxin-induced distensibility and compositional changes in the porcine cervix

A study was conducted to examine the influence of ovarian steroids on relaxin-induced changes in distensibility and composition of the uterine cervix in gilts. Ovariectomized, prepubertal gilts received (i.m.) either 1) 0.5 ml corn oil (CO) for 16 days; 2) 0.5 ml CO for 16 days and estradiol benzoate (EB; 200 micrograms) twice daily on Days 13-14; 3) EB on Days 0-1 followed by CO on Days 3-16 (EB + CO); 4) EB on Days 0-1 followed by CO on Day 2 and twice daily injections of 100 mg progesterone (P) on Days 3-16 (EB + P); or 5) EB on Days 0-1 followed by CO on Day 2 and P on Days 3-16 with additional EB treatment on Days 13-14 (EB + P + EB). One half of each group also received (i.m.) 0.5 ml 0.1 M PBS or 0.5 mg relaxin (RLX) every 6 h for 54 h coinciding with the final 2 days of the experimental period. Administration of RLX increased (p < 0.05) cervical distensibility compared to PBS treatment, with the response being greater (p < 0.05) in EB-, EB + CO-, and EB + P + EB-treated gilts compared to CO- or EB + P-treated gilts. Water content of cervical tissue was greater (p < 0.05) in EB-, EB+P- and EB + P + EB-treated gilts compared to CO- or EB + CO-treated gilt: and in all treatments, RLX enhanced (p < 0.05) imbibition of water by cervical tissues compared to that in PBS-treated gilts.(ABSTRACT TRUNCATED AT 250 WORDS)

Mammographic abnormalities and the detection of carcinoma of the breast

OBJECTIVE

In an attempt to reduce the number of unnecessary breast biopsies, the yield rate of cancer relative to specific types of mammographically detected abnormality was investigated.

STUDY DESIGN

Between 1989 and 1991, 169 patients with an abnormality as detected by mammogram but with no palpable mass were reviewed. Abnormalities detected by mammogram were divided into four types. The rate of biopsy-confirmed cancer per type of abnormality was calculated.

RESULTS

The incidence of cancer per type of mammographically detected abnormality was as follows: mass 11%, mass with abnormal calcification 21%, abnormal calcification 22%, and asymmetric density 2%.

CONCLUSION

Biopsy is recommended for mammographically detected abnormalities of a mass, a mass with abnormal calcification, and abnormal calcification without mass. Consideration should be given to deferring biopsy in favor of a follow-up study for asymmetric densities.

Beta adrenoreceptor subtype cross regulation in the human heart

OBJECTIVES

To find out in a prospective study whether beta 1 blocker treatment causes selective beta 2 adrenoreceptor sensitisation, and to find whether such sensitisation is confined to the heart.

DESIGN

A placebo controlled cross over study of two weeks of selective beta 1 blocker treatment with 10 mg of bisoprolol daily.

SUBJECTS

Six healthy volunteers.

OUTCOME MEASURES

Three days after stopping the 10 mg of bisoprolol or placebo, subjects underwent treadmill exercise (to measure cardiac beta 1 receptor responsiveness) and were given salbutamol injections (to measure cardiac beta 2 receptor responsiveness). Secondary end points were the responses of serum potassium, glucose, and insulin to beta 2 stimulation.

RESULTS

There was no difference in exercise induced increases in heart rate, but after treatment with bisoprolol the dose of salbutamol required to increase heart rate by 40 beats/min was 1.9 micrograms/kg compared with 2.9 micrograms/kg after placebo (p < 0.005). The fall in diastolic blood pressure was not significantly different on the two occasions. Hypokalaemia induced by salbutamol, but not hyperglycaemia or hyperinsulinaemia, was enhanced after bisoprolol.

CONCLUSION

This study shows that treatment with a beta 1 blocker in vivo leads to sensitisation of cardiac beta 2 adrenoreceptors but not cardiac beta 1 adrenoreceptors or vascular beta 2 receptors. This previously unrecognised form of receptor cross sensitisation in the heart may noticeably diminish the efficacy of selective beta 1 blockade in preventing arrhythmias in patients with ischaemic heart disease. These findings reopen the question of which type of beta blocker is more appropriate for such patients.

