Maternal nutritional restriction during late gestation impairs development of the reproductive organs in both male and female lambs

Maternal nutritional restrictions during late gestation could lead to fetal hypoglycemia. Glucose levels in the fetal sheep regulate circulating insulin-like growth factor 1 (IGF1) levels, which stimulate cell proliferation and differentiation of reproductive organs after binding to its own receptor or estrogen receptors. The objective of this study was to determine the effects of subnutrition of ewes during the last trimester of gestation on the serum glucose/IGF1 levels and development of reproductive organs in their lambs. Pregnant ewes carrying singletons were randomly assigned to restricted (R ewes, n = 8) or control (C ewes, n = 8) groups (4 lambs of each gender/group) and fed with 50% or 100% of metabolic energy requirements from ∼100 days of gestation to term (∼147 days), respectively. Blood samples from lambs were taken on the first day after born and once at week for serum glucose and IGF1 determination. Lambs were euthanatized at 2 months of age, reproductive organs were weighted and tissue samples were collected from them for histology and to measure mRNA expression of IGF1 and its receptor (IGF1R) by qRT-PCR. Pre-partum glucose levels in R ewes were significantly lower compared to C ewes (p < .05). Compared to lambs born from C ewes, lambs born from R ewes showed lower serum levels of glucose and IGF1 during the first week of age (p < .05). At 2 month of age, these lambs had significant lower uterine and testicular weight and lower ovarian, uterine and testicular mRNA expressions of IGF1 and its receptor (p < .05). Histological findings showed that diameter of secondary and tertiary follicles in ovaries and number of endometrial glands in uterus of females, or number of Sertoli cells and seminiferous tubules and diameter, perimeter and tubular area in testicles of males were significantly lower in lambs born from R ewes compared to the respective organs of lambs born from the C ewes (p < .05). In conclusion, these results demonstrate that maternal subnutrition during late gestation affects IGF1 levels during fetal life and impairs reproductive development in the neonatal lamb, which could have permanent negative consequences in the future reproductive performance of the offspring.

[Posterior knee instability]

Due to improved diagnostic methods, posterior knee instabilities are detected more often. Up to now, however, the natural history of isolated ruptures of the posterior cruciate ligament is not known exactly. After conservative treatment, the first degenerative changes occur after about 10-15 years, mainly in the femoropatellar joint and the medial compartment. In complex posterior instabilities with lesions of the secondary stabilizers, the posterolateral structures, the lateral collateral ligament, and the leg alignment play an important role. Conservative or operative treatment of posterior knee instabilities depends on the extent of the lesion, the violated structures, and the impairment of the patient. For replacement of the posterior cruciate ligament, grafts from the patella ligament, the quadriceps tendon, and the hamstrings are used most frequently. In simultaneous lesions of the posterolateral corner of the knee joint, additional ligament-stabilizing methods are necessary.

Cultural adaptations of Alcoholics Anonymous to serve Hispanic populations

Hispanic A.A. groups in Los Angeles operate with two different models, one involving "terapia dura" (rough therapy) and the other employing less confrontive methods. "Terapia dura" adapts expressions of the machismo value complex to produce social alternatives for young male immigrants from Central America. In the less confrontational version, machismo is muted. Hispanic A.A. groups make little provision for the problems of women, and gays are stigmatized. Members' economic status, ethnicity, and level of acculturation condition the style and content of meetings and strategies for group survival.

Families of schizophrenics: a movement in jeopardy

The family self-help movement in schizophrenia is in danger of losing its effectiveness, the authors believe. Many in the movement seem overly concerned with being accepted by professionals and others, which means that they become less single-minded in their advocacy for their relatives and for their own needs. Family groups are having difficulty maintaining their separate and unique identity and are including others who tend to undermine their efforts. The family movement in schizophrenia would do well to follow the example of the parents of the developmentally disabled in their unswerving devotion to their cause, which appears to be the key to their success in achieving greatly increased services and funding.