Factors contributing to the formation of experimentally-induced ovarian cysts in prepubertal gilts

Manipulation of an ovary during the follicular phase in cycling gilts or prepubertal gilts treated with PMSG and hCG results in formation of cysts on manipulated ovaries and corpora lutea (CL) of normal appearance on nonmanipulated ovaries. In contrast, cysts did not form after manipulation in luteal phase gilts. In the present experiment, daily administration of 50 mg progesterone to prepubertal gilts treated with PMSG and hCG established luteal phase concentrations of progesterone but did not lessen the incidence of manipulated-induced cysts. Number of cysts formed was associated with the number of follicles > or = 5 mm at manipulation, which was inversely related to serum concentrations of progesterone. Number of receptors for LH/hCG in follicular tissues did not differ between manipulated and nonmanipulated ovaries but was greater in granulosa (P < .05) and theca (P < .08) from follicles with diameters > or = 7 mm compared to 5 and 6 mm. Contents of estradiol, androstenedione, testosterone, progesterone and prostaglandins E2 and F2 alpha in follicular fluid, granulosa and theca were not different between follicles > or = 5 mm destined to form cysts. Profiles of progesterone and estradiol in peripheral serum and duration of luteal phase concentrations of progesterone were not different for gilts with induced cysts and gilts with CL. In conclusion, manipulation of follicles resulted in a failure to ovulate. Subsequent formation of cysts did not result from or result in a loss of steroidogenic function or the ability to bind LH to follicular receptors. These results demonstrate that the mechanism for ovulation is independent of other follicular processes, since ovulation can be disrupted without altering follicular steriodogenesis or subsequent luteinization.

Adolescent substance use during pregnancy

Substance use during pregnancy may be a key mediator of the association between adolescent childbearing and poor newborn outcome. Substance use during pregnancy was evaluated for 50 teens who were consecutive patients at an inner-city university clinic. Although teens reported typical lifetime rates of substance use, self-reports and two urine assays indicated minimal substance use throughout pregnancy. Findings suggest that the adolescents exercised judicious decision making in light of the known health risks of substance use during pregnancy.

Physicians' liking for their patients: more evidence for the role of affect in medical care

Correlates of physicians' liking for their patients were examined among 17 internists at a health maintenance organization and 530 of their patients 70 years of age and older. Analyses were conducted for the entire sample as well as for individual physicians, whose results were combined by meta-analysis. Both kinds of analysis showed that patients were more liked when they were in better health (based on psychometric measures of social, emotional, functional, and overall self-rated health) and when they were more satisfied with their care. In addition, male patients were liked more than female patients, and physicians who were female and less experienced liked their patients more.

Acidic fibroblast growth factor gene 5' non-coding exon and flanking region from hamster DDT1 cells: identification of the promoter region and transcriptional regulation by testosterone and aFGF protein

Selected clones of Syrian hamster DDT1-MF2 cells are responsive to testosterone for growth. Heparin binding growth factor 1 (HBGF-1) or acidic fibroblast growth factor (aFGF) can replace testosterone (T) in the stimulation of growth in these cells. This phenomena is correlated with testosterone's ability to elevate aFGF mRNA two- to threefold in DDT1 cells. To better understand the possible mechanisms of regulation of aFGF mRNA by steroids and other growth factors, we isolated the aFGF 5' non-coding exon and its flanking region from a EMBL3 DDT1 genomic library, using a 5' non-coding exon 69 bp DDT1 aFGF cDNA probe. Clones spanning 30 kb of genomic DNA were isolated. After restriction mapping and DNA sequence analysis, the clones were shown to contain all of the 5' non-coding exon included in the cDNA and approximately 10 kb of 5' flanking region. RNase protection and primer extension assays confirmed that the 5' non-coding exon is included in the DDT1 aFGF mRNA and that a major transcription start site is approximately 136 bp upstream of the 5' non-coding splice junction of this exon. The 5' flanking region DNA was inserted into pBLCAT3 reporter gene and transfected into DDT1 cells. Chloramphenicol acetyltransferase (CAT) assays demonstrated that there are promoter elements in the -1645/-392 and -392/+131 regions of the aFGF gene in the context of DDT1 cells. NIH 3T3 cells, on the other hand, show no CAT activity with these aFGF-CAT plasmids. CAT assays also demonstrated that addition of testosterone (T) or aFGF to DDT1 cells increased CAT activity threefold. This activity was mapped to -1645 to -4 bp region of this DDT1 aFGF gene promoter.

A causal model of health status and satisfaction with medical care

Patients with better health status have often been shown to be more satisfied with their medical care, but the causal factors in this relation have not been determined. In this study, a longitudinal assessment of these two constructs was undertaken in which older patients in a health maintenance organization were interviewed at baseline (N = 590) and again 1 year later (N = 526) about their health status and satisfaction with their medical care. Structural equation modeling using LISREL procedures revealed that the predominant direction of causation went from earlier self-perceived overall health and functional ability to later levels of satisfaction. There was no evidence for causal paths going from satisfaction to later health. In addition, a test of spuriousness indicated that for self-perceived overall health, the significant longitudinal path was unlikely to be explained by unmeasured confounding variables.

The family relations, peer relations, and criminal activities of Caucasian and Hispanic-American gang members

Juvenile gang members present serious problems to society, yet few empirical studies have examined their criminal activity, family relations, and peer relations in comparison with other highly antisocial youths. In a 2 (Gang Membership) x 2 (Ethnicity: Hispanic-American vs. Caucasian) design, 131 incarcerated male juvenile offenders were administered a battery assessing criminal activity, family relations, and peer relations. Results demonstrated (a) higher rates of criminal behavior (i.e., general delinquency, index offenses, school delinquency) among gang members than among offenders who did not belong to gangs, (b) higher rates of general delinquency and home delinquency among Caucasian offenders than among Hispanic-American offenders, and (c) greater aggression and less social maturity in the peer relations of gang members than in the peer relations of offenders who did not belong to gangs. In addition, gang membership mediated sociocultural differences in hard drug use. Findings are integrated with the extant literature.

Gastric emptying of nondigestible radiopaque markers after circumcostal gastropexy in clinically normal dogs and dogs with gastric dilatation-volvulus

Using radiopaque particles mixed with food, gastric emptying was assessed in healthy dogs not subjected to surgery, in healthy dogs 9 to 35 days after circumcostal gastropexy, and, in dogs 1 to 54 months after surgical treatment and recovery from gastric dilatation-volvulus (GDV). Circumcostal gastropexy surgery did not alter the 90% gastric emptying time for radiopaque particles in healthy dogs. However, 90% gastric emptying time was significantly (P less than 0.05) increased after circumcostal gastropexy in dogs with GDV, compared with healthy dogs after the same surgical procedure and recovery period. These results imply that dogs with GDV have delayed gastric emptying of solid particles. Whether delayed gastric emptying of markers detected in affected dogs after surgical treatment and recovery was the result or the cause of GDV was not determined. Results indicate that circumcostal gastropexy could be recommended as a prophylactic procedure for GDV in large breeds with deep thorax, because delayed gastric emptying of markers secondary to the surgical procedure is unlikely.

Influence of ovarian steroids on relaxin-induced uterine growth in ovariectomized gilts