Ambulatory care patient classification

Efficient, cost-effective use of resources is important in every aspect of health care. As ambulatory care continues to grow, it becomes an increasingly important area for managerial attention. Few tools which are specific to the outpatient environment have been developed. This paper has suggested an approach to developing a specific instrument to assist in controlling costs in the ambulatory unit: the ambulatory patient classification system.

Setting nursing hours standards. Part 1

Data were collected and prepared for entry to a computer. Analysis then was done to provide standard hours of care per patient classification level. Further options for use of this data and details on data analysis will be presented in Part 2 (February 1986 issue).

Short course prophylactic cranial irradiation for small cell lung cancer

Ninety-one patients with small cell carcinoma of the lung were given a shortened, intensive course of prophylactic cranial irradiation consisting of 2,000 rad in five fractions. The CNS relapse rate was 21%, but in only one of 91 patients was the brain the first and only site of relapse. Acute toxicities consisting of headache (16%) and nausea and vomiting (15%) were observed. Results are compared with previous results from other studies of cranial irradiation.

Effects of freezing on the corneal stroma of the rabbit after keratophakia

In three rabbits a keratophakia as described by Barraquer (1972) was performed on both eyes, in one rabbit it was performed on one eye. In the right eye no cryoprotective agent was used, in the left eye the cryoprotective agent KM 26 was applied. Twelve hours after the operation, the majority of keratocytes in the tissue lens were destroyed. The nuclear chromatin was clumped, the cell membrane was destroyed and cytoplasm showed vacuolar alteration; cell organelles were no longer recognizable. After 24 h hardly any keratocytes were found. All corneae operated on with and without a cryoprotective agent, showed the same morphology. The cell debris was removed by macrophages, which could be found earlier in corneae operated on without cryoprotection. Three weeks after keratophakia no increase in the number of the residual keratocytes had occurred.

Determination of valproic acid kinetics in patients during maintenance therapy using a tetradeuterated form of the drug

A method has been developed for measuring concentrations of valproic acid and, with stable isotopes, labelled forms of VPA, in the plasma of patients undergoing maintenance therapy. One tetradeutero isomer of valproic acid-di-(2,3-dideuteropropyl) acetic acid-has been synthesized for administration to patients. A [2H14]valproic acid-diheptadeuteropropyl acetic acid-was synthesized as the internal standard. After isolation from body fluids the acids were methylated with diazomethane. The McLafferty fragments of the methyl esters were used for mass spectrometric quantification. It was demonstrated that the [2H4]valproic acid used behaves kinetically like the unlabelled drug in the human body. One dose of [2H4]valproic acid was given as a pulse dose to epileptic patients and the elimination profile was measured during continuous normal treatment. The half-life of valproic acid in patients under barbiturate or carbamazepine co-medication was reduced to at least half the value found after single dose administration to healthy volunteers.

Kinetics and metabolism of carbamazepine during combined antiepileptic drug therapy

The kinetics of carbamazepine using 15N-carbamazepine were investigated in epileptic patients during combined anticonvulsant therapy. The 15N-carbamazepine plasma half-lives ranged from 5.0 to 13.6 hr with a mean of 8.2 hr. These half-lives are appreciably shorter than reported during chronic carbamazepine monotherapy. Predicted steady-state plasma levels and observed plasma levels of carbamazepine were in excellent agreement. Between 32% and 61% of the dose administered is excreted in the urine as carbamazepine-trans-diol, 5.2% to 8.8% as 9-hydroxymethyl-10-carbamoyl acridane, 1% to 1.4% as 10,-11-carbamazepine epoxide, and 0.5% as carbamazepine. The data indicate that it is the epoxide-diol pathway which is induced during long-term treatment. Concomitant therapy with primidone, phenytoin, phenobarbital, ethosuximide, or methsuximide further induces carbamazepine metabolism.