This study examined the influence of ovarian steroids on the uterotropic actions of relaxin (RLX) in ovariectomized prepubertal gilts. Ovariectomized gilts received (im) corn oil (CO), estradiol benzoate (EB), or EB and progesterone (P) for 0-16 days. Steroid administration was patterned to approximate the plasma concentrations of endogenous ovarian steroids observed during 1) the follicular phase (EB), 2) luteal phase (EB+P), and 3) early pregnancy (EB+P+EB). Half of each group also received PBS or 0.5 mg RLX every 6 h for 54 h, coinciding with the final 2 days of the experimental period. After hysterectomy, uterine tissues were analyzed for water, dry matter, protein, DNA, glycosaminoglycans (GAGs), and collagen contents. Administration of EB or P increased uterine weight 5- to 6-fold, but no differences were observed between EB+P- and EB+P+EB-treated gilts. Cotreatment with RLX enhanced steroid-induced uterine growth 40-70%, and RLX stimulated growth in CO- and EB+CO control gilts 2- to 3-fold. The water content of uterine tissues was greater in EB-, EB+P-, and EB+P+EB-treated gilts than in their respective controls, and this response was augmented by RLX in all treatment groups. Administration of steroids stimulated a 4- to 5-fold increase in uterine dry weight compared to that in controls, with responses not differing between EB+P- and EB+P+EB-treated gilts. In all groups, RLX increased uterine dry weight. Protein and DNA contents of uterine tissue increased with steroid treatment, but neither variable differed between EB+P- and EB+P+EB-treated gilts. Administration of RLX, alone or in combination with steroids, increased protein and DNA contents of uterine tissues. The tissue content of GAGs increased in response to steroids, and coadministration of RLX did not alter this response. Although the uterine tissue concentration of collagen was reduced in steroid- and RLX-treated gilts, the collagen content of the uterus was not affected by the various treatments. The results of this study indicate that RLX is a potent stimulator of uterine growth under a variety of steroidal environments. RLX- or steroid-induced uterine growth was manifest by increased water, dry matter, protein, and DNA and GAG contents, but the uterine content of collagen was not affected. The overall growth-promoting effects of EB and the stimulation of DNA accretion by RLX were not observed when gilts were cotreated with P.(ABSTRACT TRUNCATED AT 400 WORDS)

Steroid regulation of the synthesis and secretion of retinol-binding protein by the uterus of the pig

The endometrium of the pig secretes retinol-binding protein (RBP) under the influence of progesterone (P4). The objective of this study was to determine how conceptus-derived estrogen might modulate this production of RBP around days 11-13 of pregnancy when conceptuses elongate from spheres to long thread-like forms. Concentrations of retinol and RBP were low (35 +/- 7 ng/ml) in uterine flushings obtained on days 10-12 of the estrous cycle or from pregnant gilts in which conceptuses had not elongated. Concentrations of retinol and RBP increased 7- to 8-fold (P less than 0.01) in flushings where filamentous conceptuses were present. Size exclusion and ion exchange chromatography demonstrated that virtually all retinol assayed in uterine flushings was associated with RBP. Northern blot analysis with a cDNA representing uterine RBP revealed a single endometrial mRNA 1.1 kilobases in length. Expression of RBP mRNA in uterine endometrium was measured in ovariectomized prepubertal gilts after the administration of steroids according to the following regimens: I, corn oil (days 0-16; n = 10); II, estradiol benzoate (EB; days 13-14; n = 11); III, EB (days 1-2; n = 12); IV, EB (days 1-2) plus P4 (days 3-16; n = 12); and V, EB (days 1-2) plus P4 (days 3-16) plus EB (days 13-14; n = 12). EB (200 micrograms) and P4 (100 mg) were administered twice daily. Treatment IV was designed to stimulate the estrous cycle, and treatment V simulated early pregnancy. All gilts were hysterectomized on day 16, and total uterine mRNA (3 micrograms) was analyzed by Northern blotting. No RBP mRNA was detected in groups I, II, or III. In group IV, 5 of 12 gilts had detectable RBP mRNA, as measured by densitometric scanning (OD = 0.35 +/- 0.14). RNA isolated from all gilts in group V (12 of 12) gave a strong hybridization signal (OD = 1.58 +/- 0.22) for RBP. Finally, RBP mRNA was examined in the uterine endometrium of mature gilts on day 13 of the estrous cycle (n = 4), day 13 of pseudopregnancy (2.5 mg EB given on days 11-12; n = 4), or day 13 of pregnancy after conceptuses had elongated (n = 4). RBP mRNA was present in all groups, but was enhanced approximately 12-fold (P less than 0.01) in pregnant and pseudopregnant gilts compared to that in control gilts.(ABSTRACT TRUNCATED AT 400 WORDS)